COMPARISON OF IN VITRO ACTIVITY OF COLISTIN WITH CEFTOLOZANE/TAZOBACTAM AGAINST MULTI DRUG RESISTANT PSEUDOMONAS AERUGINOSA “A LAST LINE TREATMENT AGAINST MDR”
Abstract
Objectives
To evaluate and compare in vitro activity of Ceftolazane / Tazobactum and Colistin against Multi Drug Resistant (MDR) strains of Pseudomonas aeruginosa.
Methodology
After ethical approval this in vitro cross-sectional study was conducted from October 2017 to April 2018. Routine samples of pus, wound swabs, blood, tracheal aspirates and urine were collected and received from the in-patient and out-patient clinics. All the samples were submitted for culture and sensitivity testing at the microbiology laboratory of Ziauddin University Hospital, North Nazimabad campus. All the samples were processed according to the provided microbiological procedures, CLSI Guidelines 2018.
Results
Forty sample from the out-patient clinics represented pre-dominance of Multi Drug Resistant strains of Pseudomonas aeruginosa (which was found to be 41.2%). On culture and sensitivity testing, it was observed that 60% of the MDR strains of P. aeruginosa were susceptible to Ceftolazane / Tazobactum which was markedly comparable to the susceptibility shown by Colistin (99%).Statistically, P value was highly significant and was found to be 0.0001.
Conclusion
Colistin showed superior activity as compared to Ceftolazane / Tazobactum against MDR isolates of P. aeruginosa. Thus, Colistin has proven to be a possible and important alternative against MDR isolates of P. aeruginosa, but due to its narrow therapeutic window and toxicity profile this drug can be used only when there is no working alternative, or the infection is severely debilitating.
References
Bekele, T., Tesfaye, A., Sewunet, T., & Waktola, H. D. (2015). Pseudomonas aeruginosa isolates and their antimicrobial susceptibility pattern among catheterized patients at Jimma University Teaching Hospital, Jimma, Ethiopia. BMC research notes, 8(1), 488.
Buke, C., Hosgor-Limoncu, M., Ermertcan, S., Ciceklioglu, M., Tuncel, M., Köse, T., Eren, S. (2005). Irrational use of antibiotics among university students. Journal of infection. 51(2), 135-9.
Cox, C. D., & Parker, J. (1979). Use of 2-aminoacetophenone production in identification of Pseudomonas aeruginosa. Journal of clinical microbiology, 9(4), 479-484.
Cross, A., Allen, J. R., Burke, J., Ducel, G., Harris, A., John, J., ... & Skalova, R. (1983). Nosocomial infections due to Pseudomonas aeruginosa: review of recent trends. Reviews of infectious diseases, 5(Supplement_5), S837-S845.
Evans, M. E., Feola, D. J., & Rapp, R. P. (1999). Polymyxin B sulfate and colistin: old antibiotics for emerging multiresistant gram-negative bacteria. Annals of Pharmacotherapy, 33(9), 960-967.
El Baze, P., Thyss, A., Vinti, H., Deville, A., Dellamonica, P., & Ortonne, J. P. (1991). A study of nineteen immunocompromised patients with extensive skin lesions caused by Pseudomonas aeruginosa with and without bacteremia. Acta dermato-venereologica, 71(5), 411.
Farooq, L., Memon, Z., Ismail, M. O., & Sadiq, S. (2019). Frequency and antibiogram of multi-drug resistant pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan. Pakistan journal of medical sciences, 35(6), 1622.
Gill, M. M., Usman, J., Kaleem, F., Hassan, A., Khalid, A., Anjum, R., & Fahim, Q. (2011). Frequency and antibiogram of multi-drug resistant Pseudomonas aeruginosa. J Coll Physicians Surg Pak, 21(9), 531-534.
Haley, C. L., Colmer-Hamood, J. A., & Hamood, A. N. (2012). Characterization of biofilm-like structures formed by Pseudomonas aeruginosa in a synthetic mucus medium. BMC microbiology, 12(1), 181.
