Medical Research

Prevalence of drug-resistant ESBL producing Pseudomonas aeruginosa from burn wound infections | by Zareen Abbas | Dec, 2021

Zareen Abbas

There is increasing evidence that all modern diseases emerged from previous ones. As a microbiologist, I often see people affected by burn wound infections and have delayed healing processes. How could this possibly happen? The main culprit for a reason is the prevalence of Pseudomonas aeruginosa in burn wound infection, which is multidrug-resistant and produces ESBL (Extended Spectrum Beta Lactamases).

Multi drug resistant Pseudomonas aeruginosa

P. aeruginosa is present almost everywhere and can infect nearly all tissues. The diversity of virulence factors plays a vital role in burn wounds, sepsis, lungs, eyes and urinary tract infections. It is a ubiquitous and opportunistic Gram-negative bacteria. Loss of many immune mechanisms of hosts occurs due to the ability of burn wound colonization. P. aeruginosa can take advantage of immuno-compromised patients in such infections.

Pseudomonas aeruginosa is the primary pathogen that causes infection in burn units in Pakistani hospitals. The surface of moist wounds provides an environment suitable for their survival; Which indicates that it is the ideal environment for its colonization and will participate in the burns unit. In a study conducted in Pakistan, mortality rates were 18.9%.

I conducted research in which the incidence of the burn was higher in males because males mostly spend their time outside where accidents happen. The highest incidence in our study was flame burn. It may be due to socioeconomic reasons in our society. They were greater exposed to Flame and electric devices as their income source. The age group most affected by burn injury was between 16 and 50 years. In the present study, the proportion of burn-in males was higher than females (65% vs 35%), and the highest group is burns of Flame was 43.4%, followed by burning with scald (Hot water) 30.43% then burning with electricity 26.08%.

While each passing day, irrational use of antibiotics has been increased, which leads to cause resistance against many antibiotics. Multidrug-resistant bacteria play an essential role in this regard as they can resist many classes of antibiotics and have become one of the most significant challenges in clinical practice. The occurrences of antibiotic resistance and bacteria have started producing beta-lactamases and extended-spectrum beta-lactamases (ESBL) enzymes to neutralize a β-lactam group of drugs.

P. aeruginosa is prevalent in burn wound infections as well and is frequently isolated from the flame burn. 70 to 80% mortality rate is in burn wound infections.

As far as present research was concerned, one hundred burn wound swabs were collected to detect the prevalence of drug-resistant ESBL producing P. aeruginosa. Per cent prevalence of P. aeruginosa in burn wounds was 23%. These isolates were also analyzed to obtain their antimicrobial susceptibility profiles. All burn wound isolates showed resistance against colistin, whereas these isolates were quite sensitive to meropenem. Some of the isolates showed an intermediate susceptibility as well.

The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumonia, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species) are the leading cause of nosocomial infections throughout the world. Most of them are multidrug-resistant isolates, which is one of the most significant challenges in clinical practice. Multidrug resistance is among the top three global public health threats and is usually caused by excessive drug usage or prescription, inappropriate use of antimicrobials, and substandard pharmaceuticals.

Understanding the resistance mechanisms of these bacteria is crucial for developing novel antimicrobial agents or other alternative tools to combat these public health challenges. Greater mechanistic understanding would also aid in predicting underlying or even unknown mechanisms of resistance, which could be applied to other emerging multidrug-resistant pathogens. In this review, we summarize the known antimicrobial resistance mechanisms of ESKAPE pathogens.

Biswal directed a study highlighted to analyze the incidence of multidrug-resistant P. aeruginosa MDRPA recovered from burn wound infections. The result of samples processing showed that the incident rate of P. aeruginosa was about 56 isolates. A few samples were positive for MDR, and per cent prevalence was 36.12%, as 21 samples were positive out of 56 isolates.

We certainly can’t choose the incidence of burn wounds daily happening to us and the complications that are associated with them, but with the extraordinary work of scientific researchers around the world and not just in the field of infection, but, in all aspects of medical science, we are seeing breakthroughs in therapeutics which were only a dream and hope of scientists 20 years ago. Thus we are moving closer to intervening in people with specific genetic issues to ensure a healthier, longer life.

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