Pattern of Antibiotic Resistance in Pesudomonas Aeruginosa Isolated from Intensive Care Unit, Isfahan, Iran

Document Type : Original Article (s)

Authors

1 Assistant Professor, Infectious Diseases and Tropical Medicine Research Center AND Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 MSc Student, Department of Microbiology, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

4 PhD Student, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Pseudomonas aeroginosa (P. aeroginosa) is one of the most important causes of hospital infections, especially in the intensive care unit (ICU). Increasing antibiotic-resistance of P. aeroginosa cause a lot of problems for patients and in some cases, lead to septicemia and death. The most important antibiotics used in the treatment of P. aeruginosa infection are ceftazidime, ciprofloxacin, imipenem and piperacillin mainly used in hospitals. Unsuitable and prolonged use of antibiotics has led to the emergence of multidrug (MDR) and pandrug resistant (PDR) strains. In fact, infections with MDR and PDR strains often result in increased cost of treatment, lengthy stay, and overall morbidity and mortality. This study aimed to determine the pattern of drug resistance in P. aeruginosa infection in ICU of Al-Zahra hospital (Isfahan, Iran).Methods: 66 isolates of P. aeruginosa from different clinical specimens from ICU wards of Al-Zahra hospital were isolated. Antibacterial susceptibility test for imipenem, meropenem, amikacin, gentamicin, ciprofloxacin, levofloxacin, aztreonam, cefepime, piperacillin, piperacillin/tazobactam and ceftazidime was performed using disk diffusion (Kirby-Bauer) method.Findings: Of 66 separated isolates, 51 (77.2%) were of MDR and 33 (50%) were of PDR strain. 75.8% were resistant to ceftazidime and 72.7% to piperacillin. In fact, most of isolates were resistant to both antibiotics.Conclusion: This study shows that overuse and misuse of antibiotics in hospitals has increased drug resistance and creation of the PDR and MDR strains. The results suggest that antibiotic resistance can be determined by choosing the appropriate drug to treat patients.

Keywords

References

  1. Sadikot RT, Blackwell TS, Christman JW, Prince AS. Pathogen-host interactions in Pseudomonas aeruginosa pneumonia. Am J Respir Crit Care Med 2005; 171(11): 1209-23.
  2. Giske C. Carbapenem resistance in Pseudomonas aeruginosa [Thesis]. Stockholm, Sweden: Karolinska Universitetssjukhuset Solna; 2007.
  3. National Service Scotland, Health Protection Scotland. Transmission based precautions literature reviews pseudomonas aeruginosa [Online]. 2008. Available from: URL: http://www.documents.hps.scot.nhs.uk/hai/infection-control/transmission-based-precautions/ literature-reviews/mic-lr-rsv-2008-04.pdf.
  4. Dong F, Xu XW, Song WQ, Lu P, Yu SJ, Yang YH, et al. Characterization of multidrug-resistant and metallo-beta-lactamase-producing Pseudomonas aeruginosa isolates from a paediatric clinic in China. Chin Med J (Engl) 2008; 121(17): 1611-6.
  5. Lagatolla C, Edalucci E, Dolzani L, Riccio ML, De LF, Medessi E, et al. Molecular evolution of metallo-beta-lactamase-producing Pseudomonas aeruginosa in a nosocomial setting of high-level endemicity. J Clin Microbiol 2006; 44(7): 2348-53.
  6. Sevillano E, Valderrey C, Canduela MJ, Umaran A, Calvo F, Gallego L. Resistance to antibiotics in clinical isolates of Pseudomonas aeruginosa. Pathol Biol (Paris) 2006; 54(8-9): 493-7.
  7. Vettoretti L, Floret N, Hocquet D, Dehecq B, Plesiat P, Talon D, et al. Emergence of extensive-drug-resistant Pseudomonas aeruginosa in a French university hospital. Eur J Clin Microbiol Infect Dis 2009; 28(10): 1217-22.
  8. Lutz JK, Lee J. Prevalence and antimicrobial-resistance of Pseudomonas aeruginosa in swimming pools and hot tubs. Int J Environ Res Public Health 2011; 8(2): 554-64.
  9. Quan F, Liu G, Wang L, Wang X. Investigation of pulmonary infection pathogens in neurological intensive care unit. Ther Clin Risk Manag 2011; 7: 21-5.
  10. Tsukayama DT, van Loon HJ, Cartwright C, Chmielewski B, Fluit AC, van der Werken C, et al. The evolution of Pseudomonas aeruginosa during antibiotic rotation in a medical intensive care unit: the RADAR-trial. Int J Antimicrob Agents 2004; 24(4): 339-45.
  11. Carmeli Y, Troillet N, Eliopoulos GM, Samore MH. Emergence of antibiotic-resistant Pseudomonas aeruginosa: comparison of risks associated with different antipseudomonal agents. Antimicrob Agents Chemother 1999; 43(6): 1379-82.
  12. Du SJ, Kuo HC, Cheng CH, Fei ACY, Wei HW, Chang SK. Molecular mechanisms of ceftazidime resistance in Pseudomonas aeruginosa isolates from canine and human infections. Veterinarni Medicina 2010; 55: 172-82.
  13. Levasseur P, Girard AM, Claudon M, Goossens H, Black MT, Coleman K, et al. In vitro antibacterial activity of the ceftazidime-avibactam (NXL104) combination against Pseudomonas aeruginosa clinical isolates. Antimicrob Agents Chemother 2012; 56(3): 1606-8.
  14. Ozer B, Duran N, Onlen Y, Savas L. Efflux pump genes and antimicrobial resistance of Pseudomonas aeruginosa strains isolated from lower respiratory tract infections acquired in an intensive care unit. J Antibiot (Tokyo) 2012; 65(1): 9-13.
  15. Rahbar M, Mehragan H, Haji Ali Akbari N. Prevalence of drug resistance in nonfermenter gram-negative bacilli. Iran J Pathol 2010; 5(2): 90-6.
  16. Kianpour F, Havaei SA , Hosseini MM. Evaluation of Pseudomonas aeroginosa isolated from cutaneous infections and determination of drug resistance pattern in patients of Alzahra hospital in Isfahan. J Isfahan Med Sch 2010; 28(110): 503-9.
  17. Rossolini GM, Mantengoli E. Treatment and control of severe infections caused by multiresistant Pseudomonas aeruginosa. Clin Microbiol Infect 2005; 11(Suppl 4(: 17-32.
  18. Mohammadi-Mehr M, Feizabadi M. Antimicrobial resistance pattern of Gram-negative bacilli isolated from patients at ICUs of Army hospitals in Iran. Iran J Microbiol 2011; 3(1): 26-30.
Journal of Isfahan Medical School
Volume 31, Issue 232 - Serial Number 232
March and April 2013
Pages 433-438

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History

  • Receive Date: 14 February 2013
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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