Carbapenemase-producing Pseudomonas aeruginosa isolated from patients exhibited multidrug resistance in Sokoto, Nigeria

Abstract

Introduction

Carbapenemase-producing P. aeruginosa is one of the top priority pathogens responsible for treatment failures in cystic fibrosis, abscess and soft tissue infections. The study aimed to determine the prevalence of carbapenemase-producing P. aeruginosa in patients visiting two major public hospitals in Sokoto, Nigeria.

Methods

Two hundred and four samples were collected from in- and outpatients attending two major public hospitals in Sokoto, Nigeria. Identifying P. aeruginosa involved culturing on cetrimide agar and confirming by PCR detection of the oprI and oprL genes specific to P. aeruginosa. Isolates were screened for sensitivity to ten antibiotics using the Kirby-Bauer disc diffusion test. To identify carbapenemase production, isolates resistant to meropenem and imipenem were further screened using the combined disc synergy test. Molecular detection of carbapenemase was done using PCR detection of bla_VIM, bla_KPC and bla_IMP genes.

Results

Out of the 204 samples collected, 26 (12.7 %) of P. aeruginosa were recovered. All 26 isolates demonstrated resistance to more than three classes of antibiotics tested. Notably, 19.2 % (5/26) of the isolates were pan-drug-resistant to all antibiotics tested. Besides, 65.4 % (14/26) of isolates were at least resistant to ampicillin, kanamycin, cefotaxime, trimethoprim and chloramphenicol. A combined disk synergy test showed six isolates to produce carbapenemase enzyme. Likewise, bla_VIM and bla_IMP were detected in all of these isolates, while bla_KPC was not detected in any.

Conclusions

The presence of carbapenemase-producing P. aeruginosa (carrying bla_VIM and bla_IMP genes) among hospital patients in Sokoto and the high antibiotic resistance detected represent a challenging threat to public health. Further research is crucial to understanding this carbapenemase gene's transmission source and developing effective strategies to combat it.