Multidrug Resistant Pseudomonas aeruginosa in Healthcare Facilities in Port-au-Prince, Haiti.

Abstract Objectives Pseudomonas aeruginosa is a leading cause of opportunistic infections worldwide, particularly in healthcare settings, and frequently demonstrates resistance to commonly prescribed antimicrobials. Carbapenem resistance is prevalent worldwide; however, there are currently limited data available from Haiti. The aim of this study was to characterize and document this phenotype in Port-au-Prince, Haiti, to further inform the need for appropriate infection control, empiric treatment guidelines, and laboratory screening measures, both in Haiti and globally. Methods Fifty P. aeruginosa isolates were characterized by multi-locus sequence typing and antimicrobial susceptibility testing and, of these, eight isolates were subjected to whole genome sequencing (WGS) to identify potential genetic correlations of phenotypic resistance. Results Twenty-three sequence types (STs) were identified, including 13 new STs. Nineteen isolates belonged to a single, previously characterized ST (ST654), all of which demonstrated multidrug resistant phenotypes, including resistance to meropenem, imipenem, and ceftazidime; two isolates were also resistant to colistin. WGS revealed the presence of genes encoding several previously characterized resistance determinants in ST654; notably ACC(6’)-Ib3-cr and GES-7. Metallo-β-lactamase genes (blaVIM-5) were also detected in three isolates. Conclusions These findings confirm that drug-resistant clones of P. aeruginosa are present in Haiti, supporting the need for appropriate screening and control measures and confirming that drug-resistant microorganisms pose a global threat. Further investigations are required to guide appropriate antimicrobial prescribing in this region.