Antibiotic resistance in clinical isolates of Pseudomonas aeruginosa in Jamaica

Objective. To assess antibiotic resistance in clinical isolates of Pseudomonas aeruginosa in Jamaica, and to obtain baseline information on the presence of this important pathogen. Methods. A total of 51 isolates of Pseudomonas aeruginosa, obtained from 162 clinical specimens from major hospitals and laboratories in seven parishes in Jamaica, were analyzed between May and August 2002. Isolates were tested against 18 different antibiotics by a disk diffusion method. Results. Organisms were cultured from wound swabs (56%), high vaginal swabs (10.5%) and ear swabs (42.5%). Overall, the highest percentage rates of resistance were found for alpha-factor (100% of all isolates), nalidixic acid (82.4%), kanamycin (76.5%), and trimethoprim/sulfamethoxazole (56.9%). Resistance rates were 25.5% or lower for tobramycin, gentamicin and polymyxin 13, cefotaxime, ciprofloxacin and norfloxacin, piperacillin, carbapenems and amikacin. Forty-one isolates showed intermediate sensitivity to most of the antipseudomonal antibiotics, and the remaining 10 isolates were resistant to eight or more antibiotics. The multiresistant isolates, most of which were hospital isolates, were all resistant to tetracycline, nalidixic acid and trimethoprim/sulfanethoxazole, and highly (80%-90%) resistant to kanamycin, ciprofloxacin and norfloxacin. Conclusions. This study confirms that antibiotic resistance in this clinical pathogen is emerging in Jamaica, and suggests that due care must be taken in hospital settings to adequately diagnose pseudomonal infections and prescribe the antibiotic treatment most effective in preventing the increase in multidrug resistant organisms.