<i>Pseudomonas aeruginosa</i> in Nepali hospitals: poor outcomes amid 10 years of increasing antimicrobial resistance

Mahto, M, Shah, A, Show, KL, Moses, FL and Stewart, AG ORCID: 0000-0002-4931-5340 (2021) <i>Pseudomonas aeruginosa</i> in Nepali hospitals: poor outcomes amid 10 years of increasing antimicrobial resistance. PUBLIC HEALTH ACTION, 11 (1). pp. 58-63.

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Abstract

<h4>Objective</h4>To determine antimicrobial resistance patterns and prevalence of multi- (MDR, i.e., resistant to ⩾3 classes of antimicrobial agents) and extensively (XDR, i.e., resistant to ⩾3, susceptible to ⩽2 groups of antibiotics) drug-resistant strains of <i>Pseudomonas aeruginosa</i>.<h4>Methods</h4>This was a cross-sectional study conducted in Nepal Mediciti Hospital, Lalitpur, Nepal, using standard microbiological methods with Kirby Bauer disc diffusion to identify antimicrobial susceptibility.<h4>Results</h4><i>P. aeruginosa</i> (<i>n</i> = 447) were most frequently isolated in respiratory (<i>n</i> = 203, 45.4%) and urinary samples (<i>n</i> = 120, 26.8%). AWaRe Access antibiotics showed 25-30% resistance, Watch antibiotics 30-55%. Susceptibility to AWaRe Reserve antibiotics remains high; however, 32.8% were resistant to aztreonam. Overall, 190 (42.5%) were MDR and 99 (22.1%) XDR (first Nepali report) based on mainly non-respiratory samples. The majority of infected patients were >40 years (<i>n</i> = 229, 63.2%) or inpatients (<i>n</i> = 181, 50.0%); 36 (15.2%) had an unfavourable outcome, including death (<i>n</i> = 25, 10.5%). Our larger study showed a failure of improvement over eight previous studies covering 10 years.<h4>Conclusion</h4>Antibiotic resistance in <i>P. aeruginosa</i> occurred to all 19 AWaRe group antibiotics tested. Vulnerable patients are at significant risk from such resistant strains, with a high death rate. Sustainable and acceptable antibiotic surveillance and control are urgently needed across Nepal, as antimicrobial resistance has deteriorated over the last decade.

Item Type:	Article
Uncontrolled Keywords:	multidrug-resistant, extensively drug-resistant, adverse outcomes, operational research, infection control, MDR, XDR
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	05 Jan 2024 15:55
Last Modified:	05 Jan 2024 15:55
DOI:	10.5588/pha.21.0048
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3177651