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National Academy of Agricultural Sciences (NAAS)
NAAS Score: *5.38 (2020)
[Effective from January 1, 2020]
For more details click here
ICV 2023: 95.56
Index Copernicus ICI Journals Master List 2023 - IJCMAS--ICV 2023: 95.56
For more details click here
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Original Research Articles Volume : 15, Issue : 5, May, 2026

PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
Publisher : Excellent Publishers
Email : editorijcmas@gmail.com
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Editor-in-chief: Dr.M.Prakash
Index Copernicus ICV 2018: 95.39
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Int.J.Curr.Microbiol.App.Sci.2026.15(5) : 121-127
DOI : https://doi.org/10.20546/ijcmas.2026.1505.016


Carbapenem-Resistant Pseudomonas aeruginosa in Intensive Care Unit Patients: Prevalence, Antimicrobial Susceptibility, Risk Factors, and Clinical Outcomes at a Tertiary Care Centre in Western Rajasthan, India

Deepak Kanjani1*, Seema Bhamu1, Varsha Kanjani2 and Amrin Khan3
1Department of Microbiology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India 
2Department of Oral Medicine and Radiology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India 
3Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan, India
*Corresponding author
Abstract:

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) represents a critical clinical challenge in intensive care units (ICUs), limiting therapeutic options and contributing to increased morbidity and mortality. Characterizing its epidemiology and resistance determinants is essential to guide antimicrobial stewardship and infection control strategies. To determine the prevalence of CRPA among ICU patients, and to analyze antimicrobial susceptibility patterns, identify independent risk factors for resistance acquisition, and compare clinical outcomes between CRPA and carbapenem-sensitive P. aeruginosa (CSPA) infections. A prospective observational study was conducted from January 2024 to July 2024 at a tertiary care teaching hospital in Western Rajasthan, India. A total of 1,121 respiratory specimens were processed. Isolates were identified using standard biochemical methods and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method per CLSI 2024 guidelines; colistin susceptibility was confirmed by broth microdilution (BMD). Multivariate logistic regression was used to identify independent risk factors. Among 138 P. aeruginosa isolates, 39 (28.3%) were CRPA. Patients with CRPA were significantly older (mean age 64.2 ± 11.4 vs. 54.9 ± 12.1 years; p = 0.032) and had higher rates of hypertension (66.7% vs. 44.4%; p = 0.024). Independent risk factors for CRPA included prior antibiotic exposure (odds ratio (OR) 5.6; 95% CI: 2.1–14.8; p = 0.001), prolonged mechanical ventilation (OR 10.8; 95% CI: 2.4–48.3; p = 0.001), and ICU stay >7 days (OR 10.1; 95% CI: 3.5–29.2; p < 0.001). CRPA isolates showed high resistance to β-lactams (87.2%) and fluoroquinolones (82.1%), but retained 100% susceptibility to colistin and 74% susceptibility to tigecycline by disc diffusion. CRPA infections were associated with significantly higher mortality (51.3% vs. 22.2%; p = 0.004) and longer hospitalization (25.8 ± 9.8 vs. 14.9 ± 5.2 days; p < 0.001). CRPA infections in ICU settings present with limited therapeutic options and poor clinical outcomes. Strengthening antimicrobial stewardship, infection control practices, and ventilator care bundles is essential to curb CRPA spread. Multicenter studies with molecular resistance characterization are warranted.


Keywords: Pseudomonas aeruginosa, carbapenem resistance, intensive care unit, antimicrobial susceptibility, colistin, odds ratio, infection control

