Vancomycin resistant Enterococci and its associated factors among HIV infected patients on anti-retroviral therapy in Ethiopia

Background The emergence of vancomycin resistant Enterococci (VRE) has alarmed the global community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the incidence of vancomycin resistant Enterococci and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART). Methods Institution based cross sectional study was conducted among HIV infected patients on ART at from June 1 to August 30, 2020. Socio-demographic and clinical data were collected by pre-tested structured questionnaire. Stool sample was collected and processed by standard microbiological techniques. Kirby Bauer Disc diffusion method was used to perform antimicrobial susceptibility testing. Data were entered by Epi data version 4.6.0.2 and analyzed by SPSS version 25. Bivariable and multivariable logistic regression model was used to analyze the association between dependent and independent variables. P-values in the multivariable analysis, adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to determine the strength of association. P-value ≤0.05 was considered as significant. Results Enterococci spp was isolated on 123/200 (61.50%) patients. Among these isolates, the incidence of vancomycin resistant Enterococci was 11.4% [95% CI: (6.0–17.0)]. Antimicrobial susceptibility patterns against Enterococci showed highest rate of resistance to ampicillin (69.9%). Multidrug resistances were observed in 49.59% of Enterococci isolates. Study participants who had prior antibioticexposurer more than two weeks [AOR = 7.35; 95% CI: (1.2144.64)] and hospitalization for the last six months [AOR = 5.68; 95% CI: (1.09 29.74)] were significantly associated with vancomycin resistant Enterococci. Conclusions In our study high incidence of vancomycin resistant Enterococci was found. Previous exposure to antibiotics for more than two weeks and hospitalization for more than six months were significantly associated with vancomycin resistant Enterococci. The isolated Enterococci had variable degrees of resistance to commonly prescribed antibiotics. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics and implementing infection prevention protocols may reduce colonization by VRE.

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Vancomycin resistant enterococci gut Colonization and its associated factors among HIV infected patients on anti-Retro viral therapy in Ethiopia

10.21203/rs.3.rs-96175/v1 ◽

2020 ◽

Author(s):

Belayneh Regasa ◽

Zerihun Solomon ◽

Mheret Tesfaye

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

Diffusion Method ◽

Resistance Pattern ◽

P Value ◽

Cross Sectional ◽

Gut Colonization ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Study Participants

Abstract BackgroundThe emergence of vancomycin resistant Enterococci (VRE) has alarmed the global infectious diseases community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the prevalence of vancomycin resistant Enterococci gut colonization and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART).MethodsInstitution based cross sectional study was conducted among HIV infected patients on ART at from June 1 to August 30, 2020. Socio-demographic and clinical data were collected by pre-tested structured questionnaire. Stool sample was collected and processed by standard microbiological techniques. Kirby Bauer Disc diffusion method was used to perform antimicrobial susceptibility testing. Data were entered by Epi data version 4.6.0.2 and analyzed by SPSS version 25. P-value <0.05 was considered as significant.ResultsAmong a total of 200 study participants, colonization of Enterococci spp was isolated on 123 (61.50%) respondents. Among these isolates, the prevalence of vancomycin resistant Enterococci colonization was 11.4% [95% CI: (6.0-17.0)]. Enterococci isolates tested against commonly prescribed antibiotics showed highest rate of resistance to ampicillin (69.9%). Multidrug resistances were observed in 49.59% of Enterococci isolates. Study participants who had prior antibiotic exposure for more than two weeks [AOR=7.35; 95% CI: (1.2144.64)] and hospitalization in the last six months [AOR=5.68; 95% CI: (1.09 29.74)] were significantly associated with vancomycin resistant Enterococci gut colonization.ConclusionHigh prevalence of vancomycin resistant Enterococci gut colonization was found. Previous exposure to antibiotics for more than two weeks and previous hospitalization for more than six months were significant factors for vancomycin resistant Enterococci colonization. The isolated Enterococci had variable degrees of resistance to commonly prescribed antibiotics. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics and implementing infection prevention protocols may reduce colonization by VRE.

