COMPARATIVE ANALYSIS OF THE MULTIDRUG RESISTANCE PATTERN IN PSEUDOMONAS DERUGINOSE ISOLATED FROM VARIOUS SOURCE

BACKGROUND OF THE STUDY
One of the most important challenges for physicians is the adequate treatment of infections due to Gram-negative pathogens because of the increasing antimicrobial resistance in the healthcare setting.
Among infections caused by Gram-negative rods, Pseudomonas aeruginosa has a leading role, especially in critically ill and immunocompromised patients. Antimicrobial resistance has led to a serious restriction in treatment options for P. aeruginosa infections, which has become a critical and deadly issue causing a total of 51,000 healthcare infections in the USA per year. Despite this problem, physicians mainly rely on retrospective non-randomized controlled studies to derive conclusions about the optimal therapeutic management of these infections (Balcht, 1994).

Pseudomonas aeruginosa is an opportunistic and Gram-negative bacteria found in various environments and hosts such as water, soil, plants, animal, and human beings. It has a very large genome that causes more complex features than other bacteria. Because of high versatility with the host and different virulence factors such as exotoxin, elastase, rhamnolipid, pyocyanin, pyochelin, and lectin. P. aeruginosa is considered as one of the most dangerous bacteria in the world. The bacteria are colonized in the human body in wet areas such as anus, armpits, ears, nose, and throat mucosa. The prevalence of colonization in healthy people is very low, but it is increased in hospitalized patients, especially those treated with broad-spectrum antibiotics. Nowadays, nosocomial infections and subsequent antibiotic resistance are one of the serious problems at a global level, so that each year, a large number of patients involved with these infections and lose their lives. P. aeruginosa is one of the most common bacteria in nosocomial infections, especially in burn units. Burn patients, because of losing the skin barrier, are very vulnerable to infection. It can be transmitted through the flora contamination be in touch with different surfaces in hospitals, such as equipment, disinfectant solutions, nurse’s hands, and may spread among other patients (Itah, 2005).

The ability to use multiple mechanisms, including decreased outer membrane permeability, expression of efflux pump, produces antibiotic degradative enzymes, alginate production and transfer of resistance genes, the bacteria has enabled to show a high level of resistance to the most used antibiotics. Multidrug resistance (MDR) to antibiotics against Pseudomonas is a common and growing problem in most hospitals as P. aeruginosa of MDR is responsible for 4%–60% of nosocomial infections in different parts of the world. The use of broad-spectrum antibiotics such as ceftazidime in the burn ward and Intensive Care Units (ICUs) by creating a selective pressure on bacteria likely increases emergence of multidrug-resistant strains including MDR, extensively drug-resistance (XDR), and even pan-drug resistance (PDR). The presence of these strains in the burn wards has become a key issue in infection control. Due to increasing resistance to antibiotics, treatment of these infections has become constantly more complicated and difficult and will follow problems such as increased illness, higher mortality rate, and economic impacts. Hence, for proper treatment, detection of MDR strains is essential. With regard to this issue, study of antibiotic resistance and trying to control this problem by new methods of treatment is very important.

1.2 OBJECTIVES OF STUDY
The specific objectives of this study is are:
1. To examine the multidrug resistance pattern in pseudomonas deruginose.
2. To examine antibiotic resistance use to control this problem
3. To examine the various ways in which pseudomonas is transmitted
1.3 SCOPE OF STUDY
The study will cover the qualitative and quantitative analysis that is involved in multidrug resistance pattern in pseudomonas deruginose isolated from various source

1.4 SIGNIFICANCE OF STUDY
This study will be of significance importance to students of Science Laboratory Technology as it touches on their area of specialization and also to student from other related field.