SENSITIVITY PATTERNS OF PSEUDOMONAS AERUGINOSA ISOLATES OBTAINED FROM CLINICAL SPECIMENS IN PESHAWAR
AbstractBackground: Pseudomonas aeruginosa (P. aeruginosa) is a highly virulent opportunistic pathogen and a leading cause of nosocomial infections.Affected patients are often hospitalized in an intensive care unit, and are immuno-compromised as a result of disease and treatment. Suspected P. aeruginosa require timely, adequate and empirical antibiotic therapy to ensure improved outcomes. The purpose of the study was to find the sensitivity and resistance pattern of P. aeruginosa to various groups of drugs, in clinical isolates collected from two major tertiary care hospitals of Peshawar. Methods: Different clinical isolate were taken from patients admitted in various wards of Khyber Teaching Hospital and Lady Reading Hospital Peshawar. Results: A total of 258 clinical isolates were positive for P. aeruginosa out of 2058 clinical isolates. Pseudomonas showed high degree of resistance to third generation Cephalosporins (Ceftazidime, and Ceftriaxone) and moderate degree of resistance to Quinolones and Aminoglycosides (Ofloxacin, Ciprofloxacin, Levofloxacin and Amikacin). Low resistance was observed to different combinations (Cefoperazone+Sulbactum, Piperacillin+Tazobactum). Meropenem and Imipenem had negligible resistance. Conclusion: There is growing resistance to different classes of antibiotics. Combination drugs are useful approach for empirical treatment in suspected Pseudomonas infection. Imipenem and Meropenem are extremely effective but should be in reserve.Keywords: Pseudomonas aeruginosa, Drug sensitivity, Resistance pattern
Gaynes R, Edwards JR, National Nosocomial Infections Surveillance System. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 2005;41:848–54.
Pier G, Ramphal R. Pseudomonas Aeruginosa. In: Mandell GL, BennettJE, Dolin R, eds. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier/Churchill Livingstone,2005:2587–615.
Walkty A, DeCorby M, Nichol K, Karlowsky JA, Hoban DJ Zhanel GG, et al. In vitro activity of ceftobiprole against clinical isolates of Pseudomonas Aeruginosa obtained from Canadian intensive care unit (ICU) patients as part of the CAN-ICU Study. J Antimicrob Chemother 2008;62(1):206–8.
Poole K. "Efflux-mediated multiresistance in Gram-negative bacteria". Clin Microbiol Infect 2004;10(1):12–26.
Ryan KJ, Ray CG (editors).2004. Sherris Medical Microbiology (4th ed.). McGraw Hill.ISBN 0-8385-8529-9.
Yakupogullari Y, Poirel L, Bernabeu S, Kizirgil A, Nordmann P. Multidrug-resistant Pseudomonas Aeruginosa isolate co-expressing extended-spectrum-lactamase PER-1 and metallo-beta-lactamase VIM-2 from Turkey. J Antimicrob Chemother2008;61(1):221–2.
Kirikae T, Mizuguchi Y, Arakawa Y. Investigation of isolation rates of Pseudomonas Aeruginosa with and without multidrug resistance in medical facilities and clinical laboratories in Japan. J Antimicrob Chemother 2008;61(3):612–5
Hirsch EB, Tam VH. Impact of Multidrug-resistant Pseudomonas Aeruginosa Infection on Patient Outcomes. Expert Rev Pharmacoecon Outcomes Res 2010;10(4):441–51.
Agnihotri N, Gupta V, Joshi RM. Aerobic bacterial isolates from burn wound infections and their antibiograms—a five-year study. Burns 2004;30(3):241–3.
Singh NP, Goyal R, Manchanda V, Das S, Kaur I, Talwar V. Changing trends in bacteriology of burns in the burns unit,Delhi, India. Burns 2003;29(2):129–32.
Nicolau DP. Carbapenems: a potent class of antibiotics. Expert Opin Pharmacother 2008;9(1):23–37
Saha SK, Muazzam N, Begum SA, Chowdhry A, Islam MS, Perveen R. Study on Time-related Changes in Aerobic Bacterial Pattern of Burn Wound Infection. Faridpur Med Coll J 2011;6(1):41–5.
Khan JA, Iqbal Z, Rahman SU, Farzana K, Khan A. Report:prevalence and resistance pattern of Pseudomonas Aeruginosaagainst various antibiotics. Pak J Pharm Sci 2008;21(3):311–5.
Jones RN, Stilwell MG, Rhomberg PR, Sader HS. Antipseudomonal activity of piperacillin/tazobactam: more than a decade of experience from the SENTRY Antimicrobial Surveillance Program (1997-2007). Diagn Microbiol Infect Dis 2009;65(3):331–4.
Tsuji M, Takema M, Miwa H, Shimada J, Kuwahara S. In vivo antibacterial activity of S-3578, a new broad-spectrum cephalosporin: methicillin-resistant Staphylococcus aureus and Pseudomonas Aeruginosa experimental infection models. Antimicrob Agents Chemother 2003;47(8):2507–12.
Khorasani G, Salehifar E, Eslami G. Profile of microorganisms and antimicrobial resistance at a tertiary care referral burn centre in Iran: emergence of Citrobacter freundii as a common microorganism. Burns 2008;34(7):947–52.
Ranjan KP, Ranjan N, Bansal SK, Arora DR. Prevalence of Pseudomonas Aeruginosa in Post-operative Wound Infection in a Referral Hospital in Haryana, India. J Lab Physicians 2010;2(2):74–7.
Poole K. Aminoglycoside resistance in Pseudomonas Aeruginosa. Antimicrob Agents Chemother 2005;49(2):479–87.
Imran M, Faheem M, Aslam V, Hakeem A, Rehman IU, Shah A. Wound infections and culture sensitivity pattern in pediatric burn patients. J Post Med Inst 2009;23(4):304–8
Cavallo JD, Hocquet D, Plesiat P, Fabre R, Roussel-Delvallez M. Susceptibility of Pseudomonas Aeruginosa to antimicrobials: a 2004 French multicentre hospital study. J Antimicrob Chemother 2007;59(5):1021–4.
Fedler KA, Biedenbach DJ, Jones RN. Assessment of pathogen frequency and resistance patterns among pediatric patient isolates: report from the 2004 SENTRY Antimicrobial Surveillance Program on 3 continents. Diagn Microbiol Infect Dis 2006;56(4):427–36.
Viren A. Javiya, Somsuvra B. Ghatak, Kamlesh R. Patel and Jagruti A. Antibiotic susceptibility patterns of Pseudomonas Aeruginosa at a tertiary care hospital in Gujarat, India. Indian J Pharmacol 2008;40(5):230–4.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.