250267 Prevalence of multi drug resistant Pseudomonas aeruginosa in the Intensive Care Unit (ICU) patients and its association with indoor environment in Tertiary care hospital in Nepal

Tuesday, November 1, 2011

Menuka Karki , Department of Biology, New Mexico State University, Las Cruces, NM
Bharat Mani Pokharel , Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Dwij Raj Bhatta , Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
Upendra Devkota , Department of Neurology, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
P. aeruginosa is a gram negative bacterium responsible for several nosocomial infections in highly immunocompromised patients in ICU. In order to determine the prevalence and the source of transmission of P. aeruginosa in the clinical specimens of suspected patients admitted for more than 48 hours in the ICU of a Nepalese hospital, a six month cross sectional microbial study was undertaken. Different clinical and environmental samples from ICU were collected and further studied for microbial identification. Several biochemical and drugs susceptibility tests were successfully performed to determine the association between clinical and environmental isolates of P. aeruginosa. Lastly, the comparative statistical analysis was evaluated by Chi Square test. P. aeruginosa was detected in 248 (61.39%) of a total of 404 positive clinical specimens and 219 (38.97%) of 562 positive environmental samples. Antibiotic Susceptibility Test demonstrated that 84.68% of the clinical and 100% of the environmental isolates were found to be sensitive to Imipenem. Surprisingly, 19 (7.66%) of the clinical isolates later developed resistant against most of the prescribed drugs for the treatment of P. aeruginosa, however, susceptible with Polymyxin B. Significant relatedness (p<0.05) was observed between these isolates by the statistical analysis as well. This study signified that the environment of ICU (animate and inanimate) serves as a potent source of P. aeruginosa and associated infections to the ICU patients. Strict adherence to proper microbial control guidelines and regular monitoring of antimicrobial susceptibility would be the essential steps to eliminate possible outbreaks of P. aeruginosa in the ICU.

Learning Areas:
Basic medical science applied in public health
Environmental health sciences
Public health biology

Learning Objectives:
Discuss emerging drug resistant bacteria in Intensive care unit (ICU) of tertiary care hospital in Nepal Discuss the role of environment in transmission of pathogen to the patients

Keywords: Antibiotic Resistance, E Code

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I did this work as a part of my MS thesis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.