In vitro efficacy of colistin against multidrug-resistant Pseudomonas aeruginosa in burn patient by minimum inhibitory concentration with broth dilution

Blossom Neelam; Sumera Malik; Syed Muhammad Abbas Naqvi; Mahnoor Haidar Khan; Mehvish Javeed

doi:10.61529/idjp.v33i3.338

Authors

Blossom Neelam Nishtar Hospital Multan
Sumera Malik Combined Military Hospital, Multan Pakistan
Syed Muhammad Abbas Naqvi Nishtar Medical University, Multan Pakistan
Mahnoor Haidar Khan Bakhtawar Ameen Medical College, Multan Pakistan
Mehvish Javeed The Women University, Multan Pakistan

DOI:

https://doi.org/10.61529/idjp.v33i3.338

Abstract

Background: Pseudomonas aeruginosa strains cause 86% of sepsis mortality in burn victims. Therefore, to combat the multi-drug resistance in Pseudomonas aeruginosa, colistin is the new drug, and it has recently been introduced. To analyze the in vitro efficacy of colistin against multidrug-resistant Pseudomonas aeruginosa in burn patients by determining the minimum inhibitory concentration with broth dilution.

Material And Methods: The cross-sectional study was performed from March 2021 to February 2022 in the Burn Centre at Nishter Hospital in Multan, Pakistan. 300 burn patients (≥20% burn) were selected, and their pus samples were collected and processed in the microbiology laboratory. The Kirby-Bauer disc diffusion method was applied to check the antibiotic susceptibility against isolated strains. The colistin sensitivity against multi-drug resistant (MDR) strains was estimated by employing the broth dilution method at two-fold serial dilutions from 0.5 µg/mL to 0.003 µg/mL.

Results: 124 (55.3%) strains were identified as Pseudomonas aeruginosa, while the remaining strains were identified as Escherichia coli (13.0%), Streptococci (13.0%), Klebsiella pneumoniae (8.9%), Staphylococci (6.6%), and Candida albicans (2.2%). All isolated strains of Pseudomonas aeruginosa showed resistance against antibiotics: aztreonam (60.4%), cefepime (72.5%), ceftazidime (71.7%), ciprofloxacin (62.0%), imipenem (33.0%), levofloxacin (58.0%), meropenem (19.3%), piperacillin/tazobactam (66.1%), and tobramycin (63.7%). The significantly calculated MIC value of colistin against MDR strains was 0.35-0.5 mg/L (CLSI and EUCAST recommended value = ≤2 mg/L).

Conclusion: Colistin can be a good option to treat nosocomial infections of MDR Pseudomonas aeruginosa in burn patients.

Keywords: Burn patients, Colistin, Multi-drug resistance, Minimum inhibitory concentration

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