Antimicrobial resistance patterns of Pseudomonas aeruginosa in tertiary care hospitals of Makkah and Jeddah

BACKGROUND: The clinical significance of Pseudomonas aeruginosa has greatly increased due to its ability to rapidly develop resistance to major groups of antibiotics. OBJECTIVES: Our objective was to determine the pattern of antimicrobial resistance of P aeruginosa. DESIGN: Prospective, descriptive study. SETING: Four tertiary care hospitals in Makkah and Jeddah. METHODS: Clinical isolates of P aeruginosa were processed following standard microbiological procedures. A Microscan Walk Away system was used for the identification and antibiotic susceptibility of P aeruginosa isolates. MAIN OUTCOME MEASURES: Percentage of resistance of P aeruginosa to antibiotics. RESULTS: The overall drug resistance among 121 strains of P aeruginosa was low to moderate to commonly used anti-pseudomonal drugs (4.9% to 30.6%). Significantly less resistance was exhibited by piperacillin-tazobactam (4.9%; P<.05) and meropenem showed significantly high resistance (30.6%; P<.05) as compared to other antibiotics, followed by ticarcillin (22.3%) and imipenem (19%), irrespective of the site of infection. The antibiotics with <10% resistance were cefepime (8.3%), amikacin (7.4%) and piperacillin-tazobactam, which showed lowest resistance (4.9%). Although, data varied between hospitals, meropenem and ticarcillin had the highest drug resistance in all hospitals. Multidrug resistance was 10.7%. CONCLUSION: Low-to-moderate rates of drug resistance among P aeruginosa isolates were observed. Meropenem resistance was high irrespective of the site of infection. This pattern of resistance indicates probable overuse of broad-spectrum antibiotics like carbapenems. Overuse needs to be addressed by each institution, and consideration given to regulating use of broad-spectrum antibiotics. LIMITATIONS: Results cannot be generalized as the study did not include all tertiary hospitals in these cities.