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Magnitude of Vancomycin-Resistant Enterococci (VRE) Colonization among HIV-Infected Patients Attending ART Clinic in West Amhara Government Hospitals

International Journal of Microbiology ◽

10.1155/2018/7510157 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Manamenot Agegne ◽

Bayeh Abera ◽

Awoke Derbie ◽

Gizachew Yismaw ◽

Melashu Balew Shiferaw

Keyword(s):

Antimicrobial Susceptibility ◽

Associated Factors ◽

Statistical Significance ◽

Agar Plate ◽

Diffusion Method ◽

Stepwise Logistic Regression ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Government Hospitals ◽

Vancomycin Resistant

Background. Enterococci that colonize the intestinal tract of immunocompromised patients are an important cause of nosocomial infections. Data on the prevalence of vancomycin-resistant Enterococci (VRE) and its antimicrobial susceptibility patterns and associated factors are scarce in the present study area. Therefore, this study was conducted aimed at determining the prevalence of VRE colonization among HIV-infected patients attending ART clinic at West Amhara Government Hospitals. Methods. A cross-sectional study was conducted from 1 February 2017 to 31 May 2017. A total of 349 HIV patients were included in the study. A pretested structured questionnaire was used to collect sociodemographic data and possible associated factors for VRE colonization. Identification and confirmation of Enterococci from stool sample was performed based on the standard procedures. Antimicrobial susceptibility testing was done using the Kirby–Bauer disk diffusion method on the Muller–Hinton agar plate as per the standard protocol, and resistance profile of the isolates was determined according to Clinical and Laboratory Standards Institute (CLIS). Data were analyzed using SPSS v23. Descriptive analysis was used to visualize differences within data. Moreover, the stepwise logistic regression model was done to assess factors associated with VRE colonization. P value was set at 0.05 to indicate statistical significance difference. Results. The overall colonization status of Enterococci was at 63% (220/349). The VRE colonization was at 17 (7.7% (95% CI: 4.9–12.0)). Among Enterococcal isolates tested for antimicrobial susceptibility, 142 (64.5%) were found resistant to two or more antibiotics. Antibiotic treatment (for >2 weeks) and history of hospital admission in the last six month were found statistically associated for VRE colonization (AOR = 10.18, (95% CI: 1.9–53.20)) and (AOR = 20.17; (95% CI: 5.22–77.93)), respectively. Conclusions. The observed VRE with multidrug resistance colonization need a periodic surveillance of antimicrobial testing to detect emerging resistance and prevent the spread of further drug resistance.

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Intended Pregnancy as a Predictor of Good Knowledge on Birth Preparedness and Complication Readiness: the Case of Northern Ethiopia Pregnant Mothers

International Journal of Reproductive Medicine ◽

10.1155/2019/9653526 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Haile Zewdu Tsegaw ◽

Endeshaw Admassu Cherkos ◽

Marta Berta Badi ◽

Muhabaw Shumye Mihret

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Multivariable Analysis ◽

Good Knowledge ◽

P Value ◽

Northern Ethiopia ◽

Birth Preparedness ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Complication Readiness

Background. Maternal mortality remains unacceptably high in developing countries. One key strategy to reduce such mortality is utilization of birth preparedness and complication readiness (BP/CR) and creating awareness of BP/CR is an important step for pregnant women, their families, and the community. However, there was limited to no evidence regarding the community’s awareness on BP/CR in the study area. Therefore, this study aimed to assess knowledge on BP/CR and associated factors among pregnant women in Debremarkos town, Northwest Ethiopia, 2017. Methods. A Community based cross-sectional study was conducted from July 1 to 30/2017. A total of 441 pregnant women were included in the study. Structured and pretested questionnaire was administered through face to face interview to collect the data. Simple random sampling technique was used to select the study participants. The data were entered in to Epinfo version 7.0 and then exported to SPSS version 20.0 for analysis. Both bivariate and multivariable logistic regression model were fitted. Crude and adjusted odds ratio with 95 % confidence interval have been computed and variables with p-value < 0.05 were considered statistically significance. Results. The proportion of pregnant women having good knowledge on birth preparedness and complication readiness was found to be 45.2 with 95%CI (40.4, 50.0). In the multivariable analysis, having history of childbirth (AOR=2.17;95%CI:1.18,4.00), having intended pregnancy (AOR=2.13;95%CI: 1.16, 3.90), being governmental employee ( AOR=6.50; 95%CI: 2.50, 16.87), and having Antenatal care visits (AOR=5.50; 95%CI:2.2,13.70) were factors which were independently and significantly associated with good knowledge on birth preparedness and complication readiness. Conclusion. Proportion of pregnant women having good knowledge on birth preparedness and complication readiness was low. Putting emphasis on intended pregnancy and antenatal care visit was recommended.

