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首页> 外文期刊>Journal of Clinical and Diagnostic Research >The Rising Threat of Drug Resistant Pseudomonas aeruginosa- A Nightmare for Intensive Care Unit Patients
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The Rising Threat of Drug Resistant Pseudomonas aeruginosa- A Nightmare for Intensive Care Unit Patients

机译：毒性假单胞菌铜绿假单胞菌的上升威胁 - 重症监护病房患者的噩梦

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Multidrug Resistant (MDR), Extensively Drug Resistant (XDR) and Pan Drug Resistant (PDR) variants manifest a high level of intrinsic resistance to antimicrobial drugs by the help of efflux pump, biofilm formation and aminoglycoside modifying enzymes. The potentiality of Pseudomonas spp. to produce variety of drug resistance mechanism has led to evolution of drug resistant phenotypes this poses a challenge for clinicians in the treatment of severe infection among Intensive Care Unit (ICU) patients.Aim: To determine the phenotypic profiling of β-lactamases and burden of MDR, XDR and PDR Pseudomonas aeruginosa (P. aeruginosa) in ICU patients.Materials and Methods: The present cross-sectional prospective study was carried in the Department of Microbiology, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India, after permission from Institutional Ethics Committee (IEC). A total of 115 isolates of P. aeruginosa were isolated from 502 human clinical samples from January 2019 to February 2021 and all the clinical samples were non duplicate. Antimicrobial Susceptibility Testing (AST) was performed for all isolates by standard KirbyBauer disc diffusion method on Mueller Hinton Agar (MHA). Phenotypic profiling of Extended Spectrum β-Lactamase (ESBL), Metallo β-Lactamase (MBL) and Ampicillinase C (AmpC) was performed by disc potentiation test; Imipenemase (IMP) - Ethylenediamine Tetraacetic Acid (EDTA) combined disc test and Cefoxitin Cloxacillin Double Disc Synergy Test (CC-DDST), respectively. The obtained results were statistically analysed in numbers and percentages using MS Excel 2013 version.Results: Out of 502 total human clinical samples, 115 isolates were P. aeruginosa giving the prevalence rate of 23%. Among 115 Pseudomonas isolates, 60 (52%) were MDR phenotypes, 8 (7%) were XDR phenotypes and there was no PDR phenotypes isolated in present study as all isolates were sensitive to Ticarcillin/Clavulanic acid, Colistin and Polymyxin B. Out of 115 isolates, 59 (51%) were ESBL producers, 26 (23%) were MBL producers, and 6 (5%) were AmpC producers.Conclusion: Strict antibiotic policies and regular surveillance programme of antimicrobial resistance must be tailored to fend off the emergence of drug resistant Pseudomonas aeruginosa.
机译：多药抗性（MDR），广泛的耐药性（XDR）和PAN耐药性（PDR）变体表现出通过流出泵，生物膜形成和氨基糖苷改性酶的帮助表现为抗微生物药物的高度内在抗性。假单胞菌SPP的潜力。为了产生各种耐药机制，导致耐药表型的演变，这对临床医生进行了挑战，治疗重症监护单位（ICU）患者的严重感染。确定β-内酰胺酶的表型分析和负担在ICU患者中MDR，XDR和PDR假单胞菌铜绿假单胞菌铜绿假单胞菌（P. Aerginosa）。材料和方法：在许可之后，在Microbiology，Santosh医学院和医院Ghaziabad，印度北方邦的微生物学，Ghaziabad从机构伦理委员会（IEC）。从2019年1月到2021年1月，从502例人类临床样品中分离了115分离的P. Acruginosa分离株，并且所有临床样品都是未重复的。通过标准柯克布尔圆盘扩散法对穆勒林顿琼脂（MHA）进行抗菌剂易感性试验（AST）。通过椎间盘稳定性试验进行扩展光谱β-内酰胺酶（ESBL），金属β-内酰胺酶（MBL）和氨苄青霉素酶C（AMPC）的表型分析; Imipenemase（IMP） - 乙二胺四乙酸（EDTA）组合盘试验和食氧脲素克罗克林双盘协同作用试验（CC-DDST）。使用MS Excel 2013 Version的数量和百分比进行了统计学分析的结果。结果：502例人类临床样品中，115个分离物为P.铜绿假单胞患者患病率为23％。在115例分离物中，60例（52％）是MDR表型，8（7％）是XDR表型，并且目前研究中没有分离的PDR表型，因为所有分离物对Ticarcillin /克拉维酸，Colistin和Polymyxin B敏感115分离株，59（51％）是ESBL生产商，26（23％）是MBL生产商，6（5％）是AMPC生产商。结论：严格的抗生素政策和常规监测程序的抗菌抗性的抗菌性抵抗力必须定制以抵挡耐药性铜绿假单胞菌的出现。

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