Detection of drug resistance pattern among Gram-negative isolates

Introduction

Many microorganisms now are unfriendly tohuman beings who are responsible for infectionsand diseases (Reta et al., 2019). One of theimportant public health issues are infection andantibiotic resistance (Veena Kumari et al., 2007).Gram negative bacteria are the commonest causefor most of the infections and are generallyresistant to antibiotics. Recently gram negativebacteria resistant to most of the antibiotic groupshave become more prevalent and are of concernin treatment of infections (Ullah et al., 2012). Therate of survival from infections is impactedmajorly by discovery of antimicrobial agents.However, increase in the prevalence of drugresistant microorganisms and the changingpatterns of antimicrobial resistance demandedneed for new antibacterial agents. Antimicrobialresistance is a well-known clinical and publichealth problem (Lamichhane et al., 2014). 

According to the World Health Organization(WHO), antimicrobial resistance (AMR) is a majorproblem worldwide in antimicrobial therapy. It isa global problem caused mainly by overuse andmisuse of antimicrobial agent. AMR leads toprolonged illness, longer hospital stays, highermedical costs, and increased risk of death.

 AMR constitutes a continuously growing threat tothe effective treatment of microbial infections.However, the status of impact of AMR on thehealth of people in community and in hospitalizedpatients and on financial burden experienced byhealth care systems in the management ofinfections caused by drug resistantmicroorganisms are still uncertain (Elbadawi etal., 2019). Approximately about two million areinfected and 23,000 deaths results due toinfection with drug resistant microorganisms eachyear. The health care crisis is fueled bymultidrug-resistant Gram-negative organisms,including extended spectrum β lactamases(ESBL), metallobetalactamase (MBL) and AmpCbeta-lactamase (Walker et al., 2019). In general;there is direct association between mortality andinfections caused by multi-drug resistant Gramnegative bacteria (GNB). In addition, infectionswith multi-drug resistance GNB lead to lessdesirable outcomes, including longer hospitalstays and utmost cost of hospitalization (Afifi etal., 2015). Now, existence of "extreme drugresistance" in GNB that are resistant to first lineand second line antibiotics are increasing creatinga challenge for clinicians in the management ofinfections (Sandhu et al., 2019). Hence, the studywas conducted to know the drug resistancepattern among Gram-negative isolates anddetection of ESBL production.