Publication: Antimicrobial Resistance Pattern of Pseudomonas aeruginosa Isolates from Tertiary Care Hospitals in Kathmandu
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Antimicrobial resistance, caused by Pseudomonas aeruginosa (P. aeruginosa), poses
a global health threat, limiting treatment options and increasing morbidity and
mortality rates due to its intrinsic and multidrug resistance.
Objective
To determine the antimicrobial resistance patterns of P. aeruginosa isolates from
patients visiting or admitted to tertiary care hospitals in Kathmandu.
Method
A cross-sectional study was conducted at Bir Hospital and Tribhuvan University
Teaching Hospital (TUTH) from December 2021 to December 2022. Isolates were
identified and tested for antibiotic susceptibility following standard microbiological
guidelines.
Result
The antimicrobial resistance of 200 P. aeruginosa isolates increased from low to
high levels, as per the recommended anti-pseudomonal antibiotics by the Clinical
and Laboratory Standards Institute (CLSI), from 0% to 94%. piperacillin/tazobactam
exhibited significantly lower resistance at 18(9%) and while considerably higher
resistance was observed with ceftazidime at 188(94%) compared to different
antibiotics, followed by amikacin 34(17%), imipenem 58(29%), ciprofloxacin 42(21%),
aztreonam 51(25.5%), and fosfomycin 44(22%). No resistance was observed to
colistin and polymyxin B. P. aeruginosa resistant to carbapenem was accounted for
33.5% of the total, and multidrug resistance categories included multidrug resistance
(MDR) at 39.0%, extensively drug resistance (XDR) at 13.5%, and P. aeruginosa
difficult-to-treat (DTR PA) at 4.6%.
Conclusion
Most of the isolates were resistant to anti-pseudomonal antibiotics; however, colistin,
polymyxin B, amikacin, doripenem, piperacillin/tazobactam, and fosfomycin were
effective against MDR P. aeruginosa. Regular surveillance measures are essential to
manage antimicrobial resistance.
KEY WORDS
Antimicrobial resistance, Difficult-to-treat Pseudomonas aeruginosa, Extensively
drug resistance, Multidrug resistance
Description
Shrestha PM,1 Kattel HP,2 Sharma S,2 Bista P,3 Basnet BK,4 Ghimire P,1 Rijal KR1
1Central Department of Microbiology
Tribhuvan University, Kathmandu, Nepal
2Department of Microbiology
Maharajgunj Medical Campus
TU Teaching Hospital
Maharajgunj, Kathmandu, Nepal
3Department of Pathology
Bir Hospital, Mahabaudha, Kathmandu, Nepal
4National Academy of Medical Sciences
Bir Hospital, Mahabaudha, Kathmandu, Nepal
Keywords
Antimicrobial resistance, Difficult-to-treat Pseudomonas aeruginosa, Extensively drug resistance, Multidrug resistance