ABSTRACT
ABSTRACT@#In recent years, antimicrobial resistance (AMR) has become a global public health concern. The growth of resistant bacteria is increasing dramatically, while the number of new antibiotics accessible is decreasing. This is especially true in the case of Pseudomonas aeruginosa, an important causative agent of healthcare-associated infections. The ability of P. aeruginosa to survive in different environments and on medical devices has made it more resistant to antibiotics. This causes bacteremia in hospitalized patients, ventilator-associated pneumonia, catheter-associated urinary tract infections and wound infections, particularly in patients with severe burns, bed ulcers and immunocompromised individuals. The rise in the AMR rate in both developed and developing countries may be attributed to a number of factors such as variations in the standard health care, large population, awareness about antibiotic resistance, inadequate training on rationale antibiotic usage and inadequate infection control facilities in many hospitals. The emergence of Extensive Drug Resistance (XDR) and Pan Drug Resistance (PDR) among organisms that cause various infections leads to increased treatment costs, morbidity and mortality, leaving no therapeutic options. This review highlights the different mechanisms of antibiotic resistance, including intrinsic and acquired resistance, which are frequently observed in P. aeruginosa.
Subject(s)
Pseudomonas aeruginosa , Drug Resistance, MicrobialABSTRACT
Burkholderiapseudomallei is soil-dwelling bacterium which causes melioidosis, a disease of tropical climates. Very few cases have been reported from the Indian subcontinent despite similarities in environmental conditions with Southeast Asian countries. Here, we report a case of acute bloodstream infection in a diabetic patient with bilateral renal calculi with bilateral hydroureteronephrosis and left gluteal cellulitis. Blood and urine samples were processed in the microbiology laboratory for culture and sensitivity. Gram stain showed short, straight Gram-negative bacilli with a “safety-pin” appearance which were motile. Blood agar yielded smooth, creamy white translucent colonies and MacConkey agar yielded wrinkled, pink-colored colonies with metallic sheen. Isolate was identified as B. pseudomallei based on biochemical reactions which were also confirmed by Vitek 2 compact. The conventional, automated blood culture and urine culture yielded the same organism which was susceptible to ceftazidime, cotrimoxazole, carbapenems, and minocycline. Diabetes is an important risk factor for the development of bacteremic melioidosis and delayed diagnosis may lead to fatal sepsis and eventually death. Our aim is to emphasize the importance of early diagnosis and treatment with appropriate antibiotics and thereby prevent mortality