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

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.