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Vancomycin-resistant enterococci and coagulase-negative staphylococci prevalence among patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0249823 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249823

Author(s):

Degu Ashagrie ◽

Chalachew Genet ◽

Bayeh Abera

Keyword(s):

Venous Blood ◽

Multidrug Resistant ◽

Vancomycin Resistance ◽

World Health ◽

Diffusion Method ◽

P Value ◽

Coagulase Negative Staphylococci ◽

Vancomycin Resistant Enterococci ◽

Specialized Hospital ◽

Vancomycin Resistant

Background Vancomycin resistant enterococci (VRE) and vancomycin resistance coagulase negative staphylococci (VRCoNS) are common pathogens causing difficult to treat health care associated infections (HAI). Hence, the World Health Organization listed VRE as one of the high priority pathogens for new antibiotic discovery and antimicrobial resistance surveillance. Despite this, data on the prevalence of VRE and VRCoNS in Ethiopia is scarce. Thus, the present study determined prevalence of VRE and VRCoNS among patients attending Felege-Hiwot comprehensive specialized hospital, Ethiopia. Methods A hospital based cross-sectional study was conducted on 384 patients selected conveniently from February to March 2020. Data on demographic and clinical variables were collected using a structured questionnaire by face-to-face interview. Simultaneously urine, venous blood and wound swab were collected and processed following standard bacteriological technique. Antimicrobial susceptibility test was performed by minimum inhibitory concentration method using E-test for vancomycin and Kirby-Bauer disc diffusion method for other classes of antibiotics. Data was entered and analyzed using SPSS version 23. Logistic regression was performed to identify factors associated with VRE infection. P. value < 0.05 was considered as statistically significant. Results The prevalence of enterococci and CoNS were 6.8% and 12% respectively. The prevalence of VRE was 34.61% (9/26), while all CoNS (46 isolates) were susceptible to vancomycin. The majority (66.7%) of VRE was isolated from blood samples. Furthermore all VRE (100%), 58.8% of vancomycin susceptible enterococci and 45.7% of CoNS were multidrug resistant (MDR). Having educational level of secondary school and below (AOR = 12.80, CI = 1.149–142.5), previous exposure to catheterization (AOR = 56.0, CI = 4.331–724.0) and previous antibiotic use practice (AOR = 26.25, CI = 3.041–226.2) were a significant associated explanatory factor for VRE infection. Conclusions The prevalence of vancomycin resistance enterococci, which is also multidrug resistant, was significantly high. Though no vancomycin resistance CoNS detected, the MDR level of CoNS was high. Thus to limit enterococci and CoNS infections and MDR development, focused infection prevention measures should be implemented.

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Meal frequency and associated factors among children 6-23 months in Tahtay michew district, northern Ethiopia, 2018

10.21203/rs.3.rs-70779/v1 ◽

2020 ◽

Author(s):

Ermyas Brhane ◽

Teklit Grum ◽

Teklehaymanot Huluf Abraha ◽

Gebrekiros Aregawi

Keyword(s):

