Antimicrobial Resistance Pattern of Pseudomonas aeruginosa Isolated from Urine Specimen in Peshawar, Pakistan: Resistance Pattern of Pseudomonas aeruginosa

Asad Jamal; Amjad Ullah; Tariq Jamal; Asif Jamal; Fida Muhammad; Shafi Ullah; Muhammad Khan; Usama Ur Rehman; Ashraf Ali; Abdul Basit

doi:10.54393/pbmj.v7i11.1110

Authors

Asad Jamal Khyber Medical College, Peshawar, Pakistan
Amjad Ullah Khyber Medical College, Peshawar, Pakistan
Tariq Jamal National Institute of Health, Islamabad, Pakistan
Asif Jamal National College of Sciences University System, Peshawar, Pakistan
Fida Muhammad National College of Sciences University System, Peshawar, Pakistan
Shafi Ullah Khyber Medical College, Peshawar, Pakistan
Muhammad Khan Khyber Medical College, Peshawar, Pakistan
Usama Ur Rehman Khyber Medical College, Peshawar, Pakistan
Ashraf Ali Khyber Medical College, Peshawar, Pakistan
Abdul Basit Khyber Medical College, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v7i11.1110

Keywords:

Pseudomonas aeruginosa, Antibiotic Resistance, Urinary Tract Infections, Nosocomial Infections, Disc Diffusion Method

Abstract

Pseudomonas aeruginosa can cause many nosocomial infections, especially in the urinary tract, particularly in severe burns, bed ulcers, and immune-compromised patients. Objective: To determine the antibiotic resistance pattern and prevalence of Pseudomonas aeruginosa isolated from urine specimens. Methods: This a cross-sectional study. Urine samples were collected from UTI patients and culture on CLED agar and susceptibility was checked with 7 antimicrobial drugs by Disc Diffusion Method. SPSS software version 25.0 was used for data analysis. Results: A total of 243 urine samples collected from patients were tested, out of which Pseudomonas aeruginosa was isolated from 132 (54.32%) samples. In patients aged less than 8 years it accounted for 14.4 % of the sample, 19.7 % in those aged between 9 and 30 years, 28.8% in patients aged between 31 and 50, and 37.1 % in patients aged between 51 and 70. 7 different antibiotics were tested on Pseudomonas aeruginosa isolated from the urine samples. The resistance of Pseudomonas aeruginosa to Imipenem, (29.5%), Cefotaxime (90.2%), Cefoperazone (59.1%), Polymyxin-B (3.0%), Colistin, (10.6%), Aztreonam, (26.5%) and Tobramycin (22.0%). There were no significant differences in antibiotic resistance patterns between males and females. Conclusions: The results of this study showed that Pseudomonas aeruginosa was more common in females than males. Most of the stains were found to be resistant to Cefotaxime and the most sensitive to polymyxin-B. This study also showed a higher resistance percentage in older (51-70 years).

References

REFERENCES

Sorlí L, Luque S, Li J, Campillo N, Danés M, Montero M et al. Colistin for the treatment of urinary tract infections caused by extremely drug-resistant Pseudomonas aeruginosa: dose is critical. Journal of Infection. 2019 Sep; 79(3): 253-61. doi: 10.1016/j.jinf.2019.06.011. DOI: https://doi.org/10.1016/j.jinf.2019.06.011

Reynolds D and Kollef M. The epidemiology and pathogenesis and treatment of Pseudomonas aeruginosa infections: an update. Drugs. 2021 Dec; 81(18): 2117-31. doi: 10.1007/s40265-021-01635-6. DOI: https://doi.org/10.1007/s40265-021-01635-6

Newman JN, Floyd RV, Fothergill JL. Invasion and diversity in Pseudomonas aeruginosa urinary tract infections. Journal of Medical Microbiology. 2022 Mar; 71(3): 001458. doi: 10.1099/jmm.0.001458. DOI: https://doi.org/10.1099/jmm.0.001458

Pang Z, Raudonis R, Glick BR, Lin TJ, Cheng Z. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies. Biotechnology Advances. 2019 Jan; 37(1): 177-92. doi: 10.1016/j.biotechadv.2018.11.013. DOI: https://doi.org/10.1016/j.biotechadv.2018.11.013

Rehman A, Patrick WM, Lamont IL. Mechanisms of ciprofloxacin resistance in Pseudomonas aeruginosa: new approaches to an old problem. Journal of Medical Microbiology. 2019 Jan; 68(1): 1-0. doi: 10.1099/jmm.0.000873. DOI: https://doi.org/10.1099/jmm.0.000873

