Phenotypic profile of resistance and factors associated with multidrug-resistant Pseudomonas aeruginosa infection in the intensive care unit of the Douala General Hospital
Keywords:
Pseudomonas aeruginosa, Multi-resistant, Intensive care, Antibiotic Resistance, Factors, Resistance profileAbstract
Introduction: Multidrug-resistant Pseudomonas aeruginosa (MDR PA) infections are responsible for a large number of often fatal complications in intensive care. Identifying the associated factors and effective antibiotics to combat them is crucial.
Methodology: A cross-sectional study was conducted at Douala General Hospital over a five-year period. Resistance rates and logistic regression were calculated.
Results: The frequency of MDRPA was 41.67% IC95%(27.61%-56.78%). Resistance rates were : tircarcillin; 81.25% IC95%(67.67%-91.05%), piperacillin ; 79.09% IC95%(61.23%-87.41%), tircarcillin+clavulanic acid ; 50.00% IC95%(35.23%-64.77%), piperacillin+tazobactam; 33.33% IC95%(20.40%-48.41%), tobramycin ; 73.91 IC95%(58.87%-85.73%), aztreonam; 68.75% IC95%(53.75%-81.34%), ciprofloxacin ; 62.50% IC95%(47.35%-76.05%), levofloxacin; 57.45% IC95%(42.18%-71.74%), ceftazidime ; 29.17% IC95%(16.95%-44.06), amikacin: 27.08% IC95% (15.28%-41.85%), imipenem ; 14.58% IC95%(6.07%-27.76%), cefepime: 4.17% IC95%(0.51%-14.25%). Increasing age (p=0.016), being transferred from a hospital ward (p=0.006), having a history of surgery (p=0. 000), the presence of signs of sepsis (p=0.045) and undernutrition (p=0.012), having received corticosteroids (p=0.000) or quinolones (p=0.001), having a urinary (p=0.006) or gastric (p=0.001) catheter, having had an invasive method (p=0.000) and length of stay (p=0.000) were associated with MDR PA. After logistic regression, length of stay ORa=1.31 IC95% (1.028-1.667), having a urinary catheter ORa=26.23 IC95%(1.518-4.553) and having had surgery ORa=15.3 IC95%(1.37-1.709) were associated with MDR PA.
Conclusion: Long-term patients with invasive methods are the most likely to acquire MDR PA, the source of contamination appears to be predominantly exogenous, cefepime, imipenem and amikacin being the most effective antibiotics.