Associated Factors ◽

Dietary Diversity ◽

Multivariable Analysis ◽

P Value ◽

Growth Monitoring ◽

Northern Ethiopia ◽

Meal Frequency ◽

Micronutrient Deficiencies ◽

Wealth Status ◽

Cross Sectional

Abstract BackgroundThe term meal frequency is used to describe the adequacy of complementary feedings among children. In the absence of adequate meal frequency young children are susceptible to malnutrition like stunting, wasting, micronutrient deficiencies and associated morbidity and mortality. More half of Ethiopian children did not receive age appropriate minimum meal frequency. Therefore, the aim of this study is to determine minimum meal frequency and associated factors among children 6–23 months in Tahtay Michew district, Northern Ethiopia.MethodsA community based cross sectional study was conducted among systematically selected 981 mothers with index children 6–23 month. An interviewer- administered structured questionnaire was used to collect data. 24 hours dietary recalls was used to determine minimum meal frequency. Crude and Adjusted Odds Ratio with the corresponding 95% confidence interval were computed. In the multivariable analysis, variables with less than 0.05 P-value were considered statistically significant.ResultsMinimum meal frequency was 68% [95% CI: 64.9, 70.9%]. Wealth index (AOR = 1.69, 95% CI = 1.09, 2.61), growth monitoring follow up (AOR = 1.98, 95% CI = 1.41, 2.79) and mothers knowledge (AOR = 2.15, 95% CI = 1.51, 3.04) were factors significantly associated with minimum meal frequency.Conclusion and recommendationThe proportion of children who received the minimum meal frequency was found low. Improving the wealth status of families and encouraging all mothers to attend growth monitoring follow ups are important for improving meal frequency and dietary diversity.

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Timely initiation of postpartum contraceptive and associated factors among women of extended postpartum period in Pawe district, northwest Ethiopia, 2019

10.21203/rs.2.15665/v1 ◽

2019 ◽

Author(s):

Desalegn Nazi Jaleta ◽

Hedeja Yenus Yeshita ◽

Koku Sisay Tamirat

Keyword(s):

Family Planning ◽

Postpartum Period ◽

Associated Factors ◽

Northwest Ethiopia ◽

P Value ◽

Postpartum Women ◽

Modern Contraceptive ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Timely Initiation

Abstract Background: Postpartum family planning is an important intervention for reducing high risk fertility behavior and spacing birth intervals; which ultimately helpful for the health of mothers and their babies. Hence, this study aimed to determine the magnitude of timely initiation of postpartum contraceptive and associated factors among extended postpartum women in Pawe district, Northwest Ethiopia.Methods: Community based cross-sectional study design was employed from February to March 2019 in Pawe district. A stratified multistage sampling technique was used to select a total of 820 women in the extended postpartum period. Data were collected using a pretested interviewer administered questionnaire. A bivariable and multivariable logistic regression model was fitted to identify determinants of timely initiation of postpartum contraceptive among extended postpartum women. Adjusted Odds ratio (AOR) with 95% CI was computed to assess the strength and presence of an association. Variable with less than 0.05 p-value considered as a significant determinant of contraceptive initiation.Results: Out of the total participants about 37.2% [95% CI (34.0, 40.5)] initiated postpartum contraceptive. Time return of menses [AOR=18.32, 95% CI(11.66,28.80)], postnatal care [AOR=7.8, 95%bCI(3.98,15.44)], knowledge level regarding modern contraceptive methods [AOR=3.0, 95% CI(1.40,6.59)], time of resumption of sexual intercourse [AOR=2.1, 95% CI(1.327,3.21), husband approval to use contraceptive [AOR=2.45,95%CI(1.42,4.22), antenatal care [AOR=2.1,95% CI(1.13,3.76), place of delivery at institution [AOR=2.0, 95% CI(1.22,3.39)], and got family planning counseling at delivery [AOR=2.34, 95% CI(1.22,4.49)] were factors associated with timely initiation of postpartum contraceptive. Conclusion and recommendation: The magnitude of timely initiation of postpartum contraceptive was low. This suggests strengthening the integration of postpartum contraceptive use with other basic maternal health services and improving knowledge of women in practicing timely initiation of postpartum contraceptive before engagement to risk activities of unintended pregnancy is important.