References:
  1. Pang Z, Raudonis R, Glick BR, Lin TJ, Cheng Z. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies. Biotechnol Adv. 2019; 37(1): 177-192. https://doi.org/10.1016/j.biotechadv.2018.11.013
  2. Tacconelli E, Carrara E, Savoldi A, et al., Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria. Lancet Infect Dis. 2018; 18(3): 318-327. https://doi.org/10.1016/S1473-3099(17)30753-3
  3. Bassetti M, Vena A, Croxatto A, Righi E, Guery B. How to manage Pseudomonas aeruginosa Drugs Context. 2018; 7: 212527. https://doi.org/10.7573/dic.212527
  4. Kadri SS, Adjemian J, Lai YL, et al., Difficult-to-treat resistance in Gram-negative bacteremia at 173 US hospitals. Clin Infect Dis. 2018; 67(12): 1803-1814. https://doi.org/10.1093/cid/ciy378
  5. Oliver A, Mulet X, Lopez-Causape C, Juan C. The increasing threat of Pseudomonas aeruginosa high-risk clones. Drug Resist Updat. 2015; 21-22: 41-59. https://doi.org/10.1016/j.drup.2015.08.001
  6. Botelho J, Grosso F, Peixe L. Antibiotic resistance in Pseudomonas aeruginosa — mechanisms, epidemiology and evolution. Drug Resist Updat. 2019; 44: 100640. https://doi.org/10.1016/j.drup.2019.07.002
  7. Tamma PD, Aitken SL, Bonomo RA, et al., Infectious Diseases Society of America guidance on treatment of antimicrobial resistant Gram-negative infections. Clin Infect Dis. 2021; 72(7): e169-e183. https://doi.org/10.1093/cid/ciaa1478
  8. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 35th ed. CLSI supplement M100. Wayne, PA: CLSI; 2024.
  9. Vincent JL, Rello J, Marshall J, et al., International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009; 302(21): 2323-2329. https://doi.org/10.1001/jama.2009.1754
  10. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in combined medical-surgical intensive care units. Infect Control Hosp Epidemiol. 2000; 21(8): 510-515. https://doi.org/10.1086/501795
  11. Jean SS, Harnod D, Hsueh PR. Global threat of carbapenem-resistant Gram-negative bacteria. Front Cell Infect Microbiol. 2022; 12: 823684. https://doi.org/10.3389/fcimb.2022.823684
  12. Koulenti D, Tsigou E, Rello J. Nosocomial pneumonia in ICU patients: more challenges and less answers. Expert Rev Anti Infect Ther. 2017; 15(8): 729-740. https://doi.org/10.1080/14787210.2017.1338946
  13. Magiorakos AP, Srinivasan A, Carey RB, et al., Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions. Clin Microbiol Infect. 2012; 18(3): 268-281. https://doi.org/10.1111/j.1469-0691.2011.03570.x
  14. World Health Organization. Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report 2023. Geneva: WHO; 2023. Available at: https: //www.who.int/glass
  15. Paul M, Daikos GL, Durante-Mangoni E, et al., Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria. Lancet Infect Dis. 2018; 18(4): 391-400. https://doi.org/10.1016/S1473-3099(18)30099-9
  16. Rice LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J Infect Dis. 2008; 197(8): 1079-1081. https://doi.org/10.1086/533452
  17. Gellatly SL, Hancock REW. Pseudomonas aeruginosa: new insights into pathogenesis and host defenses. Pathog Dis. 2013; 67(3): 159-173. https://doi.org/10.1111/2049-632X.12033
  18. Breidenstein EBM, de la Fuente-Nunez C, Hancock REW. Pseudomonas aeruginosa: all roads lead to resistance. Trends Microbiol. 2011; 19(8): 419-426. https://doi.org/10.1016/j.tim.2011.04.005
  19. Livermore DM. Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare? Clin Infect Dis. 2002; 34(5): 634-640. https://doi.org/10.1086/338782 
  20. Sader HS, Castanheira M, Duncan LR, Flamm RK. Antimicrobial susceptibility of Enterobacteriaceae and Pseudomonas aeruginosa isolates from intensive care unit patients. Diagn Microbiol Infect Dis. 2018; 92(1): 65-69. https://doi.org/10.1016/j.diagmicrobio.2018.04.013
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How to cite this article:

Deepak Kanjani, Seema Bhamu, Varsha Kanjani and Amrin Khan. 2026. Carbapenem-Resistant Pseudomonas aeruginosa in Intensive Care Unit Patients: Prevalence, Antimicrobial Susceptibility, Risk Factors, and Clinical Outcomes at a Tertiary Care Centre in Western Rajasthan, India. Int.J.Curr.Microbiol.App.Sci. 15(5): 121-127 doi: https://doi.org/10.20546/ijcmas.2026.1505.016
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