ABSTRACT

Background: Pseudomonas aeruginosa is considered to be a foremost cause of hospital acquired infections. The initiation of antimicrobial treatment is more frequently empirical; thus it is imperative to have knowledge of the susceptibility pattern of microbes in order to choose upon the most appropriate antimicrobial drug.

Aim: To upgrade rational empirical antibacterial treatment recommendations.

Methods: In total, 160 clinical isolates of Pseudomonas aeruginosa were collected from in-hospital patients at a major tertiary care hospital in Lahore from different wards during the period March 2020 to January 2021. Antimicrobial resistance in the current study was done by using Kirby-Bauer method. Wound swab and urine samples showed a high prevalence of Pseudomonas aeruginosa isolates.

Results: The results of this study were in accordance to National Committee for Clinical Laboratory Standards (2017) guidelines. Pseudomonas aeruginosa isolates taken from different clinical samples showed decreased susceptibility and increased resistance to various antibiotics. Pseudomonas aeruginosa exhibited resistance to ceftazidime (60%), imipenem (53%), ciprofloxacin (55%), gentamicin (55%), meropenem (51%), cefoperazone/sulbactam (58%), amikacin (45%), piperacillin/tazobactam (40%) and aztreonam (50%). Department-wise isolation of Pseudomonas aeruginosa was surgery 65(40.6%), medicine 44(27.5%), orthopaedics 19(11.8%), ICU 19(11.9%), ENT 7(4.3%) and gynaecology 6(3.7%) (p≤ 0.001). Sample-wise isolation of Pseudomonas aeruginosa was wound 89(55.6%) and urine 71(44.4%). P value ≤0.05 was considered to be statistically significant. In conclusion, majority of the isolates exhibited increased level of resistance to antibiotics. This emphasizes the importance of antibiotic susceptibility testing and optimization of treatment by combining drugs.

Conclusion: This is a global phenomenon. Limiting over-usage of antibiotics is mandatory and implementing newer policies to counteract this problem is necessary.

Keywords: Nosocomial infection, multidrug-resistant, antibiotics, infection, antimicrobial therapy