Abstract
BackgroundGram-negative bacteria are frequently involved in nosocomial infections. These bacteria have a particular tendency to develop antibiotic resistance and may become extensively drug-resistant (XDR). This study aimed to detect the prevalence of XDR Gram-negative bacteria in a tertiary care hospital in Pakistan.Materials and methodsClinical samples were obtained from patients admitted to different inpatient wards and sent for microbial analysis and culture. Antibiotic susceptibility testing of isolates was performed by the disk diffusion method to detect XDR strains.ResultsAntibiotic susceptibility patterns of a total of 673 clinical samples were studied. Of all bacterial isolates, 64% were extensively drug-resistant. Klebsiella pneumoniae had the highest percentage of XDR isolates (68.4%), followed by Pseudomonas aeruginosa (67.6%) and Escherichia coli (56.1%). Most XDR pathogens were isolated from the burn unit (87.7%), followed by the intensive care unit (69.2%) and surgical unit (68.9%).ConclusionsThe rate of extensive drug-resistance is alarmingly high, which calls for strict surveillance and control measures to prevent the development of further resistance. Proper sanitation and rational prescription of antibiotics should be ensured.
Highlights
Gram-negative bacteria and its subgroup Enterobacteriaceae constitute the normal intestinal flora in most human beings
Most XDR pathogens were isolated from the burn unit (87.7%), followed by the intensive care unit (69.2%) and surgical unit (68.9%)
Research has identified various mechanisms by which Gram-negative bacteria develop resistance. These include extended-spectrum βlactamases (ESBLs), carbapenemases, and other antimicrobial resistance genes (ARGs) that are circulated among bacteria via horizontal gene transfer or acquired through mobile genetic elements such as plasmids, integrons, and transposons [2]
Summary
Gram-negative bacteria and its subgroup Enterobacteriaceae constitute the normal intestinal flora in most human beings. These bacteria are mainly involved in nosocomial infections and have a particular propensity to develop antibiotic drug resistance [1]. The Center for Disease Control & Prevention (CDC) and the European Center for Disease Control (ECDC) have developed standardized definitions of all these entities, which are universally accepted [3] According to these definitions, XDR bacteria are resistant to all but two or fewer antimicrobial categories. Gram-negative bacteria are frequently involved in nosocomial infections These bacteria have a particular tendency to develop antibiotic resistance and may become extensively drug-resistant (XDR).
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