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Objective: Pseudomonas aeruginosa is a common cause of nosocomial infections worldwide. Increasing in the emergence and spread of multidrug-resistant (MDR) strains is a serious health concern. The aim of the present study was to determine the antibiotic resistance pattern of P. aeruginosa isolated from clinical samples. Materials and Methods: The current retrospective cross-sectional study was conducted at a tertiary-care hospital in Oman. The data of P. aeruginosa isolates identified during 2015-2019 at Sohar Hospital were retrieved from Al-Shifa computerized data system. The data were systematically analyzed using SPSS 22 software system, IBM Chicago. Descriptive statistics were applied to find frequencies and percentages. Trends were analyzed using a one-sample Chi-square test. Results: A total of 5865 P. aeruginosa strains identified in clinical samples of 4024 patients were studied. The frequency of isolation of P. aeruginosa was more among people aged >60 years (33%). The rate of isolation was significantly high (47%) in pus/wound swabs. The overall resistance of P. aeruginosa was low to moderate (10%-30%) to commonly used anti-pseudomonal drugs. Among, 10% were MDR strains. The lowest resistance (10%) was observed to piperacillin-tazobactam (TAZP), while significantly high resistance (29%-30%) was exhibited by carbapenems. Furthermore, strains isolated from respiratory secretions and urine samples have shown a significantly high percentage of resistance compared to others. Conclusions: Piperacillin-tazobactam is recommended as the drug of choice for treating especially severe Pseudomonas infections. Moderate resistance to carbapenems is an alarming sign. This pattern of resistance suggests the probable overuse of drugs. Therefore, it emphasizes strict antibiotic policy, rapid detection, and continuous monitoring of drug-resistant strains, and timely dissemination of the resistant report to clinicians. [ABSTRACT FROM AUTHOR]

Urinary tract infection is one of the most common infectious diseases worldwide. This study aimed to determine the frequency of Urinary tract infections, identify the microorganisms involved, and determine the antibiotic resistance pattern of Escherichia coli. Conventional biochemical techniques identified isolates. The antibiogram was produced using the Muller-Hinton agar disc diffusion method according to the recommendations of the Antibiotic Committee of the French Microbiology Society. During the study period, 21. 4% of the samples were identified as positive. The microorganisms isolated were: Escherichia coli (47%), Klebsiella pneumoniae (19%) followed by Trichomonas vaginalis (9%), Candida albicans, and Pseudomonas sp (8%). Finally, Staphylococcus aureus and Proteus rettgeri represent 4% of isolates. The dominant resistance of E.coli was to amoxicillin and ticarcillin (55%) followed by cefalotine (39%). Resistance to fluoroquinolones was 27% (norfloxacin). The amikacin and gentamicin resistance rates were 12.5%, and 10.5% respectively. The resistance to the third-generation cephalosporins (ceftazidime, cefotaxime) was 10.5%. E. coli were resistant to nitrofurantoin and fosfomycin with percentages of 10.5%, and 6.6% respectively. However, the resistance to imipenem does not exceed 2%. Increasing rates of E.coli antibiotic resistance indicate that careful monitoring of their use is necessary. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is a bacteria which can live in freshwater, soil and plants. It is a commensal of the digestive tube, slightly abundant in human body. Its presence in wells water is a result of current anthropogenic activity and pollution loads. It is an important nosocomial pathogenic agent characterized by an intrinsic resistance to multiple antimicrobial agents which can develop high-level multidrug resistance. To assess the contamination of these well waters by this pathogenic germ, two hundred samples were collected for four seasonal campaigns between March 2017 and May 2018 with a rate of forty three (43) samples per season in an irrigated zone. The samples were analysed to identify P. aeruginosa, then the isolated serotypes were determined by slid agglutination test using four pools and 20 monovalent Antisera. The detected P. aeruginosa were tested for susceptibility to 18 antibiotics. A total of (n=85/139) isolated strains were identified as P. aeruginosa representing 61.15 % of prevalence among Pseudomonas spp. Antimicrobial resistance revealed that 68% of them are multidrug resistant, while15.09 % of strains resist at least to 7 antibiotics, 30.19% resist at least to 11 antibiotics, 13.21% resist at least to 12 antibiotics, 5.66% resist at least to 13 antibiotics, and 3.77% resist at least to 14 antibiotics. The high level resistance of P. aeruginosa is observed with piperacillin tazobactam (100/10µg) (84.91%), ciprofloxacin (5µg) (79.25%), imipenem (10µg) and ceftazidime (30μg) (37.58%). The resistance of phenotypes of P. aeruginosa strains allowed to identify (n=20/85) ESBL, (n=31/85) oxacillinase broad spectrum ES-OXA, (n=5/85) phenotype of impermeability to imipenem, (n=12/85) cephalosporinase AMPC, and (n=17/85) wild type. The results showed the high antibiotic resistance levels of P. aeruginosa strains from well water samples against antibiotics. Furthermore, based on the results, these well waters can be a source of P. aeruginosa and human and animal susceptibility to other opportunistic pathogens. [ABSTRACT FROM AUTHOR]

The production of diverse and extended spectrum β-lactamases among Escherichia coli and ESKAPE pathogens is a growing threat to clinicians and public health. We aim to provide a comprehensive analysis of evolving trends of antimicrobial resistance and β-lactamases among E. coli and ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acine to bacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) in the Arabian region. A systematic review was conducted in Medline PubMed on papers published between January 2000 and February 2020 on countries in the Arab region showing different antibiotic resistance among E. coli and ESKAPE pathogens. A total of n = 119,144 clinical isolates were evaluated for antimicrobial resistance in 19 Arab countries. Among these clinical isolates, 74,039 belonged to E. coli and ESKAPE pathogen. Distribution of antibiotic resistance among E. coli and ESKAPE pathogens indicated that E. coli (n = 32,038) was the predominant pathogen followed by K. pneumoniae (n = 17,128), P. aeruginosa (n = 11,074), methicillin-resistant S. aureus (MRSA, n = 4370), A. baumannii (n = 3485) and Enterobacter spp. (n = 1574). There were no reports demonstrating Enterococcus faecium producing β-lactamase. Analyses revealed 19 out of 22 countries reported occurrence of ESBL (Extended-Spectrum β-Lactamase) producing E. coli and ESKAPE pathogens. The present study showed significantly increased resistance rates to various antimicrobial agents over the last 20 years; for instance, cephalosporin resistance increased from 37 to 89.5%, fluoroquinolones from 46.8 to 70.3%, aminoglycosides from 40.2 to 64.4%, mono-bactams from 30.6 to 73.6% and carbapenems from 30.5 to 64.4%. An average of 36.9% of the total isolates were reported to have ESBL phenotype during 2000 to 2020. Molecular analyses showed that among ESBLs and Class A and Class D β-lactamases, blaCTX-M and blaOXA have higher prevalence rates of 57% and 52.7%, respectively. Among Class B β-lactamases, few incidences of blaVIM 27.7% and blaNDM 26.3% were encountered in the Arab region. Conclusion: This review highlights a significant increase in resistance to various classes of antibiotics, including cephalosporins, β-lactam and β-lactamase inhibitor combinations, carbapenems, aminoglycosides and quinolones among E. coli and ESKAPE pathogens in the Arab region. [ABSTRACT FROM AUTHOR]