Prevalence rate of resistance to ciprofloxacin among clinical pseudomonas aeruginosa isolates in Kurdistan province, west of Iran

Infection by drug resistant Pseudomonas aeruginosa causes important therapeutic problems. The present study was performed to investigate the antibiotic susceptibility and prevalence of antimicrobial resistance genes in P. aeruginosa.

In this cross sectional study, 61 clinical P. aeruginosa isolates were collected in Sanandaj between April and September 2017. Isolates were examined by disk diffusion method to determine susceptibility to 8 antibiotics and by polymerase chain reaction to detect the presence of extended-spectrum beta lactamase blaCTX-M gene and plasmid-mediated quinolone resistance determinants, qnrA, qnrB, and qnrS. We also evaluated the effect of resistance to quinolones on cross resistance to other antibiotics. We used descriptive statistics for data analysis.

Meropenem showed the highest susceptibility rate (88.5%), followed by piperacillin (85.2%), ceftazidime and amikacin (80.3%, each), imipenem (77%), cefepime (73.8%), ciprofloxacin (49.2%), and gentamicin (39.3%). Among 61 isolates, 32.8% showed multidrug resistance. Ciprofloxacin-resistant isolates had cross resistance to gentamicin (93.5%), cefepime (45.2%), ceftazidime and imipenem (38.7%, each), amikacin (35.5%), piperacillin (29%), and meropenem (22.6%). We detected qnrS in three isolates (4.9%). blaCTX-M, qnrB and qnrA were not identified.

Our results suggested that ciprofloxacin may not be effective against P. aeruginosa. According to our knowledge, this is the first report of presence of qnr in P. aeruginosa from Kurdistan which highlights the need for continuous monitoring for prevention of the transmission of qnr.