Emergence of Ciprofloxacin Resistance Among Pseudomonas Aeruginosa Isolated from Burn Patients

Background: Increasing resistance of Pseudomonas aeruginosa to ciprofloxacin in ICU/burn units has created a problem in the treatment of infections caused by this microorganism. Methods: Fifty P. aeruginosa strains were isolated from burn patients hospitalized in the Kerman Hospital during May 1999-April 2000 and were tested for in-vitro sensitivity to different antibiotics by disc diffusion breakpoint assay.  The isolates were subjected to minimum inhibitory concentration (MIC) test by agar dilution method.  Existence of the plasmids was also investigated in the isolates. Results: Thirty-four patients infected with ciprofloxacin strains showed MIC of 8 mg/ml [p<0.001].  Sixteen patients were infected with sensitive strains exhibiting MIC range of 0.0125-0.125 ± 0.033 mg/ml.  The isolates were also also resistant to other antibiotics [p<0.001].  Plasmid isolation and agarose gel electrophoresis (0.7%) revealed three plasmid bands in strains 8 and 16, and one band in strain 35.Conclusion: The emergence of ciprofloxacin resistance of P. aeruginosa in burn patients is alarming since this antibiotic has only recently been introduced onto the market in Iran.  One important observation was that some isolates exhibited cross resistance to other antibiotics.  Furthermore, some strains were carriers of plasmids which might have acted as the potential source of acquired resistance in the hospital setting.