Kielhofner, M., Atmar, R. L., Hamill, R. J., & Musher, D. M. (1992). Life-threatening Pseudomonas aeruginosa infections in patients with human immunodeficiency virus infection. Clinical infectious diseases, 14(2), 403-411.
Kerem, E., Corey, M., Gold, R. T., & Levison, H. (1990). Pulmonary function and clinical course in patients with cystic fibrosis after pulmonary colonization with Pseudomonas aeruginosa. The Journal of pediatrics, 116(5), 714-719.
Kalantar, E., Torabi, V., Salimizand, H., Soheili, F., Beiranvand, S., & Dallal, M. M. S. (2012). First Survey of metallo-β–lactamase producers in clinical isolates of Pseudomonas aeruginosa from a referral burn center in Kurdistan province. Jundishapur journal of natural pharmaceutical products, 7(1), 23.
Kattel, H. P., Mishra, S. K., Acharya, J., Sigdel, M. R., Prasad, N., Shah, A. S. S., ... & Pokhrel, B. M. (2012). Antibiotic sensitivity profile of different uropathogens in a tertiary care center in Nepal. Journal of Nepal Association of Medical Laboratory Science, 11(1), 19-33.
Levy, S. B. (2002). Factors impacting on the problem of antibiotic resistance. Journal of Antimicrobial Chemotherapy, 49(1), 25-30.
Landersdorfer, C. B., & Nation, R. L. (2015, February). Colistin: how should it be dosed for the critically ill?. In Seminars in respiratory and critical care medicine (Vol. 36, No. 01, pp. 126-135). Thieme Medical Publishers.
Mahmoud, A. B., Zahran, W. A., Hindawi, G. R., Labib, A. Z., & Galal, R. (2013). Prevalence of multidrug-resistant Pseudomonas aeruginosa in patients with nosocomial infections at a university hospital in Egypt, with special reference to typing methods. J Virol Microbiol, 13, 165-59.
Mittal, R., Aggarwal, S., Sharma, S., Chhibber, S., & Harjai, K. (2009). Urinary tract infections caused by Pseudomonas aeruginosa: a minireview. Journal of infection and public health, 2(3), 101-111.
Pfaller, M. A., Shortridge, D., Sader, H. S., Flamm, R. K., & Castanheira, M. (2017). Ceftolozane–tazobactam activity against drug-resistant Enterobacteriaceae and Pseudomonas aeruginosa causing healthcare-associated infections in Australia and New Zealand: Report from an Antimicrobial Surveillance Program (2013–2015). Journal of global antimicrobial resistance, 10, 186-194.
Rossolini, G. M., & Mantengoli, E. (2005). Treatment and control of severe infections caused by multiresistant Pseudomonas aeruginosa. Clinical Microbiology and infection, 11, 17-32.
Trautmann, M., Halder, S., Hoegel, J., Royer, H., & Haller, M. (2008). Point-of-use water filtration reduces endemic Pseudomonas aeruginosa infections on a surgical intensive care unit. American journal of infection control, 36(6), 421-429.
Venier, A. G., Leroyer, C., Slekovec, C., Talon, D., Bertrand, X., Parer, S., ... & Clair, B. (2014). Risk factors for Pseudomonas aeruginosa acquisition in intensive care units: a prospective multicentre study. Journal of Hospital Infection, 88(2), 103-108.
Ventola, C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. Pharmacy and therapeutics, 40(4), 277.
Wolinsky, E., & Hines, J. D. (1962). Neurotoxic and nephrotoxic effects of colistin in patients with renal disease. New England Journal of Medicine, 266(15), 759-762.
Yuliandra, Y. (2017). Antibacterial Resistance Pattern of Pseudomonas Aeruginosa Isolated from Clinical Samples at A General Hospital in...
Copyright (c) 2020 K. M. Anwarul Islam, Muhammad Aitmaud Uddolah Khan, Sara Azhar, Muhammad Rashid Ahmed, Sumreen Khurram, Hina Masood, Lubna Farooq
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