title: Prevalence of Extended Spectrum β-Lactamase and Antimicrobial Susceptibility Pattern of Clinical Isolates of Pseudomonas from Patients of Khyber Pakhtunkhwa, Pakistan.
abstract: Majority of gram negative pathogenic bacteria are responsible for extended spectrum β-lactamases (ESBLs) production, which show resistance to some newer generation of antibiotics. The study was aimed at evaluating the prevalence of ESBL and antibiotic susceptibility pattern of Pseudomonas isolates collected during 2010 to 2014 from tertiary care hospitals of Peshawar, Pakistan. Out of 3450 samples, 334 Pseudomonas spp. isolates comprised of 232 indoor and 102 outdoor patients were obtained from different specimens and their susceptibility pattern was determined against 20 antibiotics. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer agar diffusion method and ESBL production was detected by Synergy Disc Diffusion technique. The mean age group of the patients was 29.9 + 9.15 years. Meronem showed best activity (91.02%) from class carbapenem, β-lactam and β-lactamase inhibitors exhibited 69.16% activity, and doxycycline had a diminished activity (10.18%) to Pseudomonas spp. Outdoor isolates were more resistant than the indoor and during the course of the study the sensitivity rate of antibiotics was gradually reducing. ESBL production was observed in 44.32% while the remaining was non-ESBL. The moderate active antibiotics were amikacin (50.7%), SCF (51.4%), TZP (52.7%), and MXF (54.1%) among ESBL producing isolates. Lack of antibiotic policy, irrational uses (3GCs particularly), and the emergence of antibiotic resistant organisms in hospitals may be causes of high antibiotic resistance.
authors.affiliation: Department of Biochemistry, Faculty of Health Sciences, Hazara University, Mansehra, Khyber Pakhtunkhwa 21120, Pakistan.
authors.forename: Manzoor
authors.identifier: 0000-0002-1830-4964
authors.initials: M
authors.lastname: Ahmad
authors.affiliation: Department of Biochemistry, Faculty of Health Sciences, Hazara University, Mansehra, Khyber Pakhtunkhwa 21120, Pakistan.
authors.forename: Mukhtiar
authors.initials: M
authors.lastname: Hassan
authors.affiliation: Department of Biochemistry, Faculty of Health Sciences, Hazara University, Mansehra, Khyber Pakhtunkhwa 21120, Pakistan; Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad 22060, Pakistan.
authors.forename: Anwar
authors.identifier: 0000-0002-5668-7986
authors.initials: A
authors.lastname: Khalid
authors.affiliation: University College of Pharmacy, University of Punjab, Lahore 54000, Pakistan.
authors.forename: Imran
authors.initials: I
authors.lastname: Tariq
authors.affiliation: Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad 22060, Pakistan.
authors.forename: Muhammad Hassham Hassan Bin
authors.initials: MH
authors.lastname: Asad
authors.affiliation: Department of Biochemistry, Faculty of Health Sciences, Hazara University, Mansehra, Khyber Pakhtunkhwa 21120, Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Samad
authors.affiliation: Department of Environmental Sciences, COMSATS Institute of Information Technology, Abbottabad 22060, Pakistan.
authors.forename: Qaisar
authors.initials: Q
authors.lastname: Mahmood
authors.affiliation: Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad 22060, Pakistan.
authors.forename: Ghulam
authors.identifier: 0000-0001-5649-5768
authors.initials: G
authors.lastname: Murtaza
mesh_terms: D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002470:Cell Survival / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D011549:Pseudomonas / Q000145:classification / Q000187:drug effects* / Q000201:enzymology*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D012307:Risk Factors; D017678:Sex Distribution; D013045:Species Specificity; D018440:beta-Lactam Resistance / Q000187:drug effects; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases