Detection of carbapenem-resistant Pseudomonas aeruginosa in tertiary care hospital in Saudi Arabia

Abstract

Background:Pseudomonas aeruginosa is one of the common emerging multidrug-resistant causative bacteria which causes healthcare associated infections that leads to increased morbidity and mortality rates. Aim: Detection of resistance pattern of studied isolates to different antipseudomonal drugs and to determine the prevalence of carbapenem resistant Pseudomonas aeruginosa and to detect the involved carpabenemasesgenes among resistant isolates. Methods:The study was done  from November 2021 to  April, 2022 in Al-Quwayiyah general hospital. Eighty six Pseudomonas aeruginosa isolates were collected. Identification of isolates and antimicrobial susceptibility testing were done using vitek-II machine. Carbapenem resistance was detected by modified Hodge Test then confirmed using multiplex PCR for the detection of blaVIM, blaKPC, blaIMP, blaNDM-1, blaOXA-48,  blaGIM, blaSPM and blaSIM  genes. Results: Thirty two (37.20%) strains were  carbapenem-resistant Pseudomonas aeruginosa(CRPA) as detected by multiplex PCR. Among these 32 strains the resistance was 100% to imipenem, meropenem and ciprofloxacin. The isolates had least resistance to aztreonam, 21.88%  and colistin, 31.25%. Among  32 CRPA isolates 23 (71.88. %) were multi-drug resistant, 19 (59.38%) were Extensively-drug resistant. PCR identified the presence of blaOXA-48 in 15 (46.88%) isolates, blaVIM gene in 10 (31.25%) isolates and blaNDM in 12 (37. 5%) isolates. On the other hand, blaGIM, blaIMP and blaSIM were only detected in 2 isolates for each and blaKPC detected in one isolate only. Conclusion: The prevalence  of CRPA was high (37.2%). The appropriate study of the antimicrobial resistance molecular mechanisms will help in management of CRPA patients and implementation of  infection control procedures.