Antimicrobial resistance patterns of Pseudomonas aeruginosa in tertiary care hospitals of Makkah and Jeddah.

BACKGROUND

The clinical significance of Pseudomonas aeruginosa has greatly increased due to its ability to rapidly develop resistance to major groups of antibiotics.

OBJECTIVES

Our objective was to determine the pattern of antimicrobial resistance of P aeruginosa.

DESIGN

Prospective, descriptive study.

SETTING

Four tertiary care hospitals in Makkah and Jeddah.

METHODS

Clinical isolates of P aeruginosa were processed following standard microbiological procedures. A Microscan Walk Away system was used for the identification and antibiotic susceptibility of P aeruginosa isolates.

MAIN OUTCOME MEASURES

Percentage of resistance of P aeruginosa to antibiotics.

RESULTS

The overall drug resistance among 121 strains of P aeruginosa was low to moderate to commonly used anti-pseudomonal drugs (4.9% to 30.6%). Significantly less resistance was exhibited by piperacillin tazobactam (4.9%; P < .05) and meropenem showed significantly high resistance (30.6%; P < .05) as compared to other antibiotics, followed by ticarcillin (22.3%) and imipenem (19%), irrespective of the site of infection. The antibiotics with < 10% resistance were cefepime (8.3%), amikacin (7.4%) and piperacillin-tazobactam, which showed lowest resistance (4.9%). Although, data varied between hospitals, meropenem and ticarcillin had the highest drug resistance in all hospitals. Multidrug resistance was 10.7%.

CONCLUSION

Low-to-moderate rates of drug resistance among P aeruginosa isolates were observed. Meropenem resistance was high irrespective of the site of infection. This pattern of resistance indicates probable overuse of broad-spectrum antibiotics like carbapenems. Overuse needs to be addressed by each institution, and consideration given to regulating use of broad-spectrum antibiotics.

LIMITATIONS

Results cannot be generalized as the study did not include all tertiary hospitals in these cities.