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Journal of Drug Metabolism & Toxicology

Journal of Drug Metabolism & Toxicology
Open Access

ISSN: 2157-7609

+44-20-4587-4809

Review - (2020)Volume 11, Issue 4

Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal

Rajani Shrestha*, Niranjan Nayak, Dharm Raj Bhatta, Deependra Hamal, Supram Hosuru Subramanya and Shishir Gokhale
 
*Correspondence: Rajani Shrestha, Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal, Tel: 00 977 9856039849, Email:

Author info »

Abstract

Background: Clinical isolates of Pseudomonas aeruginosa often exhibit multidrug resistance due to their inherent ability to form biofilms. Drug resistance in Pseudomonas aeruginosa is a major clinical problem, especially in the management of patients with nosocomial infections and those admitted to ICUs with indwelling medical devices. To evaluate the biofilm forming abilities of the clinical isolates of Pseudomonas aeruginosa and to correlate biofilm formation with antibiotic resistance.

Methods

A total of 90 consecutive isolates of P. aeruginosa obtained from various specimens collected from patients visiting the Manipal Teaching Hospital, Pokhara, Nepal between January 2018 - October 2018 were studied. Isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. All the isolates were tested for their biofilm forming abilities by employing the tissue culture plate assay.

Results

Of the 90 Pseudomonas aeruginosa isolates maximum i.e 42 (46.6%) were from patients in the age group of >50 years. Majority (30; 33.3%) of the isolates were obtained from sputum samples. However, percentage isolation from other specimens like urine, endotracheal tube (ETT), pus, eye specimens and blood were 18.9%, 16.7%, 16.7%, 7.8% and 6.7% respectively. All the isolates were sensitive to polymixin B and colistin, 91.1% of the organisms were sensitive to imipenem, and more than 80% to aminoglycosides (80% to gentamicin, 83.3% to amikacin). A total of 29 (32.2%) organisms were biofilm producers. Maximum numbers of biofilm producing strains were obtained from ETT (8 of 15; 53.3%), pus (8 of 15; 53.3%) and blood (2 of 6; 33.3%) i.e from all invasive sites. None of the isolates from noninvasive specimens such as conjunctival swabs were biofilm positive. Significantly higher numbers of biofilm producers (23 of 29; 79.3%) were found to be multidrug resistant as compared to non-biofilm (6 of 61; 9.8%) producers (p=0.000)[1,2].

Conclusion

Pseudomonas aeruginosa colonization leading to biofilm formation in deep seated tissues and on indwelling devices is a therapeutic challenge as majority of the isolates would be recalcitrant to commonly used antipseudomonal drugs. Effective monitoring of drug resistance patterns in all Pseudomonas clinical isolates should be a prerequisite for successful patient management.

References

  1. Shrestha R, Nayak N, Gurung B, Gokhale S. Infectious keratitis in western Nepal: An experience from a tertiary care hospital.Nepal Med Coll J. 2019; 21:288-9.
  2. Shrestha R, Nayak N, Bhatta DR, Hamal D, Subramanya SH. Reemergence of Chloramphenicol Sensitivity among Salmonella enterica serovars Typhi and Paratyphi: a six year experience in a tertiary care hospital in Nepal. Int J Adv Life Sci Res. 2018;1:8- 12.

Author Info

Rajani Shrestha*, Niranjan Nayak, Dharm Raj Bhatta, Deependra Hamal, Supram Hosuru Subramanya and Shishir Gokhale
 
Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
 

Citation: Shrestha R, Nayak N, Bhatta DR, Hamal D, Subramanya SH, Gokhale S (2020) Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal. J Drug Metab Toxicol. 11:250. doi: 10.35248/2157-7609.20.11.250

Received: 29-Jul-2020 Accepted: 11-Aug-2020 Published: 25-Sep-2020 , DOI: 10.35248/2157-7609.20.11.250

Copyright: © 2020 Shrestha R, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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