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Evolving trends among Pseudomonas aeruginosa

A 12-year retrospective study from the United Arab Emirates

Bibliographic Data

ID22090069
AuthorsJens Thomsen (0000-0002-2646-9494, Khalifa University of Science and Technology), Godfred Antony Menezes (0000-0002-4102-2279, Ras al-Khaimah Medical and Health Sciences University, corresponding author), Najiba M Abdulrazzaq (Dubai Hospital), Carole Ayoub Moubareck (0000-0001-8369-5271, Zayed University), Abiola Senok (0000-0001-6382-198X, Mohammed Bin Rashid University of Medicine and Health Sciences), Dean Everett (0000-0002-8458-6779, Khalifa University of Science and Technology), Dean B Everett
Year2023
Volume11
Pages1243973-1243973
Publication date2023-11-30
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2023.1243973
PMID38106909
OpenAlexW4389245513
LanguageEN
References cited55

Introduction Pseudomonas is a group of ubiquitous non-fermenting Gram-negative bacteria (NFGNB). Of the several species associated with humans, Pseudomonas aeruginosa (PA) can acclimate to diverse environments. The global frequency of PA infections is rising and is complicated by this organism's high intrinsic and acquired resistance to several clinically relevant antibiotics. Data on the epidemiology, levels, and trends of antimicrobial resistance of PA in clinical settings in the MENA/GCC region is scarce. Methods A retrospective 12-year analysis of 56,618 non-duplicate diagnostic Pseudomonas spp. from the United Arab Emirates (UAE) was conducted. Data was generated at 317 surveillance sites by routine patient care during 2010–2021, collected by trained personnel and reported by participating surveillance sites to the UAE National antimicrobial resistance (AMR) Surveillance program. Data analysis was conducted with WHONET ( https://whonet.org/ ). Results Among the total isolates ( N = 56,618), the majority were PA (95.6%). Data on nationality revealed 44.1% were UAE nationals. Most isolates were from soft tissue (55.7%), followed by respiratory tract (26.7%). PA was more commonly found among inpatients than among outpatients, followed by ICUs. PA showed a horizontal trend for resistance to fluoroquinolones, 3rd- and 4th-generation cephalosporins, and decreasing trends of resistance for aminoglycosides and meropenem. The highest percentage of multidrug resistant (MDR) isolates was reported in 2011 at 35.6%. As an overall trend, the percentage of MDR, extensively drug-resistant (XDR), and possible pandrug-resistant (PDR) isolates generally declined over the study period. Carbapenem-resistant PA (CRPA) were associated with a higher mortality (RR: 2.7), increased admission to ICU (RR: 2.3), and increased length of stay (LOS) (12 excess inpatient days per case), as compared to carbapenem-susceptible PA (CSPA). Conclusion The resistance trends in Pseudomonas species in the UAE indicated a decline in AMR and in percentages of Pseudomonas isolates with MDR and XDR profiles. The sustained Pseudomonas spp. circulation particularly in the hospital settings highlights the importance of surveillance techniques, infection control strategies, and stewardship to limit the continued dissemination. This data also shows that CRPA are associated with higher mortality, increased ICU admission rates, and a longer hospitalization, thus higher costs due to increased number of in-hospital and ICU days

Antibiotic resistance · Antibiotics · Bacteria · Biology · Cephalosporin · Drug resistance · Meropenem · Multiple drug resistance · Pseudomonas aeruginosa · Veterinary medicine · Antibiotic Resistance in Bacteria · Antibiotic Use and Resistance · Infections and bacterial resistance · Medicine · Epidemiology · Internal Medicine · Microbiology

  • Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria

    Open Access•Anna-Pelagia Magiorakos, Arjun Srinivasan et al.•Clinical Microbiology and Infection•2012

  • Surveillance of antimicrobial resistance in the United Arab Emirates

    Open Access•Jens Thomsen, Najiba M Abdulrazzaq et al.•Frontiers in Public Health•2023

  • Prevalence and Antimicrobial-Resistance of Pseudomonas aeruginosa in Swimming Pools and Hot Tubs

    Open Access•Jonathan Lutz, Jonathan K Lutz et al.•International Journal of…•2011

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