Fernández-Billón M, Llambías-Cabot AE, Jordana-Lluch E, Oliver A, Macià MD. Mechanisms of antibiotic resistance in Pseudomonas aeruginosa biofilms. Biofilm. 2023 Dec; 5: 100129. doi: 10.1016/j.bioflm.2023.100129. DOI: https://doi.org/10.1016/j.bioflm.2023.100129

Ude J, Tripathi V, Buyck JM, Söderholm S, Cunrath O, Fanous J et al. Outer membrane permeability: Antimicrobials and diverse nutrients bypass porins in Pseudomonas aeruginosa. Proceedings of the National Academy of Sciences. 2021 Aug; 118(31): e2107644118. doi: 10.1073/pnas.2107644118. DOI: https://doi.org/10.1073/pnas.2107644118

Pachori P, Gothalwal R, Gandhi P. Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit; a critical review. Genes & Diseases. 2019 Jun; 6(2): 109-19. doi: 10.1016/j.gendis.2019.04.001. DOI: https://doi.org/10.1016/j.gendis.2019.04.001

Bassetti M, Vena A, Croxatto A, Righi E, Guery B. How to manage Pseudomonas aeruginosa infections. Drugs in Context. 2018 May; 7. doi: 10.7573/dic.212527. DOI: https://doi.org/10.7573/dic.212527

Saleem S and Bokhari H. Resistance profile of genetically distinct clinical Pseudomonas aeruginosa isolates from public hospitals in central Pakistan. Journal of Infection and Public Health. 2020 Apr; 13(4): 598-605. doi: 10.1016/j.jiph.2019.08.019. DOI: https://doi.org/10.1016/j.jiph.2019.08.019

Samad A, Ahmed T, Rahim A, Khalil A, Ali I. Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar. Pakistan Journal of Medical Sciences. 2017 May; 33(3): 670. doi: 10.12669/pjms.333.12416. DOI: https://doi.org/10.12669/pjms.333.12416

Martinez JL. General principles of antibiotic resistance in bacteria. Drug Discovery Today: Technologies. 2014 Mar; 11: 33-9. doi: 10.1016/j.ddtec.2014.02.001. DOI: https://doi.org/10.1016/j.ddtec.2014.02.001

Asghar F, Muhammad S, Anjum AA, Ali T, Asghar AS, Naureen S et al. Multi-drug resistance pattern of bacterial isolates from urinary tract infection. Pakistan Journal of Pharmaceutical Sciences. 2023 Jul; 36(4): 1107-13.

Khan T, Ullah H, Nasar A, Ullah M. Antibiotic Resistance and sensitivity pattern of Pseudomonas aeruginosa obtained from clinical samples. Lett Appl NanoBioScience. 2023 May; 12(4): 112. doi: 10.33263/LIANBS124.112. DOI: https://doi.org/10.33263/LIANBS124.112

Farooq L, Memon Z, Ismail MO, Sadiq S. Frequency and antibiogram of multi-drug resistant Pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan. Pakistan Journal of Medical Sciences. 2019 Nov; 35(6): 1622. doi: 10.12669/pjms.35.6.930. DOI: https://doi.org/10.12669/pjms.35.6.930

Kateete DP, Nakanjako R, Namugenyi J, Erume J, Joloba ML, Najjuka CF. Carbapenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii at Mulago hospital in Kampala, Uganda (2007-2009). Springerplus. 2016 Dec; 5: 1-1. doi: 10.1186/s40064-016-2986-7. DOI: https://doi.org/10.1186/s40064-016-2986-7

Maharjan N. Pseudomonas aeruginosa isolates among clinical samples showing growth in a Tertiary Care Centre: a descriptive cross-sectional study. JNMA: Journal of the Nepal Medical Association. 2022 Aug; 60(252): 676. doi: 10.31729/jnma.6517. DOI: https://doi.org/10.31729/jnma.6517

Motbainor H, Bereded F, Mulu W. Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia: a cross-sectional study. BioMed Central Infectious Diseases. 2020 Dec; 20: 1-1. doi: 10.1186/s12879-020-4811-8. DOI: https://doi.org/10.1186/s12879-020-4811-8

Pokharel K, Dawadi BR, Bhatt CP, Gupte S. Prevalence of Pseudomonas aeruginosa and its antibiotic sensitivity pattern. 2019 Apr; 17(1): 109-113. doi: 10.33314/jnhrc.1877. DOI: https://doi.org/10.33314/jnhrc.v17i01.1877

Pramodhini S, Umadevi S, Seetha K. Prevalence of antimicrobial resistance in clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital, Puducherry, India. International Journal of Current Microbiology and Applied Sciences. 2015; 4: 718-26.

