Multidrug-resistant and extremely drug-resistant Pseudomonas aeruginosa in clinical samples from a tertiary healthcare facility in Nigeria

INTRODUCTION: Pseudomonas aeruginosa have been globally implicated in healthcare associated infection. The susceptibility pattern of clinical isolates of Pseudomonas aeruginosa to anti-pseudomonal antibiotics is reported.
METHODS: Clinical samples namely blood, urine, tracheal aspirate, cerebrospinal fluid, wound swabs, high vaginal swabs, eye and ear exudates were collected from patients and processed and identified using standard microbiological protocols. The antibiotic susceptibility testing was undertaken using Kirby Bauer Disc diffusion method and the results were reported following Clinical and Laboratory Standards Institute guidelines.
RESULTS: Of the 104 Pseudomonas aeruginosa isolates identified, higher incidence was observed in males (52.88%) than females (47.11%) patients. Highest prevalence was recorded from wound swabs [46 (44.23%)] followed by ear exudates [23 (22.12%)], urine [22 (21.15%)], while eye exudates and samples from the cerebrospinal fluid yielded the least [1 (0.96% each)]. From the antibiogram, imipenem had the highest antibiotic activity (91.3%) followed by polymyxin B (84.6%). The isolates exhibited highest resistance to ceftazidime (73.1%) and piperacillin-tazobactam (61.5%). Antibiotic resistance pattern of P. aeruginosa isolates revealed 7.69% susceptible, 26% resistant, 61% multidrug resistance (MDR), 5% extremely drug resistance (XDR) and an absence (0%) of pandrug resistant phenotypes.
DISCUSSION AND CONCLUSION: The study revealed an alarmingly high prevalence of MDR phenotypes and some XDR phenotypes of P. aeruginosa in UPTH. It will help to identify existing gaps in antimicrobial resistance surveillance and assist in improving public health policies regarding antibiotic stewardship, initiatives and interventions.