Prevalence of Pseudomonas Aeruginosa among the Indoor Patients of National Institute of Neurological and Allied Sciences and its Antibiotic Susceptibility Profile

Abstract

The use of broad-spectrum antibiotics and immunosuppressive drugs, along with the availability of invasive procedures or instrumentations has led to the rise in patients with impaired immune defenses worldwide, thereby leading to an increase in nosocomial infections especially by Gram-negative organisms such as Pseudomonas. Thus a six month cross sectional study was undertaken with an objective to determine the hospital based prevalence of Pseudomonas aeruginosa in clinical specimens of suspected patients admitted for more than 48 hours at the National Institute of Neurological and Allied Sciences (NINAS) hospital, Kathmandu, Nepal. A total of 1146 clinical specimens were collected from 301 inpatients and were identified by conventional microbiological method and antibiogram was performed by Kirby- Bauer disc diffusion method and Clinical Laboratory Standard Institute (CLSI) guidelines. The overall prevalence of P. aeruginosa was 18.5% (212/1146) of which 28.8% (61/212) showed polymicrobial growth. The prevalence of P. aeruginosa was found to be highest in respiratory specimens (36.4% in sputum and 29.7% in tracheal specimens). Among the total 212 isolates, 48.6% (n=103) were from the patients of ICU and 51.4% (n=109) were from patients of Non ICU wards. Imipenem was found to be the most effective drug against most of the clinical isolates followed by Piperacillin/Tazobactum. Isolates exhibited maximum resistance to Cefepime (93.9%) followed by Cephotaxime (90.1%). The study showed statistically significant association (P<0.05) between the sex of the patients and infection status, while no association was found (P> 0.05) between the MDR isolates and the wards. The prevalence of Multi-drug resistant P. aeruginosa was 85.4%. Most of MDR isolates were obtained from tracheal aspirates. The study showed alarming condition of MDR P. aeruginosa in the hospitalized patients indicating need of surveillance for MDR and timely intervention for control.