title: Incidence of multidrug resistant pseudomonas aeruginosa isolated from burn patients and environment of teaching institution.
abstract: BACKGROUND
  Pseudomonas aeruginosa is an important pathogen which causes nosocomial infections in immunocompromised patients, especially in hospitalized burn patients. In recent times, it has emerged as a widespread Multi Drug Resistant (MDR) pathogen which requires antibiotic susceptibility testing on a regular as well as a periodic basis.
  
  
  OBJECTIVE
  The present study was undertaken to determine the antibiogram of P. aeruginosa which was isolated from inpatients and environmental sources, and to type the strains, based on their antibiogram patterns.
  
  
  METHODS
  A prospective study was undertaken with 525 samples (blood and wound swabs) which were taken from 60 patients who were admitted to Vardhman Mahavir Medical College and Safdarjang hospital with burn injuries and with 101 samples which were obtained from environmental sources viz. surgical instruments, dressings, suction devices, sinks, antiseptic solutions, etc.
  
  
  METHODS
  The strains were cultured and identified by standard microbiological techniques and Kirby- Bauer disc diffusion antibiotic susceptibility testing was done for each.
  
  
  METHODS
  Chi -squire tests were done and p- values of less than 0.05 were considered to be significant.
  
  
  RESULTS
  Fifty six strains and two strains, respectively, of P. aeruginosa were isolated from inpatients and environmental samples (one strain from sink and one strain from door wall, among the two) respectively. In total, 58 (81%) P. aeruginosa strains were found to be resistant to aminoglycosides, 41-70% were resistant to beta-lactams - piperacillin, ceftazidime, and aztreonam, 34.5% were resistant to piperacillin-tazobactam, 12.06% were resistant to ciprofloxacin and 13-19% were resistant to carbapenems. All strains were sensitive to colistin. P. aeruginosa was resistant to three of the four 'in-use' drugs i.e. piperacillin+tazobactam, imipenem, ceftazidime, and gentamicin, which was taken as MDR, which depicted MDR percentage as 36.2 (21/58).
  
  
  CONCLUSIONS
  Strategies of optimal prescribing, including control of antibiotic usage, coupled with periodic studies on MDR P. aeruginosa infections in burn patients, appear to be leading priorities which help in improving therapeutic gains in such patients.
authors.affiliation: Senior Resident, Department of Microbiology, Delhi State Cancer Institute , Dilshad Garden, New Delhi, India .
authors.forename: Indu
authors.initials: I
authors.lastname: Biswal
authors.affiliation: Professor, Department of Microbiology, Vardhman Mahavir Medical College & Safdarjang Hospital , New Delhi, India .
authors.forename: Balvinder Singh
authors.initials: BS
authors.lastname: Arora
authors.affiliation: Associate Professor, Department of Microbiology, Vardhman Mahavir Medical College & Safdarjang Hospital , New Delhi, India .
authors.forename: Dimple
authors.initials: D
authors.lastname: Kasana
authors.affiliation: Senior Resident, Department of Microbiology, Hindu Rao Medical College & Hospital , Delhi, India .
authors.lastname: Neetushree
keywords: Antibiotyping; Multidrug resistance; Pseudomonas aeruginosa