AMB Volume 40, Issue 4, 2024 Pages 457-467 https://doi.org/10.59393/amb24400405
Carbapenemase-Producing Pseudomonas aeruginosa Isolates: Prevalence and Their Phenotypic Characteristics in Four Health Facilities in Calabar, Nigeria
Eyo A-A., Udoh D., Umoh N., Ogba O., Ibeneme E., Asuquo A.
Emergence of multi-drug-resistant Pseudomonas aeruginosa is one of the challenging problems of antimicrobial chemotherapy which has become a global public health concern. This cross-sectional study was designed to determine the antibiotic resistance profile of this important pathogen and the prevalence of carbapenemase-producing P. aeruginosa strains isolated in four hospitals in Calabar Metropolis. Three hundred and twelve suspected P. aeruginosa strains non-repetitively isolated from different clinical specimens in four hospitals were characterized and re-identified with the Microgen™ GNA+B-ID system. Antimicrobial susceptibility testing was performed using the disc diffusion method. Phenotypic tests for the detection of extended-spectrum beta-lactamases (ESBLs), inducible cephalosporinases (AmpC), and carbapenemases by Carba NP test were performed following CLSI guidelines. P. aeruginosa ATCC 27853 was used for quality control. Overall prevalence of confirmed P. aeruginosa was 63.14% (197/312). Of these 197 isolates, 31.47% produced AmpC and 41.12% produced ESBLs. Thirty (15.23%) P. aeruginosa isolates produced carbapenemases, which comprised 40.0% (12/30) Class A and 60.0% (18/30) Class B metallo-beta-lactamase (MBL). Significant multidrug resistance >70% was observed among the isolates. Analysis of the risk factors showed strong associations between carbapenemase-producing Pseudomonas aeruginosa-related infections and hospitalization (p = 0.03), surgery (p = 0.03), and intensive care wards (p = 0.04). The study revealed a significant burden of multidrug-resistant strains of carbapenemase-producing Pseudomonas aeruginosa in Calabar Metropolis. To avert an impending public health crisis due to the spread of these strains, hospital infection control units must be established as a matter of policy for adequate surveillance and antimicrobial stewardship.
Keywords: Pseudomonas aeruginosa, antibiotic resistance, carbapenemase-production, AmpC, ESBL, MBL
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