Beyond treatment Beyond treatment: Escalating crisis of multidrug-resistant gram-negative pathogens, transmission dynamics and potential risk factors in a tertiary care hospital
DOI:
https://doi.org/10.55629/pakjpathol.v36i4.901Abstract
Objective: To assess the frequency, antimicrobial susceptibility and risk factors (prior hospitalization, antibiotic use, age ≥60 years) for emergence of multidrug-resistance Gram negative rods (MDR-GNRs) in a tertiary care hospital in Bahawalpur.
Material and Methods: This analytical cross-sectional study was conducted in the Department of Pathology at a tertiary-care hospital in Bahawalpur, Pakistan, from January 2023 to February 2025. Risk factors including age, prior hospitalization, and antibiotic use were assessed. Blood, urine, tissue, respiratory, pus, and body fluid specimens were processed, and organisms were identified by colony morphology, differential media, and standard biochemical tests. Antimicrobial resistance was interpreted according to CLSI criteria, with zone diameter cutoffs used to define resistance, including ≤ 19 mm for meropenem or imipenem to confirm carbapenem resistance.
Results: Data of 396 hospitalized patients yielding Gram negative pathogens were analyzed, of which 201(50.75%) isolates were MDR-GNRs. The most prevalent isolate was E. coli 196/396 (49.5%) followed by Pseudomonas aeruginosa 76/396 (19.2%), whereas the most prevalent MDR-GNRs were Acinetobacter baumannii 54.7% and Klebsiellaa spp 42.8%. Statistical analysis revealed a concerning prevalence of MDR-GNRs with statistically significant association to prior hospitalization (OR=14.87), prior antibiotic use (OR=7.34) and age ≥60 (OR=3.39).
Conclusion: High MDR-GNRs frequency linked to prior hospitalization, antibiotic exposure, and old age highlights urgent need for infection control measures and antimicrobial stewardship.
Keywords: Antibiotic use, Antimicrobial stewardship, Multi-drug resistant Gram-negative rods, Infection control, Tertiary care Hospital Bahawalpur.
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