A 3-year study of Infection Profile and Anti-Microbial Resistance of Pseudomonas aeruginosa Isolated from various clinical samples at a tertiary care hospital in Bangladesh

Author(s): Sanjida Khondakar Setu, Abu Naser Ibne Sattar, Sanjar Taufiq, Md. Towfique Hasan Firoz, Sifat Noor, Chowdhury Rafia Naheen

Background: Pseudomonas aeruginosa is widely recognized as a significant contributor to hospital and community-acquired infections. These bacteria exhibit resistance to numerous antibiotics through both intrinsic and acquired mechanisms, complicating treatment efforts. Therefore, ongoing monitoring of infection rates and antibiotic resistance patterns is essential to effectively select appropriate therapeutic options.

Methods: This retrospective cross-sectional study was carried out at a tertiary care hospital in Bangladesh, focusing on Pseudomonas aeruginosa isolates identified between 2022 to 2024 at Bangladesh Medical University, Dhaka. All clinical isolates were incubated at 37 °C for 24 hours in various media, including 5% sheep blood agar, MacConkey agar, and chromogenic agar media based on types of clinical samples. The identification of bacterial species and their antibiotic susceptibility profiles were assessed using the Vitek-2 automated system from bioMérieux. Data were analyzed systematically using SPSS version 27, developed by IBM in Chicago. Descriptive statistics were employed to determine frequencies and percentages, while trends were assessed through a one-sample Chi-square test.

Results: Throughout the three years, a total of 102096 specimens, including sputum, blood, pus, urine, throat swab, wound swab, tracheal aspirate, catheter tip and endotracheal tubes, were analyzed. The yearly isolation rates of Pseudomonas aeruginosa showed a significant increase (p-value <0.05), with 510 (21.95%) isolates in 2022, 718 (30.90%) in 2023, and 1095(47.13%) in 2024. Notably, resistance rates to cefoprazole-sulbactam, piperacillin-tazobactam exhibited a significant decline (p-value <0.05), although the overall resistance to ceftazidime remained concerning at 59.62%. The reduction in multidrug-resistant (MDR) isolates was statistically significant over the three years, with counts of 27.65%, 16.63%, and 12.89% in 2022, 2023, and 2024, respectively (p-value <0.05).

Conclusion: The incidence of Pseudomonas aeruginosa infections is on the rise, yet there has been a gradual decline in both resistant and MDR isolates from 2022 to 2024, indicating a positive trend. Further investigation is necessary to identify and promote the factors contributing to this improvement.