Sara E Mohammed^1,, Omnia M Hamid², Sababil S Ali¹, Mushal Allam³, A M Elhussein⁴

Background. Pseudomonas aeruginosa is a common opportunistic Gram-negative pathogen responsible for a wide range of hospital acquired infections that may present high rates of antimicrobial resistance. It could also become multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan drug-resistant (PDR) during a short period. The aim of the present study is to determine the prevalence of MDR, XDR and PDR-P. aeruginosa clinical isolates in Khartoum State-Sudan. Materials and Methods. A multihospital laboratory-based study was conducted to collect P. aeruginosa clinical isolates from various clinical specimen’s culture during eighteen-month period from March 2020 to December 2021. The P. aeruginosa strains were reidentified by conventional biochemical methods and genotypically by amplification of 16S rRNA gene by Polymerase chain reaction (PCR) assay. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method. MDR, XDR and PDR were determined according to new recommendation of the Clinical and Laboratory Standards Institute and the European Committee for Antimicrobial Susceptibility Testing. Results. Of 512 P. aeruginosa clinical isolates were recovered from various clinical specimen’s culture, only 289 (66.4%) of the isolates were confirmed as P. aeruginosa strains genotypically, out of those P. aeruginosa strains were categorized regarding antimicrobial resistance to 98 (33.9%) MDR, 61 (21.1%) XDR and 2 (0.7%) PDR. The XDR strains were exhibited significant overall resistance to all used antibiotic classes, whereas MDR strains were insignificant resistant to fluoroquinolones and polymyxins. Patients prior of hospitalized for 1-2weeks, uses of companied antibiotics therapy with duration of one week and source of isolation from wound swab and blood specimen (P <0.05), remained independently associated with an increased likelihood of antimicrobial resistant in clinical P. aeruginosa isolates. Conclusion. The study highlights the increase prevalence of MDR and XDR P. aeruginosa clinical isolates in both hospital and community settings, along with emerged two pandrug resistant strains. Thus, continuous antimicrobial resistance surveillance for this bacterium is necessary for guiding antimicrobial treatment and stewardship as well as based knowledge for future comparative studies.

pseudomonas aeruginosa, clinical isolates, multidrug-resistant, extensively drug-resistant, pan drug-resistant, Khartoum