Olana Matifan Dereje, Asrat Daniel, Swedberg Göte
Department of Medical Laboratory Sciences, Collage of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Infect Dis. 2024 Dec 28;24(1):1472. doi: 10.1186/s12879-024-10359-3.
Pseudomonas aeruginosa is one of the leading causes of nosocomial infections and the most common multidrug-resistant pathogen. This study aimed to determine antimicrobial resistance patterns, biofilm-forming capacity, and associated factors of multidrug resistance in P. aeruginosa isolates at two hospitals in Addis Ababa, Ethiopia.
A cross-sectional study was conducted from August 2022 to August 2023 at Tikur Anbessa Specialized Hospital and Yekatit 12 Hospital Medical College. Culture and identification of P. aeruginosa were done using standard microbiological methods. An antimicrobial susceptibility test was done by Kirby-Bauer disk diffusion according to CLSI recommendations. The microtiter plate assay method was used to determine biofilm-forming capacity. SPSS version 25 was used for data analysis. Bivariate and multivariable logistic regression were used to assess factors associated with multidrug resistance in P. aeruginosa. The Spearman correlation coefficient (rs = 0.266)) was performed to evaluate the relationship between biofilm formation and drug resistance.
The overall prevalence of P. aeruginosa was 19.6%. High levels of resistance were observed for ciprofloxacin (51.8%), ceftazidime (50.6%), and cefepime (48.2%). The level of multidrug-resistance was 56.6%. The isolates showed better susceptibility to ceftazidime-avibactam (95.2%) and imipenem (79.5%). Overall, 95.2% of P. aeruginosa were biofilm-producing isolates, and 27.7% and 39.8% of isolates were strong and moderate biofilm producers, respectively. A positive correlation and statistically significant relationship was observed between resistance to multiple drugs and the level of biofilm formation (rs = 0.266; p-value = 0.015). Previous history of exposure to ciprofloxacin (OR, 5.1; CI, 1.12-24.7, p-value, 0.032) was identified as an independent associated factor for multidrug resistance in P. aeruginosa.
The present study indicates an association between multidrug resistance in P. aeruginosa and its biofilm formation capabilities. Additionally, over half of the isolates were resistant to multiple drugs, with prior use of ciprofloxacin linked to the development of multidrug-resistance. These findings suggest that antibiotic stewardship programs in hospital settings may be beneficial in addressing resistance.
铜绿假单胞菌是医院感染的主要病因之一，也是最常见的多重耐药病原体。本研究旨在确定埃塞俄比亚亚的斯亚贝巴两家医院铜绿假单胞菌分离株的抗菌耐药模式、生物膜形成能力以及多重耐药的相关因素。
2022年8月至2023年8月在提库尔·安贝萨专科医院和耶卡蒂特12医院医学院进行了一项横断面研究。使用标准微生物学方法对铜绿假单胞菌进行培养和鉴定。根据CLSI建议，采用 Kirby-Bauer 纸片扩散法进行抗菌药敏试验。采用微量滴定板测定法确定生物膜形成能力。使用SPSS 25版进行数据分析。采用二元和多变量逻辑回归评估与铜绿假单胞菌多重耐药相关的因素。采用Spearman相关系数（rs = 0.266）评估生物膜形成与耐药性之间的关系。
铜绿假单胞菌的总体患病率为19.6%。观察到对环丙沙星（51.8%）、头孢他啶（50.6%）和头孢吡肟（48.2%）的耐药水平较高。多重耐药水平为56.6%。分离株对头孢他啶-阿维巴坦（95.2%）和亚胺培南（79.5%）表现出较好的敏感性。总体而言，95.2%的铜绿假单胞菌分离株可产生生物膜，27.7%和39.8%的分离株分别为强生物膜生产者和中度生物膜生产者。观察到对多种药物的耐药性与生物膜形成水平之间存在正相关且具有统计学意义（rs = 0.266；p值 = 0.015）。先前接触环丙沙星的病史（比值比，5.1；可信区间，1.12 - 24.7，p值，0.032）被确定为铜绿假单胞菌多重耐药的独立相关因素。
本研究表明铜绿假单胞菌的多重耐药性与其生物膜形成能力之间存在关联。此外，超过一半的分离株对多种药物耐药，先前使用环丙沙星与多重耐药的发生有关。这些发现表明，医院环境中的抗生素管理计划可能有助于解决耐药问题。