Chen X, Xu J, Zhu Q, Ren Y, Zhao L. Polymyxin B resistance rates in carbapenem‑resistant Pseudomonas aeruginosa isolates and a comparison between Etest® and broth microdilution methods of antimicrobial susceptibility testing. Experimental and Therapeutic Medicine. 2020 Aug; 20(2): 762-9. doi: 10.3892/etm.2020.8777. DOI: https://doi.org/10.3892/etm.2020.8777

Farhan SM, Ibrahim RA, Mahran KM, Hetta HF, Abd El-Baky RM. Antimicrobial resistance pattern and molecular genetic distribution of metallo-β-lactamases producing Pseudomonas aeruginosa isolated from hospitals in Minia, Egypt. Infection and Drug Resistance. 2019 Jul: 2125-33. doi: 10.2147/IDR.S198373. DOI: https://doi.org/10.2147/IDR.S198373

Shah SH, Ali W, Shah FA, Falah SF, Rehman E, Umar A et al. Multi Drug Resistance Pseudomonas aeruginosa Frequency and Antibiogram in A Tertiary Teaching Care Hospital in Pakistan: Frequency and Antibiogram of Pseudomonas aeruginosa. Pakistan BioMedical Journal. 2022 Jul: 231-5. doi: 10.54393/pbmj.v5i7.667. DOI: https://doi.org/10.54393/pbmj.v5i7.667

Forouzani F, Khasti T, Manzouri L, Ravangard S, Shahriarirad R, Koleini M et al. Resistance pattern of isolated microorganisms from 783 clinical specimen cultures in patients admitted to Yasuj Educational Hospitals, Iran. BioMed Central BMC Microbiology. 2023 Aug; 23(1): 205. doi: 10.1186/s12866-023-02952-4 DOI: https://doi.org/10.1186/s12866-023-02952-4

Chooramani G, Jain B, Chauhan PS. Prevalence and antimicrobial sensitivity pattern of bacteria causing urinary tract infection; study of a tertiary care hospital in North India. Clinical Epidemiology and Global Health. 2020 Sep; 8(3): 890-3. doi: 10.1016/j.cegh.2020.02.018. DOI: https://doi.org/10.1016/j.cegh.2020.02.018

Shah DA, Wasim S, Abdullah FE. Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from urine samples of Urinary Tract Infections patients in Karachi, Pakistan. Pakistan Journal of Medical Sciences. 2015 Mar; 31(2): 341. doi: 10.12669/pjms.312.6839. DOI: https://doi.org/10.12669/pjms.312.6839

Arooj I, Asghar A, Javed M, Elahi A, Javaid A. Prevalence and Antibiotic Susceptibility Profiling of MDR Pseudomonas aeruginosa from UTI Patients of Southern Punjab, Pakistan. RADS Journal of Biological Research & Applied Sciences. 2022 Jul; 13(1): 1-9. doi: 10.37962/jbas.v13i1.407.

Mohamed A and Abdelhamid F. Antibiotic susceptibility of Pseudomonas aeruginosa isolated from different clinical sources. Zagazig Journal of Pharmaceutical Sciences. 2020 Feb; 28(2): 10-7.

Ahmad S, Alotaibi MA, Alamri MS. Antibiotic sensitivity pattern of clinical isolates of Pseudomonas aeruginosa at a tertiary care hospital in Saudi Arabia. Dhaka University Journal of Pharmaceutical Sciences. 2020; 19(1): 77-82. doi: 10.3329/dujps.v19i1.47821. DOI: https://doi.org/10.3329/dujps.v19i1.47821

Chikwendu CI, Amadi ES, Obi RK. Prevalence and antimicrobial resistance in Pseudomonas aeruginosa and Klebsiella pneumoniae isolates from non-clinical urine samples. New York Science Journal. 2010; 3(11): 194-200.

Ullah A, Sultan W, Mazhar S, Shireen F, Rabnawaz M, Khan K et al. Antimicrobial Susceptibility Patterns of Pseudomonas Aeruginosa Isolates in A Tertiary Care Hospital, Peshawar, Pakistan. BioScientific Review. 2024 Sep; 6(3): 133-40. DOI: https://doi.org/10.32350/bsr.63.09