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Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0249736 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249736

Author(s):

Anteneh Ayelign Kibret ◽

Mohammed Oumer ◽

Abebe Muche Moges

Keyword(s):

Associated Factors ◽

Multivariable Analysis ◽

Northwest Ethiopia ◽

Adult Patients ◽

Outpatient Department ◽

P Value ◽

Multivariable Logistic Regression Analysis ◽

Cross Sectional ◽

Specialized Hospital ◽

The University

Introduction Hemorrhoidal disease is a very common benign anorectal disease. It affects millions of people around the world, and represent a major medical and socioeconomic problem. However, studies that determine the magnitude and risk factors are limited. Therefore, the aim this study is to assess the prevalence and associated factors of hemorrhoid among adult patients visiting the surgical outpatient department at the University of Gondar Comprehensive Specialized Hospital (UoGCSH) Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February to May 2020. A systematic random sampling technique was used to select a total of 403 participants. The data were collected then entered using EPI DATA version 3.1 and exported to the STATA 14 for analysis. Bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratio (AOR) with 95% confidence interval was used as a measure of association. Variables having P-value < 0.05 from the multivariable analysis were considered to have a significant association with the outcome. Result Out of the 403 study participants, 13.1% (95%CI; 10.1, 16.8) had hemorrhoids. Constipation (AOR = 4.32, 95% CI; 2.20, 8.48) and BMI ≥25kg/m2 (AOR = 2.6, 95% CI; 1.08, 6.23) had a statistically significant association with hemorrhoid. Conclusion The overall prevalence of hemorrhoid was high and its prevalence was higher in male subjects. Constipation and being overweight were found to increase the odds of having hemorrhoids. Screening for early identification and intervention of hemorrhoids, especially for risk groups is better to be practiced by health professionals.

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Emergence of CC8/ST239- SCCmec III/t421 tigecycline resistant and CC/ST22-SCCmec IV/t790 vancomycin resistant Staphylococcus aureus strains isolated from wound: A two-year multi-center study in Tehran, Iran

Acta Microbiologica et Immunologica Hungarica ◽

10.1556/030.2021.01534 ◽

2021 ◽

Keyword(s):

Staphylococcus Aureus ◽

Acquired Resistance ◽

Multidrug Resistant ◽

Diffusion Method ◽

Resistance Pattern ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Phenotypic Resistance ◽

Multiplex Pcr Assay ◽

Vancomycin Resistant

Abstract Staphylococcus aureus as an opportunistic bacterial pathogen with intrinsic and acquired resistance to many antibiotics is a worldwide problem. The current study was undertaken to evaluate the resistance pattern, and determine the genetic types of multidrug-resistant S. aureus isolated from wound. This cross-sectional study was conducted over the period of two years (from December 2018 to November 2020) at the hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. In present study, 75 multidrug-resistant S. aureus isolates collected from wound infections were investigated. Phenotypic resistance was assessed by Kirby–Bauer disk diffusion method. Conventional PCR was performed for the detection of virulence encoding genes. Genotyping of strains was performed based on coa gene polymorphism using multiplex-PCR assay. SCCmec typing, spa typing and MLST were also used to characterize the genotype of the mupirocin, tigecycline and vancomycin resistant multidrug-resistant S. aureus isolates. All 75 multidrug-resistant S. aureus isolates in the study were confirmed as MRSA. Coagulase typing distinguished isolates into five genotypic patterns including III (40%), I (24%), IVb (16%), V (10.7%) and type X (9.3%). Resistance to tigecycline was detected in 4% of MDR-MRSA isolates and all belonged to CC8/ST239- SCCmec III/t421 lineage. According to our analysis, one VRSA strain was identified that belonged to coa type V and CC/ST22-SCCmec IV/t790 lineage. Resistance to mupirocin was detected in 9.3% of strains. All 7 mupirocin resistant MDR-MRSA isolates exhibited resistance to mupirocin in high level. Of these, 4 isolates belonged to CC/ST8-SCCmec IV/t008 (57.1%), 2 isolates belonged to CC/ST8-SCCmec IV/t064 (28.6%) and one isolate to CC/ST22-SCCmec IV/t790 (14.3%). Altogether, current survey provides a snapshot of the characteristics of S. aureus strains isolated from patients. Our observations highlighted type III as predominant coa type among multidrug-resistant MDR strains indicating low heterogeneity of these isolates. Our study also indicates the importance of continuous monitoring of the genotypes of MDR-MRSA isolates to prevent nosocomial outbreaks and the spread of MDR isolates.

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Prevalence and Associated Factors of Pre-Hypertension Among Adults Visiting the Outpatient Department at Mizan Tepi University Teaching Hospital, Mizan-Aman, Ethiopia, 2021.

