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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
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-09-04 , DOI: 10.2147/idr.s327652 Tesfa Addis 1, 2 , Shambel Araya 1 , Kassu Desta 1
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-09-04 , DOI: 10.2147/idr.s327652 Tesfa Addis 1, 2 , Shambel Araya 1 , Kassu Desta 1
Affiliation
Purpose: 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 biobank 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 re-analyzed, 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.
Conclusion: This study shows an increasing rate of MDR and XDR isolates and the appearance of PDR in P. aeruginosa strains; this is a serious problem in Ethiopia. The lack of newer anti-pseudomonal antibiotics adds to the problem. In order to alleviate this, infection prevention activities should be promoted, and treatment of bacterial infections should be guided by antibiotic susceptibility test results.
Keywords: P. aeruginosa, antimicrobial resistance, carbapenemase enzyme, Ethiopia
中文翻译：
埃塞俄比亚公共卫生研究所生物库中存储的推定分离株出现多种、广泛和泛耐药的铜绿假单胞菌和碳青霉烯酶生产
目的：铜绿假单胞菌是医院感染的常见原因，并具有相关的发病率和死亡率，因为该生物体对常用抗菌药物没有反应。本研究的目的是确定铜绿假单胞菌的多重耐药（MDR）、广泛耐药（XDR）和泛耐药（PDR）表型及其来自埃塞俄比亚生物库中存储的假定分离株的碳青霉烯酶生产率。公共卫生研究所（EPHI）。
方法： 2021 年 3 月至 6 月在埃塞俄比亚亚的斯亚贝巴 EPHI 实验室进行了一项横断面研究。使用 Becton Dickinson (BD) Phoenix 自动化系统对通过手动识别方法进行表征的样本进行进一步处理，以进行物种级识别 (ID) 和抗菌药物敏感性测试 (AST)。使用改良的碳青霉烯灭活方法（mCIM）分析分离株的碳青霉烯酶产量。使用SPSS 20版软件进行数据分析。
结果：本研究对生物库中的110株假单胞菌进行了重新分析，发现其中100株为假单胞菌，其中铜绿假单胞菌占98%，恶臭假单胞菌占2%。大多数分离株是从伤口样本（46%）中回收的，其次是耳拭子样本（18%）。对头孢他啶的耐药性最高（35%），对阿米卡星的耐药性最低（2%）。 27 个分离株被确定为碳青霉烯酶生产测试的候选株，其中只有 3/27 (11%) 分离株被检测为碳青霉烯酶生产者。
结论：本研究表明铜绿假单胞菌菌株中 MDR 和 XDR 分离株的比例不断增加，并且 PDR 的出现；这是埃塞俄比亚的一个严重问题。新型抗假单胞菌抗生素的缺乏加剧了这个问题。为了缓解这种情况，应促进感染预防活动，并应以抗生素药敏试验结果指导细菌感染的治疗。
关键词：铜绿假单胞菌，抗菌素耐药性，碳青霉烯酶，埃塞俄比亚
更新日期：2021-09-04
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 re-analyzed, 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.
Conclusion: This study shows an increasing rate of MDR and XDR isolates and the appearance of PDR in P. aeruginosa strains; this is a serious problem in Ethiopia. The lack of newer anti-pseudomonal antibiotics adds to the problem. In order to alleviate this, infection prevention activities should be promoted, and treatment of bacterial infections should be guided by antibiotic susceptibility test results.
Keywords: P. aeruginosa, antimicrobial resistance, carbapenemase enzyme, Ethiopia
中文翻译：
埃塞俄比亚公共卫生研究所生物库中存储的推定分离株出现多种、广泛和泛耐药的铜绿假单胞菌和碳青霉烯酶生产
目的：铜绿假单胞菌是医院感染的常见原因，并具有相关的发病率和死亡率，因为该生物体对常用抗菌药物没有反应。本研究的目的是确定铜绿假单胞菌的多重耐药（MDR）、广泛耐药（XDR）和泛耐药（PDR）表型及其来自埃塞俄比亚生物库中存储的假定分离株的碳青霉烯酶生产率。公共卫生研究所（EPHI）。
方法： 2021 年 3 月至 6 月在埃塞俄比亚亚的斯亚贝巴 EPHI 实验室进行了一项横断面研究。使用 Becton Dickinson (BD) Phoenix 自动化系统对通过手动识别方法进行表征的样本进行进一步处理，以进行物种级识别 (ID) 和抗菌药物敏感性测试 (AST)。使用改良的碳青霉烯灭活方法（mCIM）分析分离株的碳青霉烯酶产量。使用SPSS 20版软件进行数据分析。
结果：本研究对生物库中的110株假单胞菌进行了重新分析，发现其中100株为假单胞菌，其中铜绿假单胞菌占98%，恶臭假单胞菌占2%。大多数分离株是从伤口样本（46%）中回收的，其次是耳拭子样本（18%）。对头孢他啶的耐药性最高（35%），对阿米卡星的耐药性最低（2%）。 27 个分离株被确定为碳青霉烯酶生产测试的候选株，其中只有 3/27 (11%) 分离株被检测为碳青霉烯酶生产者。
结论：本研究表明铜绿假单胞菌菌株中 MDR 和 XDR 分离株的比例不断增加，并且 PDR 的出现；这是埃塞俄比亚的一个严重问题。新型抗假单胞菌抗生素的缺乏加剧了这个问题。为了缓解这种情况，应促进感染预防活动，并应以抗生素药敏试验结果指导细菌感染的治疗。
关键词：铜绿假单胞菌，抗菌素耐药性，碳青霉烯酶，埃塞俄比亚
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