Incidence of Multidrug Resistant Pseudomonas Aeruginosa Isolated From Burn Patients Tertiary Care Hospital, Jamnagar, Gujarat, India.

Abstract

Background: Pseudomonas aeruginosa is a ubiquitous micro-organism that can rapidly acquire resistance to different broad-spectrum antibiotics. Multidrug resistant (MDR) Pseudomonas aeruginosa is an emerging cause of mortality and morbidity in burn patients, which causes 4-60% nosocomial infections in different parts of the world. 1 Objectives:  To isolate Pseudomonas aeruginosa from pus samples of burns patients.  To assess the rates of antibiotic resistance and multidrug resistance among Pseudomonas isolates. Material & Methods: This study was carried out in the Department of Microbiology, Shri M. P. Shah Government Medical College, Jamnagar, Gujarat from September 2014 to June 2015 from burns ward, Guru Govind singh Govt. Hospital Jamnagar. A total of 391 swab samples were tested. The Pseudomonas aeruginosa isolates were identified by their direct microscopy examination,colony morphologies, pigment , Gram’s staining patterns, oxidase test, catalase test, Oxidation fermentation test, Triple sugar iron agar test, Arginine dihydrolase and Sugar fermentation test. Antibiotic sensitivity was determined for Amikacin (30mcg), Netilmycin(30mcg),Gentamycin(10mcg),Ceftazidime(30mcg),Piperacillin(100mcg), Piperacillin + Tazobactum(100mcg/10mcg), Aztreonem (30mcg), Imipenem (10mcg), Meropenem (10mcg), Colistin (10mcg), Polymixin B(300units), Ciprofloxacin(5mcg). Results: Incidence of Pseudomonas aeruginosa from burns patients is 36.45%. Incidence of Multidrug Resistant (MDR) Pseudomonas aeruginosa is 36.48%. Antibiotic susceptibility tests showed high level resistance toGentamycin(93.24%), Ciprofloxacin(89.18%), Amikacin(85.13%), Aztreonem(83.78%), Ceftazidime(81.08%), Netilmicin(75.67%), Piperacillin(72.97%), Piperacillin+Tazobactum(56.76%), Imipenem(14.86%). Resistance to Colistin and Polymixin B were 0%. Conclusions: We conclude that Pseudomonas aeruginosa with high level resistance to Aminoglycosides, Fluoroquinolones & Penicillin group of drugs. Infection in burns continues to be a great problem which is not yet solved and posses a challenge to the microbiologist and the surgeon. Based on the result of the antibiotic susceptibility testing of the various isolates antibiotics are to be administered only on clinical suspicion of sepsis.