Burn Patients Infected With Metallo-Beta-Lactamase-Producing Pseudomonas aeruginosa: Multidrug-Resistant Strains.

Mojtaba Anvarinejad,Pejman Abbasi,Jalal Mardaneh,Maneli Amin Shahidi,Mohammad Ali Dehyadegari,Ebrahim Alipour,Noroddin Rafaatpour,Aziz Japoni

doi:10.5812/atr.18182

Mojtaba Anvarinejad, Pejman Abbasi + Show 6 more

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https://doi.org/10.5812/atr.18182

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Abstract

Background:Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians.Objectives:The aim of this study was to detect MBL-producing P. aeruginosa in burn patients and determine multidrug-resistant (MDR) strains, and respective resistance patterns.Patients and Methods:In this cross-sectional study, 270 strains of P. aeruginosa were isolated from the burn patients referred to Ghotbeddin Burn Hospital, Shiraz, Iran. Among them, 55 MBL-producing P. aeruginosa strains were isolated from 55 patients hospitalized in burn unit. Minimum inhibitory concentrations (MICs) and MBLs were determined by the E-test method.Results:Of the 55 burn cases, 29 (53%) were females and 26 (47%) males. Injured burn patients’ ages ranged from 16 to 87 years, with maximum number of cases in the age group of 16 to 36 years (n, 40; 72.7%). Overall, 32 cases were accidental (60%), and 22 were suicidal burns (40%). Of the 55 burn patients, 17 cases were expired (30%). All deaths were due to chemical exposures. In antibiotic susceptibility testing by E-test method, ceftazidime was the most effective one and 35 isolates (63.5%) were resistant to all the 11 tested antibiotics.Conclusions:Routine microbiological surveillance and careful in vitro testing of antibiotics prior to prescription and strict adherence to hospital antibiotic policy may help to prevent, treat, and control MDR and pandrug-resistant (PDR) P. aeruginosa strains in burn units.

Highlights

Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians
MBL-producing P. aeruginosa strains have been identified from clinical isolates worldwide with increasing frequency over the past several years, and these isolates are responsible for protracted nosocomial infections in different countries [22]
When administering empirical treatment in burn patients with nosocomial infections with P. aeruginosa, MBL should be considered in case the patients are not responsive to carbapenem therapy

Summary

Introduction

Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians. 55 MBL-producing P. aeruginosa strains were isolated from 55 patients hospitalized in burn unit. Conclusions: Routine microbiological surveillance and careful in vitro testing of antibiotics prior to prescription and strict adherence to hospital antibiotic policy may help to prevent, treat, and control MDR and pandrug -resistant (PDR) P. aeruginosa strains in burn units. Pseudomonas aeruginosa is an obligate aerobic, motile, rod-shaped, Gram-negative bacterium, which is able to grow and survive in almost any environment and is resistant to temperature extremes [1]. It is an opportunistic pathogen causing severe acute and chronic nosocomial infections, especially in immunocompromised hosts and patients with serious underlying medical conditions [2, 3]. Burn hospitals often harbor multidrug resistant P. aeruginosa (MDRPA) isolates that can serve as the source of infection for other patients hospitalized in burn ward [12]

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