10.21203/rs.3.rs-727712/v1 ◽

2021 ◽

Author(s):

Mirresa Guteta

Keyword(s):

Blood Pressure ◽

Teaching Hospital ◽

Associated Factors ◽

University Teaching ◽

Outpatient Department ◽

Outcome Variable ◽

P Value ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Starting Point

Abstract Background: Prehypertension is a systolic blood pressure (SBP) of 120-139 millimeters of mercury (mmHg) and a diastolic blood pressure (DBP) of 80-89 millimeters of mercury (mmHg) According to JNC-7 report the new added category. It is considered as a starting point for cardiovascular and many other morbidities. Little is known about the magnitude of prehypertension and its associated factors in study area. Objective: To assess prevalence of Pre-hypertension and Associated factor among adults visiting the Outpatient department at Mizan Tepi university teaching hospital, Mizan-Aman, Ethiopia, 2021.Methods: Institution based cross sectional study design was conducted in Mizan Tepi University Teaching hospital. Simple random sampling method was used to recruit study participants. Data was entered into Epi data version 3.1 and exported to SPSS version 23 for data analysis. The descriptive analysis of data was done and the result presented using frequency tables and graphs. Multivariable logistic regression model was fitted, Adjusted Odds Ratio (AOR) at 95% confidence interval and p-value <0.05 were estimated to determine statistically significant association between predictors and outcome variable.Result: The prevalence of Prehypertension among adults visiting the Outpatient department at Mizan Tepi university teaching hospital was 30.7%. Significant association of prehypertension was found with age (AOR=1.22, 95% CI: 0.69, 2.15), educational status (AOR=0.32, 95% CI: 0.11, 1.00), physical exercise (AR=1.11, 95% CI: 0.57, 2.16) and Body Mass Index (AOR=4.14, 95% CI: 0.44, 39.34). Conclusion: Pre-Hypertension is high in the study area. As a result, concerned body should take action to enhance patients visiting Mizan Tepi University Teaching hospital about impact of Pre-Hypertension on individual health and how to control it.

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Antibiotic Resistance Pattern of Pseudomonas aeruginosa Isolated from Clinical Specimens from a Tertiary Care Centre in Central Kerala with Special Reference to Carbapenemase Detection

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.4.34 ◽

2021 ◽

Author(s):

P.M. Anooja ◽

Anu P. John

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Resistance ◽

Antimicrobial Susceptibility ◽

Tertiary Care ◽

Diffusion Method ◽

Resistance Pattern ◽

Disc Diffusion ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Extended Spectrum Beta Lactamase

Pseudomonas aeruginosa is inherently resistant to many drugs. It is now an emerging opportunistic pathogen of clinical relevance. The emergence of carbapenemases is another major concern. Initiation of appropriate therapy is of paramount importance thus highlighting the need of active surveillance for newer emerging resistance trends for better infection control. To study the resistance pattern of P. aeruginosa isolates obtained from lab specimens and to determine the production of ESBL and Carbapenemase among them. A hospital-based cross-sectional study was carried out in the Department of Microbiology, Government medical college Thrissur, among P. aeruginosa isolates obtained from lab specimens, from January 2018 – December 2018. 162 isolates were studied. Antimicrobial susceptibility testing was done by Kirby–Bauer disc diffusion method, extended-spectrum beta-lactamase (ESBL) production was confirmed by and phenotypic confirmatory disc diffusion test. Carbapenemase detection was done using the modified carbapenemase inactivation (mCIM) method. The obtained data was analysed. Among 162 isolates 83% were non- multidrug-resistant (MDR) strains and 17% were MDR strains. 22% of ceftazidime resistant isolates were ESBL producers. 6.2% isolates were resistant to imipenem. Among the imipenem resistant isolates, Carbapenemase production was seen in 30% isolates by mCIM test. According to our study, the most effective antibiotic against P. aeruginosa were imipenem and cefoperazone/sulbactam showing resistance in 6.3% and 6.9% isolates respectively. The diversity of antibiotic resistance mechanisms and the emergence of carbapenem resistance is a threat that limits treatment choices. This suggests the need for ongoing antimicrobial susceptibility studies in the future.

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