Antimicrobial susceptibility pattern and multidrug resistance ındex in Pseudomonas aeruginosa among clinical isolates in Denizli, Turkey

Background: Pseudomonas aeruginosa is an important hospital infection agent causing morbidity and mortality with the ability to gain resistance to many antimicrobials. The objective of this study was to determine the sensitivity profiles of nosocomial P.aeruginosa isolates in Denizli, Turkey.Methods: A total 120 P. aeruginosa strains which were isolated from specimens sent to the microbiology laboratory between January 2015 and December 2015 were investigated. Antimicrobial resistance was determined by agar disc diffusion method using Mueller-Hinton agar according to Clinical and Laboratory Standards Institute recommendations.Results: With respect to sensitivity pattern, the most sensitive antimicrobials were  Amikacin, colistin, tobramisin, netilmicin and gentamicin  and the resistance rates were detected as 97%, 96%, 92%, 90%, 83%, respectively over 120 P. aeruginosa strains. The sensitivity rates for the other antimicrobials were 56% for Piperacilin and 54% for Tazobactam. P. aeruginosa strains 62 (52%) isolates showed multiple antimicrobial resistance to 13 antimicrobialsConclusion: To prevent the spread of the resistant bacteria, it is critically important to have strict antimicrobial policies while surveillance programmes for multidrug resistant organisms and infection control procedures need to be implemented. In the meantime, it is desirable that the antimicrobial susceptibility pattern of bacterial pathogens like P. aeruginosa in specialized clinical units to be continuously monitored and the results readily made available to clinicians so as to minimize the development of resistance.

[1]  M. Parkins,et al.  Tobramycin inhalation powder: an efficient and efficacious therapy for the treatment of Pseudomonas aeruginosa infection in cystic fibrosis. , 2015, Therapeutic delivery.

[2]  Neang S. Ly,et al.  Two Mechanisms of Killing of Pseudomonas aeruginosa by Tobramycin Assessed at Multiple Inocula via Mechanism-Based Modeling , 2015, Antimicrobial Agents and Chemotherapy.

[3]  D. Biswas,et al.  Efficacy of anti-pseudomonal antibiotics: Need to reconsider the empirical use of cefepime , 2014, The Indian journal of medical research.

[4]  S. Kose,et al.  Evaluation of the in vitro colistin susceptibility of Pseudomonas aeruginosa and Acinetobacter baumannii strains at a tertiary care centre in Western Turkey. , 2014, Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive.

[5]  D. Keskin,et al.  Beta-lactamases production and antimicrobial resistance ratio of Pseudomonas aeruginosa from hospitalized patients in Kahramanmaras, Turkey. , 2013, Journal of environmental biology.

[6]  M. Soliman,et al.  Prevalence and Antimicrobial Susceptibility Pattern of Pseudomonas aeruginosa Isolated from Environmental and Clinical Samples in Upper Egypt , 2013 .

[7]  T. Murray,et al.  Antimicrobial susceptibility patterns of multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii against carbapenems, colistin, and tigecycline. , 2012, Saudi medical journal.

[8]  Emel Çalışkan,et al.  Antibiotic Resistance of Pseudomonas aeruginosa Strains and Frequency of Metallo-beta-lactamases , 2011 .

[9]  M. Burattini,et al.  Metallo‐beta‐lactamases among imipenem‐resistant Pseudomonas aeruginosa in a brazilian university hospital , 2010, Clinics.

[10]  S. Malik,et al.  Antimicrobial susceptibility and ESBL prevalence in Pseudomonas aeruginosa isolated from burn patients in the North West of Pakistan. , 2009, Burns.

[11]  Camille Lemieux,et al.  Outbreak of Multidrug-Resistant Pseudomonas aeruginosa Colonization and Infection Secondary to Imperfect Intensive Care Unit Room Design , 2009, Infection Control & Hospital Epidemiology.

[12]  S. Dinçer,et al.  Antibacterial agents and heavy metal resistance in Gram-negative bacteria isolated from seawater, shrimp and sediment in Iskenderun Bay, Turkey. , 2008, The Science of the total environment.

[13]  P. Mathur,et al.  An evaluation of four different phenotypic techniques for detection of metallo-beta-lactamase producing Pseudomonas aeruginosa. , 2008, Indian journal of medical microbiology.

