Prevalence of multi and pan drug resistant Pseudomonas aeruginosa with respect to ESBL and MBL in a tertiary care hospital.

Multi drug resistant Pseudomonas aeruginosa (MDRPA) and pan drug resistant Pseudomonas aeruginosa (PDRPA) isolates in critically ill patients are often difficult to treat. Prevalence of MDRPA and their antibiotic profile was investigated to select an appropriate empirical therapy. Moreover lack of sufficient data on prevalence of PDRPA in tertiary care hospitals indicated the need for this study. Pseudomonas aeruginosa was isolated in 245 patients over a period of one and half years from various clinical materials and their antibiotic profile was determined. Minimum inhibitory concentration (MIC) for Imipenem and Meropenam was determined by broth dilution method. Phenotypic confirmation test and EDTA double disk synergy test was used to detect Extended spectrum a-lactamase (ESBL) and Metallo-a-lactamase (MBL) producers respectively. Out of 245 isolates, 54 strains (22 %) and 11 strains (4%) were found to be MDRPA and PDRPA respectively. Carbapenem resistant isolates showed MICs ranging from 16 to > 64 microg/ml. Thirty eight strains (15.5%) were ESBL producers and six (54.5%) among 11 PDRPA were MBL producers. Prevalence of MDR and PDR isolates of Pseudomonas aeruginosa was found to be 22% and 4% respectively, which is less compared to other studies. Majority of the PDRPA isolates were MBL producers which have propensity to spread to other bacteria.