Occurrence of Multiple, Extensive and Pan Drug-resistant Pseudomonas Aeruginosa and Carbapenemase Production from Presumptive Isolates Stored in a Biobank at Ethiopian Public Health Institute
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Date
2021-06
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Addis Abeba University
Abstract
Background: Pseudomonas aeruginosa is a common cause of nosocomial infections with
associated morbidity and mortality because the organism is unresponsive to commonly
available antimicrobials. This study was undertaken to determine the Multiple Drug-Resistant
(MDR), Extensive Drug-Resistant (XDR) and Pan Drug-Resistant (PDR) phenotype of
P.aeruginosa and its carbapenemase production rate from presumptive isolates stored in the
bio-bank at the Ethiopian Public Health Institute (EPHI).
Methods: A cross-sectional study was conducted at the EPHI laboratory, Addis Ababa,
Ethiopia from March to June 2021. Stored isolates of Pseudomonas spp. which had been
characterized by manual identification methods were further processed for species-level
identification (ID) and antimicrobial susceptibility testing (AST) using a Becton Dickinson
(BD) Phoenix automated system. The isolates were analyzed for carbapenemase enzyme
production using the modified Carbapenem Inactivation Method (mCIM). The data analysis
was done using SPSS version 20 software.
Results: In this study, 110 presumptive Pseudomonas isolates from a biobank were reanalyzed,
100 of them were found to be Pseudomonas and among these P.aeruginosa
accounted for 98% and P.putida accounted for 2%. The majority of isolates were recovered
from wound (46%) specimens followed by ear swabs (18%). The highest level of resistance
was observed against Ceftazidime (35%) and the lowest level of resistance was observed
against Amikacin (2%). Twenty-seven isolates were identified as candidates for
carbapenemase enzyme production testing, of which only 3/27 (11%) isolates were detected
as carbapenemase enzyme producers.
Conclusions: This study shows an increasing rate of MDR and XDR isolates and the
appearance of PDR in P.aeruginosa strain, this is a serious problem in Ethiopia. The lack of
newer anti-pseudomonal antibiotics adds to the problem. In order to alleviate this problem,
Infection prevention activities should be promoted, and treatment of bacterial infections
should be guided by antibiotic susceptibility test results.
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Keywords
P.aeruginosa, Antimicrobial Resistance, Carbapenemase enzyme, Ethiopia