The emergence of multidrug-resistant Pseudomonas aeruginosa in cystic fibrosis patients on inhaled antibiotics

• Published in: Lung India 2017-11, Vol.34 (6), p.527-531
• Main Authors: AbdulWahab, Atqah, Zahraldin, Khalid, Sid Ahmed, Mazen A, Jarir, Sulieman Abu, Muneer, Mohammed, Mohamed, Shehab F, Hamid, Jemal M, Hassan, Abubaker A I, Ibrahim, Emad Bashir
• Format: Article
• Language: English
• Subjects: Care and treatment; Cystic fibrosis; Drug therapy; Health aspects; inhaled antibiotics; Inhaled medication; Microbial drug resistance; Mortality; Multidrug resistant organisms; multidrug-resistant Pseudomonas aeruginosa; Mutation; Nosocomial infections; Original; Pathogens; Pseudomonas aeruginosa; Siblings
• ISSN: 0970-2113; 0974-598X; 0974-598X
• DOI: 10.4103/lungindia.lungindia_39_17

Multidrug-resistant Pseudomonas aeruginosa (MDR-PA) is an important and growing issue in the care of patients with cystic fibrosis (CF), and a major cause of morbidity and mortality. The objective of the study was to describe the frequency of MDR-PA recovered from the lower respiratory samples of pediatric and adult CF patients, and its antibiotic resistance pattern to commonly used antimicrobial agents including β-lactams, aminoglycosides, and fluoroquinolones. The lower respiratory isolates of P. aeruginosa were obtained from inpatients and outpatients CF clinics from a tertiary care teaching hospital for the period from October 2014 to September 2015. The identification and antimicrobial susceptibility for all the isolates were performed by using the BD Phoenix™ and E-test in compliance with Clinical and Laboratory Standards Institute (CLSI) guidelines. A total of 61 P. aeruginosa samples were isolated from thirty CF patients from twenty families. Twelve sputum samples were positive for MDR-PA (seven nonmucoid and five mucoid isolates) from five CF patients (five families) with moderate-to-very severe lung disease given MDR-PA frequency of 19.7%. The median age of the study group was 20 (range 10-30) years. Three CF patients were on chronic inhaled tobramycin and two on nebulized colistin. The antimicrobial patterns of isolates MDR-PA showed the highest rate of resistance toward each gentamycin, amikacin, and cefepime (100%), followed by 91.7% to ciprofloxacin, 75% to tobramycin, 58.3% to meropenem, and 50% to piperacillin-tazobactam. None of the isolates were resistant to colistin during the study period. The study results emphasize that the emergence of a significant problem in the clinical isolates of P. aeruginosa in CF patients that dictate appropriate attention to the antibiotic management after proper surveillance.