title: Prevalence of Multidrug-resistant, Extensively Drug-resistant, and Pandrug-resistantPseudomonas aeruginosafrom a Tertiary Level Intensive Care Unit.
abstract: BACKGROUND
  Infection byPseudomonas aeruginosais common in the Intensive Care Unit (ICU), leading to increased morbidity and mortality. The organism is classified into various phenotypes based on the drug resistance pattern, namely, drug-resistant (DR), multi-DR (MDR), extensively DR (XDR), and pan-DR (PDR). We aim to study the incidence ofP. aeruginosaphenotypes in a tertiary level ICU.
  
  
  METHODS
  We conducted this prospective, observational study for 2 years (January 2014-December 2015) and collected appropriate clinical samples (blood, urine, wound discharge, etc.,) from all the patients admitted to ICU. We excluded patients with known septicemia andP. aeruginosainfection. Group 1 comprised a total 1915 patient samples and Group 2 comprised 100 active surveillance samples, collected from the medical staff and the hospital environment. The data were analyzed using appropriate statistical methods, and aP< 0.05 was considered statistically significant.
  
  
  RESULTS
  We isolated 597 pathogenic bacteria out of 1915 specimens, giving a culture positivity rate of 31.2%.Klebsiella(43%),Acinetobacter(22%), andP. aeruginosa(15%) were the top three isolated bacteria. None of the surveillance samples grewP. aeruginosa. Antibiotic resistance studies revealed that 47.7% ofP. aeruginosaisolates were DR, 50% were MDR, and 2.3% were XDR phenotype. None of the strains showed PDR phenotype.
  
  
  CONCLUSIONS
  Our data revealed a high prevalence of DR phenotypes ofP. aeruginosain the ICU. Judicious use of antibiotics and strict infection control measures are essential to reduce the prevalence of drug resistance.
authors.affiliation: Department of Microbiology, AFMC, Pune, India.
authors.forename: J S
authors.initials: JS
authors.lastname: Gill
authors.affiliation: Department of Pathology, Command Hospital, Chandimandir, Haryana, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Arora
authors.affiliation: Department of Pathology, Command Hospital, Chandimandir, Haryana, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Khanna
authors.affiliation: Department of Endocrinology, Army Hospital (R and R), Delhi, India.
authors.forename: Kvs Hari
authors.initials: KH
authors.lastname: Kumar
keywords: Drug resistance; Intensive Care Unit; Pseudomonas aeruginosa; multidrug-resistant phenotype