الفهرس | Only 14 pages are availabe for public view |
Abstract Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic human pathogen and causes pneumonia, urinary tract infections, wound infections and blood stream infections. Moist environments can act as reservoirs P. aeruginosa in the hospital settings. Consequently, P. aeruginosa is a common nosocomial pathogen and often is the main pathogen in cases of nosocomial infections and catheter-related blood stream infections. P. aeruginosa is intrinsically resistant to several antibiotics because of the low permeability of its outer membrane, the constitutive expression of various efflux pumps and the production of antibiotic inactivating enzymes (e.g., cephalosporinases). Furthermore, it also has a remarkable capacity to develop or acquire new mechanisms of resistance to antibiotics. This study was performed at Menofia University Hospital to estimate the frequency of isolation of P. aeruginosa from patients at different wards. Also, to study the antibiotic resistance pattern and to make typing for the different isolated strains. The study covered the period from May 2010 to July 2011. Samples were obtained from 287 hospitalized cases (group I), from 20 individuals of medical staff (group II) and 200 samples from hospital environment(group III) . All samples obtained were cultured on appropriate media including nutrient agar, blood agar and MacConkey’s agar. P.aeruginosa isolates was identified by it′s morphology and biochemical reactions. The results revealed that the most frequent nosocomial isolates were S. aureus (28.97%), followed by Klebsiella species (21.55%), E. coli (20.8%), P. aeruginosa (19.1%), Proteus (4.5%), Enterococcus (3.88%) and Candida (1.41%). P. aeruginosa was more frequently isolated from burn unit (32.31%) than from other departments with no statistically significant difference (P>0.05) between it and other departments .Then followed by urology department (18.75%), otolaryngology department (17.24%), ICU (15.62%) and surgery department (12.9%) The highest rate of isolation of P. aeruginosa was found in patients with age group more than 60 years (32.56%, P <0.05), followed by age group 31-60 (15.70%) then age group 11-30 (10.53%), while the lowest rate was found among patients less than 10 years (7.14%). It also shows that P. aeruginosa was isolated from males more frequently (21.82%) than females (14.75%) with no statistical significant difference (P>0.05). The highest rate of isolation of P. aeruginosa was found in patients with history of antibiotic administration (21.16%) versus other patients with a significant statistical t difference (P<0.05) The highest rate of isolation of P. aeruginosa was found in patients with duration of hospital stay more than 10 days (30,87%, P<0.001) , followed by patients with hospital stay between 6 and 10 days (6.67%) then hospital stay less than than6 days (4.84%). Regarding the history of invasive procedures the highest rate of isolation of P. aeruginosa was found in patients underlying invasive procedures (20.8%) versus patients with no underlying invasive procedures (12.7%) with no significant difference (P> 0.05). Also, the highest rate of isolation of P. aeruginosa was found in patients with underling systemic diseases (20.2%) versus patients with no underlying systemic diseases (14.03%). |