Emergence of Extremely Drug Resistant and Pan Drug Resistant Acinetobacter baumanii and Pseudomonas aeruginosa Isolated from Diverse Samples in Delhi

Aims and objectives: The purpose of this study is to observe the recent prevalence to assess drug resistance pattern of Extremely-drug resistant (XDR) and Pan drug resistant (PDR) isolates of Acinetobacter baumanii and Pseudomonas aeruginosa among clinically diagnosed cases from diverse samples in Dr Lal Path Labs, Delhi. Materials and Methods: Retrospective analysis of XDR and PDR resistance in 1655 isolates of Acinetobacter baumanii and 4238 isolates of Pseudomonas aeruginosa considered between one-year period March 2019-2020, performed at Microbiology department of Dr Lal Path Labs. Identification was carried out by MALDI-TOF and antimicrobial susceptibility was evaluated by VITEK® 2 with respective susceptibility card (AST 281, BioMerieux, India) as per as CLSI M100-S-29. Results: This Retrospective study conducted to analyse XDR resistance prevalence among 258 (15.6%) in Acinetobacter baumanii and 512 (12.1%) in Pseudomonas aeruginosa isolates from various clinical specimens. Of the1655 total isolates 41, (2.5%) of Acinetobacter baumanii and 4328 total isolates 166, (3.8%) of Pseudomonas aeruginosa were resistant to all available antibiotics (Pan Drug Resistant). Variability of Acinetobacter baumanii XDR isolates was seen in different sample type that is pus (23.8%), respiratory (21.8%), fluid (21.2%), whereas XDR Pseudomonas aeruginosa was largely isolated from fluid (15.1%), followed by urine (12.8%), pus (11.4%). PDR strains of both species were isolated from respiratory and urine specimens. The other variable included in this study was impact of age with respective of isolates detection. The most predominant age group infected with Acinetobacter baumanii were Young adults (<=21-40 years) constituted 37.2% while in Pseudomonas aeruginosa constituted 46.4% elderly adults (≥ 60 years of age) of all isolates. Conclusion: XDR and PDR isolates of Acinetobacter baumanii and Pseudomonas aeruginosa become more virulent; is a reality and leading to clinical treatment failure leaving very few or no treatment options in our hand. XDR and PDR has become the concern for policy makers and urgent need of strictly adhere to the concept of reserve drugs policy, to minimize the misuse of available antimicrobial Colistin in our country.