Antimicrobial drug sensitivity pattern of Pseudomonas aeruginosa in respiratory infections

Authors

  • Syed S. Ameen Department of Pharmacology, Dr. B R Ambedkar Medical College, Bangalore, Karnataka, India
  • Shanmukananda Prakash Department of Pharmacology, Dr. B R Ambedkar Medical College, Bangalore, Karnataka, India
  • Laxminarayana Bairy K. Director, Manipal Centre of Clinical Research, Manipal, India
  • Shahabuddin Soherwardi Department of Internal Medicine 2017-18, Howard University Hospital, Washington DC, USA

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20172635

Keywords:

Antimicrobial susceptibility, Antipseudomonal agents, Nosocomial infections, P. aeruginosa

Abstract

Background: Pseudomonas aeruginosa, a gram-negative pathogen commonly associated with nosocomial infections is the most widespread multidrug-resistant pathogen causing pneumonia in hospitalized patients. Inadequate empirical therapy has been associated with high mortality and morbidity. Objective: To evaluate and analyze the antimicrobial susceptibility pattern of P. aeruginosa in respiratory infections in a tertiary care hospital.

Methods: The study was carried out at Kasturba Hospital, Manipal from Jan 2011 to Dec 2011. Specimens of 63 in-patients were analyzed who were culture positive for P. aeruginosa.

Results: Majority of patients were aged above 40yrs with a male preponderance. Specimens were taken from patients who were diagnosed with bronchiectasis, pneumonia, COPD, bronchial asthma etc. Overall the organism was most sensitive to carbapenems (87.3%) followed by cefoperazone-sulbactam combination (85.7%). Sensitivity to ceftazidime and cefepime was equal (82.5%) and was more when compared to piperacillin-tazobactam (81.5%). Overall resistance rate was highest for fluoroquinolones (23.8%) followed by aztreonam (22.2%).

Conclusions: Hence we would like to recommend cefoperazone-sulbactam as the preferred antipseudomonal agent and carbapenems as reserved drugs in treating pseudomonal lung infections. Use of fluoroquinolones and aztreonam as monotherapy in resistant P. aeruginosa infections should be restricted.

Author Biography

Syed S. Ameen, Department of Pharmacology, Dr. B R Ambedkar Medical College, Bangalore, Karnataka, India

 

 

References

Kanj SS, Sexton DJ. Epidemiology and pathogenesis of Pseudomonas aeruginosa infection. Available at: http://www.uptodate.com/contents/ epidemiologyandpathogenesis- of pseudomonas aeruginosa infection?source=search_result & search = pseudomonas + aeruginosa & selected Title=3~150. Accessed on 24 MAY 2017.

National nosocomial infection surveillance (NNIS) system report: data summary from January 1992 through June 2003. Available at: 0% 20% 40% 60% 80% 100% Resistant sensitive http://www.cdc.gov/ncidod/dhqp/pdf. Accessed on 24 March 2017.

Ramphal R. Infections due to Pseudomonas species and related organisms. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jamson JL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18th Edition. New York: McGraw-Hill Companies; 2012:1266-1273.

Pier GB, Ramphal R. Pseudomonas aeruginosa. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 7th Edition. New York: Churchill Livingstone Elsevier; 2010:2835-2857.

Genner S, Ak O, Benzonana N, Batirel A, Ozer S. Susceptibility pattern and cross-resistance of antibiotics against Pseudomonas aeruginosa in a teaching hospital of Turkey. Ann Clin Microbiol Antimicrob. 2002;1:2-7.

National committee for clinical laboratory standards. Performance standards for antimicrobial disk susceptibility tests. Approved standard M2 A7 NCCLS. Villanova; 1995:15.

Javiya VA, Ghatak SB, Patel KR, Patel JA. Antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujrat, India. Indian J Pharmacol. 2008;40(5):230-4.

Petri WA. Penicillins, Cephalosporins, and Other β-Lactam Antibiotics. In: Brunton LL, Chabner BA, Knollmann BC, editors. Goodman and Gilman's The Pharmacological Basis of Therapeutics, 12th Ed. New York: The McGraw-Hill Companies, Inc; 2012:1475-1503.

Chambers HF, Deck DH. Beta-Lactam and Other Cell Wall- and Membrane- Active Antibiotics. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic And Clinical Pharmacology, 11th Ed. New York: The McGraw-Hill Companies; 2009:773-794.

Karlowsky JA, Jones ME, Thornsberry C, Evangelista AT, Yee YC, Sahm DF. Stable Antimicrobial Susceptibility Rates for Clinical Isolates of Pseudomonas aeruginosa from the 2001-2003 Tracking Resistance in the United States Today Surveillance Studies. Clin Infect Dis. 2005;40(2):89-98.

Obritsch MD, Fish DN, Macleran R, Jung R. National Survillence of Antimicrobial Resistance in Pseudomonas Aeruginosa Isolates Obtained From Intensive Care Unit Patients From 1993-2002. Antimicrobial Agents Chemother. 2004;48(12):4606-10.

Bert F, Maubec E, Bruneau B, Berry P, Lambert ZN. Multiresistant Pseudomonas aeruginosa outbreak associated with contaminated tap water in a neurosurgery intensive care unit. J Hosp Infect. 1998;39(1):53-62.

Chen HY, Yuan M, Ibrahim EIB, Livermore DM. National survey of susceptibility to antimicrobials amongst clinical isolates of Pseudomonas aeruginosa. J Antimicrob Chemother. 1995;35(4):521-34.

Fass RJ, Barnishan J, Solomon MC, Ayers LW. Invitro activities of quinolones, b-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli. Antimicrob Agents Chemother. 1996;40(6):1412-8.

Sofianou D, Tsakris A, Skoura L, Douboyas J. Extended high-level cross-resistance to antipseudomonal antibiotics amongst Pseudomonas aeruginosa isolates in a university hospital. J Antimicrob Chemother. 1997;40(6):740-2.

Gales AC, Jones RN, Turnidge J, Rennie R, Ramphal R. Characterization of Pseudomonas aeruginosa isolates: occurrence rates, antimicrobial susceptibility patterns, and molecular typing in the global sentry antimicrobial surveillance program, 1997-1999. Clin Infect Dis. 2001;32(2):146-55.

Jones RN, Kirby JT, Beach ML, Biedenbach DJ, Pfaller MA. Geographic variations in activity of broad-spectrum b-lactams against Pseudomonas aeruginosa: summary of the worldwide SENTRY Antimicrobial Surveillance Program (1997-2000). Diagn Microbiol Infect Dis. 2002;43:239-43.

Landman D, Quale JM, Mayorga D, Adedeji A, Vangala K, Ravishankar J, et al. Citywide clonal outbreak of multiresistant Acinetobacter baumannii and Pseudomonas aeruginosa in Brooklyn, NY: the preantibiotic era has returned. Arch Intern Med. 2002;162(13):1515-20.

Safdar N, Maki DG. The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus, enterococcus, gram-negative bacilli, Clostridium difficile, and Candida. Ann Intern Med. 2002;136(11):834-44.

Wenzel RP, Wong MT. Managing antibiotic use-impact of infection control. Clin Infect Dis. 1999;28(5):1126-7.

Downloads

Published

2017-06-23

How to Cite

Ameen, S. S., Prakash, S., K., L. B., & Soherwardi, S. (2017). Antimicrobial drug sensitivity pattern of Pseudomonas aeruginosa in respiratory infections. International Journal of Basic & Clinical Pharmacology, 6(7), 1591–1595. https://doi.org/10.18203/2319-2003.ijbcp20172635

Issue

Section

Original Research Articles