Isolation and Identification of Multi-Drug Resistant Strains of Non-Lactose Fermenting Bacteria from Clinical Refuses in Major Hospitals of Khyber Pakhtunkhwa, Pakistan
Purpose: The present studied was performed in order to investigate the drug resistance of different non-lactose fermenting gram negative bacteria from clinical isolates. The bacteria were morphologically characterized through culturing and gram staining techniques were used for the identification of different bacterial strains. Methods: A total of 324 samples were collected from patients, after they were diagnosed by physicians at different hospitals at district Peshawar. Samples were morphologically identified by blood agar, MacConkey agar and Eosine Methylene Blue, identified by gram staining techniques. Modified Kirby-Bauer Disc diffusion method was used to test the in-vitro susceptibility of the identified isolates to different antibiotics. Results: The non-lactose fermenting gram negative bacteria were isolated from samples of blood (33.30%), pus/ wound (33.30%), urine (23.30%) and from ascetic/pleural fluids (10.20%). The study revealed that Pseudomonas aeroginosa showed high resistance against Gentamicin (74%) and Aztreonam (74%), followed by Ciprofloxacin (59.20%) and Amikacin (33.30). Tazocin was active as low resistance (18.50%) is shown. More resistance was seen in Morganella morganii against Aztreonam (77.7%) followed by Gentamicin (62.90%), Ciprofloxacin (40.70%). Tazocin show low resistance (3.70%). Multidrug resistant Proteus mirabillis was highly resistance to Gentamicin (66.60%), followed by Aztreonam (62.90%), Amikacin (55.50%), Ciprofloxacin (40.20%) and low resistance to Tazocin was (22.20%). Salmonella typhi demonstrated high resistance against Amikacin (62.90%), followed by Aztreonam (48.10%), Tazocin (40.70%). Gentamicin showed low resistance (29.60%), and hence it is more active against S. typhi. Conclusions: It can be concluded from the present study that different species of non-lactose fermenting gram negative bacteria have shown a different resistivity pattern. This study is a gate way for better and suitable management strategy for the infections caused by non-Lactose fermenting bacteria in the sampling region.
References
[1]
White, D.G., Hudson, C., Maurer, J.J. and Ayers, S. (2000) Characterization of Chloramphenicol and Florfenical Resistance in Escherichia coli Associated with Bovine Diarrhea. Journal of Clinical Microbiology, 38, 4593-4598.
[2]
Gokale, S.K. and Metgud, S.C. (2010) Characterization and Antibiotic Sensitivity Pattern of Non-Fermenting Gram Negative Bacilli from Various Clinical Samples in a Tertiary Care Hospital, Belgaum. Journal of Pharmaceutical and Biomedical Science, 17, 2230-7885.
[3]
Gowan Jr., Mc. and John, E. (2006) Resistance in Non-Fermenting Gram-Negative Bacteria: Multidrug Resistance to the Maximum. The American Journal of Medicine, 119, 29-36. http://dx.doi.org/10.1016/j.amjmed.2006.03.014
[4]
Moon, A.H. and Kamble, V.A. (2012) Comparative Studies on: Drug Resistance Patterns of Common Clinical Bacterial Isolates against Essential Oils and Commercial Antibiotics. Asiatic Journal of Biotechnology Resources, 3, 1447- 1454.
[5]
Zehra, A., Naqvi, B.S., Bushra, R. and Ali, S.Q. (2010) Comparative Study on Resistance Pattern of Different Pathogens against Cefixime and Cefepime. Jordan Journal of Pharmaceutical Science, 3, 145-156.
[6]
Masood, S.H. and Aslam, N. (2010) In Vitro Susceptibility Test of Different Clinical Isolates against Ceftriaxone. The Open Museum Journal, 25, 199-202. http://dx.doi.org/10.5001/omj.2010.56
[7]
Cheesbrough, M. (2000) District Laboratory Practice Manual in Tropical Countries Part 2. Cambridge University Press, Cambridge, 178-179.
[8]
Harley, J. and Prescott, L. (1990) Laboratory Exercises in Microbiology. Wm. C. Brown Publishers, 49-53.
[9]
Gloria, A., Cheryl, B., John, E., Richard, F., Joan, S.K., Tanja, P., Joy, W. and Scott, F.D. (2003) Manual for the Laboratory Identification and Antimicrobial Susceptibility Testing of Bacterial Pathogens of Public Health Importance in the Developing World. Centers for Disease Control and Prevention, Atlanta, and World Health Organization, Department of Communicable Disease Surveillance and Response, 103-118.
[10]
Roshan, M., Ikram, A., Mirza, I.A., Malik, N., Abbasi, S.A. and Alizai, S.A. (2011) Susceptibility Pattern of Extended Spectrum B-Lactamase Producing Isolates in Various Clinical Specimens. Journal of the College of Physicians and Surgeons, 21, 342-346.
[11]
Mahmod, A. (2000) Bacteriology of Surgical Site Infections and Antibiotic Susceptibility Pattern of the Isolates at a Tertiary Care Hospital in Karachi. Journal of Pakistan Medical Association, 50, 256-259.
[12]
Upgade, A., Prabhu, N., Gopi, V. and Soundararajan, N. (2012) Current Status of Antibiotic Resistant Non-Fermentative Gram Negative Bacilli among Nosocomial Infections. Advances in Applied Science Research, 3, 738-742.
[13]
Bhargavi, P.S., Gopala, R.T.V., Mukkanti, K., Dinesh, K.B. and Krishna, T.P. (2010) Increasing Emergence of Antibacterial Resistance Mainly in Uropathogens: Southeast Part of India. International Journal of Microbio Research, 2, 1-6.
