Sivanmaliappan different antibiotics. Among all the isolates 55.5%

Sivanmaliappan (2011) suggest that Pseudomonas aeruginosa is
responsible for causing major tissue damage in the diabetic foot ulcer
patients. The major problem of P.
Aeruginosa is the high level of resistance to broad spectrum of
antibiotics. The purpose of this study was to investigate the antimicrobial
resistance and sensitivity of P.
Aeruginosa  isolates. The current
research study was done from june 2006 to April 2007 in the Department of
Microbiolpogy, Dr N.G.P Arts and Science College, Coimbatore. They investigate
270 samples of pus collected from the foot ulcer of diabetic patients. For the
confirmation purposes first of all the collected samples were gram stained and
then cultured after then the antimicrobial sensitivity to 15 different
antibiotics were done. Out of all 270 samples (14.28%) 18 strains of P. aeruginosa were investigated. Total
of the strain shows resistance  of
different degree to different antibiotics. Among all the isolates 55.5% shows
multidrug resistance which were resistant from 8 to 11 antibiotics. The P.aeruginosa isolates were sensitive
only to ciprofloxacin, cefotaxime but 100% resistant to ampicillin,
erythromycin, norfloxacin and cefoperazone by disk diffusion method.

Vaziri (2011) suggested that the
opportunistic pathogens Pseudomonas
aeruginosa can cause mainly the nosocomial infections. For the treatment of
p.aeruginosa the Aminoglycosides are
best option. The drug modifying enzymes is commonly inactivated by
Aminoglycoside. The main objective of the current study was to investigate the
existence of aminoglycosides resistance and prevelance of four main modifying enzyme genes (aac (6′)-I, aac (6′)-II, aph (3′)-VI, ant
(2″)-I) in P. aeruginosa in Iran.
A total of 250 P. aeruginosa isolateswere
isolated from different hospital in seven cities of Iran. With the help of disk
diffusion method and E-test the antimicrobial sensitivity of all the 250
isolates were determined while PCR were used for the identification of the
presence of modifying enzyme. The P.aeruginosa
rate of resistance was 24% toward imikacin, 38% to tobramycin while 43 % to
gentamicin with the help of using disk diffusing method. To  investigate that genes aac (6′)-II was mostly found in phenotypic resistant isolates
followed by ant (2″)-1, aac (6′)-I, aph
(3′)-VI.  The resistance to
Aminoglycoside is a main problem of P. aeruginosa
in Iran. Therefore, there is considerable local surveillance of aminoglycoside
resistance.

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Paterson (2006) showed
significance of Gram-negative rods infections as they are the main cause of
infection in developing countries. High death rates have been linked with
infection caused by Gram-negative bacteria.

            Martínez
(2008) studied about the P. aeruginosa
habitat as they inhabits in moist and humid envoirnment.Its flexible nature and
resistance to antibiotics make it easy it to live on a broad range of natural
and artificial setting such as surfaces in medical amenities. Life threatening P. aeruginosa infections is often
nosocomial, and all are associated with weakened host defenses. Drug resistance
results in extended hospital stay of patients and increased in health
expenditures.

            Maragakis
et al. (2008) worked
on modifying enzymes as they are the most general mechanism of amino glycoside
resistance. Aminoglycosides resistance mechanism includes modification of
enzymes, lack of permeability, efflux pump, bio-film formation, and methylation
16s rRNA. Amino glycoside resistance genes are positioned on mobile genetic
elements which could easily spread among rest of bacteria. Colistin is the only
therapy for P. aeruginosa infections. Studies showed that among 161
strains of P. aeruginosa (54.39%) were resistant to as a minimum three
of the antimicrobial groups amongst piperacillin-tazobactam, ceftazidime,
aminoglycosides, fluoroquinolones, carbapenems, and colistin.

            Breidenstein
et al. (2008) reported high resistance to
ciprofloxacin associated with Fluoroquinolones genes was detected in Centre for
Microbial Diseases and Immunity Research, University of British Columbia,
Canada. Drlica and Zhao (2007) revealed that among fluoroquinolones, the two
main antibiotics ciprofloxacin and levofloxacin are generally used in the
treatment of P. aeruginosa infection. Poirel, Cattoir and
Nordmann. (2012) worked on the resistance to
fluoroquinolones as it is mediated by the production of Qnr proteins that
targets DNA Gyrases.Spanish research evaluated that ant (2″)-Ia gene
occurred commonly among P. aeruginosa strains round about 65.0% and
28.0% of tested isolates in Iranian studies.

Shahcheraghi (2008) worked on ESBL-positive isolates. These isolates showed
MICs i.e 4?g/ mL for different drugs. These isolates were grown in LB broth at
37°C all night later DNA was extracted by extraction kit. After extraction  PCR was carried out in which spe­cific primers
and annealing temperature for amplify­ing the blaSHV, blaTEM, blaPER-1, and
blaCTX-M1 and blaVEB-1 genes were used the results showed that K. pneumoniae containing the blaSHV,
blaCTX-M and blaTEM genes and P.
aeruginosa containing the blaPER gene.

Reller et al. (2009) showed significance of antimicrobial
susceptibility testing in microbiology laboratory as it is use to verify
susceptibility in order to choose empirical antimicrobial agents and to
identify resistance in individual bacterial isolates by Disk diffusion test.

Khuntayaporn et al. (2012) reported
that drug resistance among pathogens has emerged an important problem in
current medicine all over the world. Improper use of antibiotic induced a
selective pressure on the microorganism which results in development of
antimicrobial resistance.

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