Multi Drug Resistant Pseudomonas aeruginosa in a Health Care Setting in Alexandria

Abstract

The emergence of Multi drug resistant Pseudomonas aeruginosa (MDRPA) among intensive care unit (ICU) patients is increasingly recognized as a public health threat worldwide. This work aimed to study the occurrence of MDRPA among critically ill patients in a health care setting in Alexandria. During a 12 months period, different clinical samples (sputum, endotracheal aspirates, blood, urine, and pus) obtained from ICU patients were tested for the isolation and identification of Pseudomonas aeruginosa (P. aeruginosa) strains; that were screened for their antimicrobial susceptibility patterns using single disc diffusion method. Identified MDRPA strains were further tested for their susceptibility to polymyxin E (colistin), polymyxin B, and tigecycline. Polymerase chain reaction (PCR) assay was performed to detect VIM and IMP MBL genes. Of the 105 P. aeruginosa strains isolated from various clinical samples, 20 (19%) were found to be MDRPA, of which 16 (80%) were sensitive to each of colistin and polymyxin B, while only 5 (25%) strains were sensitive to tigecycline. PCR assay revealed that 9 (45%) strains possessed VIM MBL gene and none (0%) harbored IMP MBL gene. The occurrence of MDRPA strains among critically ill patients in this study was noticeable; with colistin and polymyxin B being effective upon the majority of identified MDRPA strains, and VIM MBL gene was found to be significantly harbored.

Keywords

• multidrug resistance pseudomonas aeruginosa
• metallo beta lactamases
• polymyxins
• colistin
• tigecycline
• vim & imp mbl genes