Dissemination of Multidrug-Resistant, Extensively Drug Resistant and Pandrug-Resistant Pseudomonas aeruginosa Isolates among In-Patients and Out-Patients in a Multi-Profile Health Care Settings

Abstract

Pseudomonas aeruginosa is one of the most life-threatening pathogens, especially in healthcare settings, and a main contributor to multi-drug resistance (MDR), extensive-drug resistance (XDR), and pan-drug resistant (PDR) phenotypes. However, there is limited data on the degree of resistance of these isolates in this region. This study seeks to determine the distribution of MDR, XDR, and PDR Pseudomonas aeruginosa strains from different patient groups. A total of five hundred (500) non-duplicated strains of Pseudomonas aeruginosa of human clinical samples were collected from the Microbiology Laboratory Unit of Alex Ekwueme Teaching Hospital Abakaliki. The isolates were identified and re-characterized by standard microbiology techniques. MDR, XDR, and PDR were determined using the Kirby–Bauer disk diffusion method, and the results were analyzed using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. The result shows that the overall resistant phenotype was MDR 50. 7%, XDR 20.5%, and PDR 9.6% while in samples from in-patients and out-patients, resistant phenotype proportions were MDR 43.2%, XDR 32.4%, PDR 10.1% and MDR 61.2%, XDR 29.7%, and PDR 18.5% respectively. Worrisomely, only a few tested antimicrobial agents (Amikacin, cefepime) were active against the test organism, presenting a limited therapeutic option. It is therefore imperative to establish strong regulative measures and guidelines that would help in curtailing the increasing dissemination of these superbugs in healthcare institutions in Nigeria.