[14]
Bhongle, N.N., Nagdeo, N.V. and Thombare, V.R. (2012) The Prevalence of Metallo β-Lactamases in the Clinical Isolates of Pseudomonas aeruginosa in a Tertiary Care Hospital: An Alarming Threat. Journal of Clinical Diagnose Research, 6, 1200-1202.
[15]
Anjum, F. and Mir, A. (2010) Susceptibility Pattern of Pseudomonas aeruginosa against Various Antibiotics. African Journal of Microbiology Research, 4, 1005-1012.
[16]
Javeed, I., Hafeez, R. and Anwar, M.S. (2011) Antibiotic Susceptibility Pattern of Bacterial Isolates from Patients Admitted to a Tertiary Care Hospital in Lahore. D Biomedica, 27, 19-23.
[17]
Singla, N., Kaistha, N., Gulati, N. and Chander, J. (2010) Morganella morganii Could Be an Important Intensive Care Unit Pathogen. Indian Journal of Critical Care Medicine, 14, 154-155. http://dx.doi.org/10.4103/0972-5229.74176
[18]
Lee, I.K. and Liu, J.W. (2006) Clinical Characteristics and Risk Factors for Mortality in Morganella morganii Bacteremia. Journal of Microbial Immunological Infection, 39, 328-334.
[19]
Saito, R., Okugawa, S., Kumita, W., Sato, K., Chida, T., Okamura, N., Moriya, K. and Koike, K. (2007) Clinical Epidemiology of Ciprofloxacin Resistant Proteus Mirabilis Isolated from Urine Samples of Hospitalized Patients. Clinical Microbiology and Infection, 13, 1204-1206. http://dx.doi.org/10.1111/j.1469-0691.2007.01826.x
[20]
Jombo, G.T.A., Emanghe, U.E., Amefule, E.N. and Damen, J.G. (2012) Nosocomial and Community Acquired Uropathogenic Isolates of Proteus Mirabilis and Antimicrobial Susceptibility Profiles at a University Hospital in Sub-Saharan Africa. Asian Pacific Journal of Tropical Disease, 2, 7-11.
[21]
Nagshetty, K., Shivannavar, T., Channappa and Gaddad, S.M. (2010) Antimicrobial Susceptibility of Salmonella typhi in India. Journal of Infection in Developing Countries, 4, 70-73.
[22]
Hasan, R., Zafar, A., Abbas, Z., Mahraj, V. and Malik, F. (2008) Zaidi A. Antibiotic Resistance among, Serovars Typhi and Paratyphi A in Pakistan (2001-2006). Journal of Infection in Developing Countries, 2, 289-294.
http://dx.doi.org/10.3855/jidc.224
[23]
Satti, L., Abbasi, S., Qumar, T.A., Khan, M.S. and Hashmi, Z.A. (2010) In Vitro Efficacy of Cefepime against Multi- Drug Resistant Pseudomonas aeruginosa, an Alarming Situation in our Setup. The Open Drug Resistance Journal, 1, 12-16. http://dx.doi.org/10.2174/1876521101101010012
[24]
Rajat, R.M., Ninama, G.L., Kalpesh, M., Rosy, P., Kanu, P. and Vegad, M.M. (2012) Antibiotic Resistance Pattern in Pseudomonas aeruginosa Species Isolated at a Tertiary Care Hospital, Ahmadabad. National Journal of Medical Research, 2, 156-159.
[25]
Romão, C.M.C.P.A., Faria, Y.N.D., Pereira, L.R. and Asensi, M.D. (2006) Susceptibility of Clinical Isolates of Multi Resistant Pseudomonas aeruginosa to a Hospital Disinfectant and Molecular Typing. Mem Inst Oswaldo Cruz, Rio de Janeiro, 100, 541-548.
[26]
Falagas, M.E., Kavvadia, P.K., Mantadakis, E., Kofteridis, D.P., Bliziotis, I.A., Saloustros. E., Maraki, S. and Samonis, G. (2005) Morganella morganii Infections in a General Tertiary Hospital. Infection, 34, 315-321.
[27]
Xiao-Bo, M., Xiao-Ju, L., Li-Yuan, M., Hui-Li, C., Wen-Zhao, C., Xiao-Jingo, G., Chuan-Min, T. and Zhi-Xing, C. (2008) Antimicrobial Susceptibility Analysis of Ninety-One Clinical Isolates of Morganella morganii. Chinese Journal of Antibiotics.
[28]
Akinyemi, K.O., Smith, S.I., Oyefolu, A.O.B. and Coker, A.O. (2005) Multidrug Resistance in Salmonella enterica serovar typhi Isolated from Patients with Typhoid Fever Complications in Lagos, Nigeria. Public Health, 119, 321-327.
http://dx.doi.org/10.1016/j.puhe.2004.04.009
[29]
Islam, M.J., Das, K.K., Sharmin, N., Hasan, M.N. and Azad, A.K. (2008) Antimicrobial Susceptibility of Salmonella Serovars Isolated from Blood. Journal of Innovative Development Strategy, 2, 22-27.
[30]
Pokhare, B.M., Koirala, J., Daha, R.K., Mishra, S.K., Khadga, P.K. and Tuladhar, N.R. (2006) Multidrug-Resistant and Extended-Spectrum Beta-Lactamase (ESBL)-Producing Salmonella enterica (Serotypes Typhi and Paratyphi A) from Blood Isolates in Nepal: Surveillance of Resistance and a Search for Newer Alternatives. International Journal of Infectious Diseases, 10, 434-443. http://dx.doi.org/10.1016/j.ijid.2006.07.001