Abstract :
Introduction: The multidrug resistant nature of P. aeruginosa is a major cause of morbidity in immunocompromised patients. The mechanisms which play a role in causing multidrug resistance of P.aeruginosa includes lower outer membrane permeability, increased expression of efflux pumps, presence of Amp C Beta lactamase enzyme. The present retrospective study aims to analyse the antibiotic sensitivity pattern of P.aeruginosa in our clinical setting in various clinical specimens and to study the various mechanisms playing a role in resistance to antibiotics.
Materials and methods: The retrospective study included all the Psedomonas aeruginosa isolates from clinical specimens received in our microbiology department between June 2015 to June 2016. The specimens included pus, aural swab, conjunctival swab, blood, urine and endotracheal tube. A total of 40 cases were included in the study.
Results: highest sensitivity was observed for amikacin(65%), Piperacillin/ tazobactum(52.5%),Gentamycin(47.5%) Highest resistance (77.5%) was to Trimethoprim/ sulphamethaxazole, 62.5% to nalidixic acid, 57.5% cases had resistance to quinolones. Impermeability to carbapenems accounted for 42.5% cases, followed by carbapenamase(metallo-oxa) resistance mechanism in 37.5%.
Conclusion: Growing resistance to commonly used antibiotics is a major concern to clinicians as several complex mechanisms are involved in the multi-drug resistance nature of P.aeruginosa. Careful use of antibiotics, culture and sensitivity testing and prudent selection of drugs and effective infection control measures would help the clinicians in planning and executing effective treatment thus limiting the emergence of multidrug resistant strains of Pseudomonas aeruginosa.
Keyword :
P. aeruginosa, Resistance mechanism, AAC, ANT, Carbapenemase, AmpC