[14]  Gabriela C. Moraes,et al.  Metallo-β-Lactamase Detection: Comparative Evaluation of Double-Disk Synergy versus Combined Disk Tests for IMP-, GIM-, SIM-, SPM-, or VIM-Producing Isolates , 2008, Journal of Clinical Microbiology.

[15]  R. Jamasbi,et al.  Phenotypic and Genotypic Characteristics of Clinical Isolates of Pseudomonas aeruginosa: Rate of Occurrence and Distribution of Different Serotypes, Antimicrobial Susceptibility Profiles, and Molecular Typing , 2008 .

[16]  E. Bingen,et al.  Pseudomonas aeruginosa May Accumulate Drug Resistance Mechanisms without Losing Its Ability To Cause Bloodstream Infections , 2007, Antimicrobial Agents and Chemotherapy.

[17]  B. Markova,et al.  Problematic clinical isolates of Pseudomonas aeruginosa from the university hospitals in Sofia, Bulgaria: current status of antimicrobial resistance and prevailing resistance mechanisms. , 2007, Journal of medical microbiology.

[18]  R. Jones,et al.  Global assessment of the antimicrobial activity of polymyxin B against 54 731 clinical isolates of Gram-negative bacilli: report from the SENTRY antimicrobial surveillance programme (2001-2004). , 2006, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[19]  Yehuda Carmeli,et al.  Multidrug-Resistant Pseudomonas aeruginosa: Risk Factors and Clinical Impact , 2006, Antimicrobial Agents and Chemotherapy.

[20]  N. Elkhizzi,et al.  Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa. , 2004, Saudi medical journal.

[21]  Ronald N. Jones,et al.  Increasing prevalence of antimicrobial resistance among Pseudomonas aeruginosa isolates in Latin American medical centres: 5 year report of the SENTRY Antimicrobial Surveillance Program (1997-2001). , 2003, The Journal of antimicrobial chemotherapy.

[22]  A. Alonso,et al.  Emergence of multidrug-resistant mutants is increased under antibiotic selective pressure in Pseudomonas aeruginosa. , 1999, Microbiology.

[23]  H. Siegrist,et al.  Susceptibility to levofloxacin of clinical isolates of bacteria from intensive care and haematology/oncology patients in Switzerland: a multicentre study. , 1999, The Journal of antimicrobial chemotherapy.

[24]  L S Gonzalez,et al.  Aminoglycosides: a practical review. , 1998, American family physician.

[25]  M. Cheesbrough.  Medical Laboratory Manual for Tropical Countries , 1991 .

[26]  P. H. Krumperman.  Multiple antibiotic resistance indexing of Escherichia coli to identify high-risk sources of fecal contamination of foods , 1983, Applied and environmental microbiology.

[27]  H. Stone.  Review of Pseudomonas Sepsis in Thermal Burns: Verdoglobin Determination and Gentamicin Therapy , 1966, Annals of surgery.

[28]  P. Srivastava,et al.  DETECTION AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF PSEUDOMONAS AERUGINOSA ISOLATES IN VARIOUS CLINICAL SAMPLES WITH SPECIAL REFERENCE TO METALLO BETA LACTAMASE FROM A TERTIARY CARE HOSPITAL IN JAIPUR, INDIA , 2014 .

[29]  Madhu Sharma,et al.  Metallo-beta-lactamase Producing Pseudomonas aeruginosa in Neonatal Septicemia , 2010, Journal of laboratory physicians.

[30]  Sudhir Aggarwal,et al.  Urinary tract infections caused by Pseudomonas aeruginosa: a minireview. , 2009, Journal of infection and public health.

[31]  P. Shah.  Parenteral carbapenems. , 2008, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[32]  M. Oh,et al.  Risk factors for antimicrobial resistance and influence of resistance on mortality in patients with bloodstream infection caused by Pseudomonas aeruginosa. , 2005, Microbial drug resistance.

[33]  A. Olayinka,et al.  Prevalence of multi-drug resistance (MDR) Pseudomonas aeruginosa isolates in surgical units of Ahmadu Bello University teaching Hospital, Zaria, Nigeria: An indication for effective control measures , 2004 .

[34]  M. Ferraro.  Performance standards for antimicrobial susceptibility testing , 2001 .

[35]  P. C. Legolvan.  Biochemical Tests for Identification of Medical Bacteria , 1981 .

[36]  Chunfang ZHANGt.  Pseudomonas aeruginosa. , 1966, Lancet.