In vitro antibiotic resistance patterns of Pseudomonas spp. isolated from clinical samples of a hospital in Madinah, Saudi Arabia

Pseudomonas spp. are the leading cause of nosocomial infections. Rise in multidrug resistance among clinical isolates limit therapeutic options and hence increase mortality rate. Clinical samples (6840) from a hospital in Madinah, Saudi Arabia were collected for a duration of 14 months to study the frequency, antimicrobial sensitivity pattern and seasonal variations of Pseudomonas isolates. Conventional biochemical tests were done to identify the probable organism and antibiotic susceptibility was performed by disc diffusion method and Phoenix automated microbiology 100 ID/AST system. Pseudomonas represented 6.5% of all positive samples of which 65% were from males. Majority of the organisms (85%) were isolated from sputum and wound swabs followed by catheter tips (6.4%) and throat aspirates (3.4%). From the remaining samples, less than 1% organisms were obtained. Assessment of antimicrobial susceptibility to 11 different antibiotics revealed that imipenem was the most effective with highest sensitivity of 99.5%, and low intermediate resistance of only 0.5%. This was followed by ciprofloxacin (97.5%), ceftazidime (96.3%), cefpiramide/amikacin (94.1%), aztreonam (93.2%), gentamycin (87.7%), ampicillin (83%), and cotrimoxazole (80.1%). The most resistant drugs included augmentin (25%), cotrimoxazole (19.9%), ampicillin (17%) and gentamycin (12.3%) while the least resistant were ciprofloxacin (1.5%) and imipenem (0%). Results recommend imipenem as a promising antibiotic against Pseudomonas infections. In case of resistance to imipenem, ciprofloxacin, ceftazidime, cefpiramide, amikacin, and aztreonam may be recommended. In acute cases, Pseudomonas infections may require combined antimicrobial therapy. Frequency of these infections was the lowest (17%) during spring. It was the highest (30%) during summers and winters but reduced to 22% during autumn maybe due to better hygiene during pilgrimage season.