Case Report: Pan-Drug Resistant Pseudomonas aeruginosa from a Child with an Infected Burn Wound at the University Teaching Hospital of Kigali, Rwanda

Innocent Ndikubwimana,1 Noel Gahamanyi,2,3 Thaddée Bwanakweli,2 Henri Desire Uwayo,2 Gaspard Habimana,4 Tanya Rogo5 1Pediatric Department, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 2National Reference Laboratory, Rwanda Biomedical Centre, Kigali, Rwanda; 3Biology Department, College of Science and Technology, University of Rwanda, Kigali, Rwanda; 4Pediatric Department, Kigali University Teaching Hospital, Kigali, Rwanda; 5Pediatric Infectious Diseases, Brown University Alpert Medical School, Providence, RI, USACorrespondence: Innocent Ndikubwimana, Email [email protected]: Pseudomonas aeruginosa is a significant cause of morbidity and mortality in intensive care units, and is prevalent in nosocomial infections and cystic fibrosis. The increasing rates of antimicrobial resistance (AMR) complicate the treatment of P. aeruginosa infections, especially because of the multidrug resistance (MDR), extensively drug-resistant (XDR), and pan-drug resistant (PDR) strains.Case Presentation: We report the case of a 4-year-old male with severe burns covering 45% of his body surface who developed nosocomial PDR P. aeruginosa infection at the University Teaching Hospital of Kigali (CHUK) in Rwanda. A wound culture yielded a PDR P. aeruginosa isolate that was resistant to all the tested antimicrobials, with intermediate resistance to colistin. However, the patient improved with a combination of ceftazidime and amikacin following cessation of fever and successful skin grafting. The patient was discharged on day 95.Conclusion: P. aeruginosa is a common hospital-acquired pathogen that is particularly challenging to treat, owing to its antimicrobial resistance profile and biofilm production. Antibiotic-resistant strains are a significant public health threat, especially in pediatric burn units. This case underscores the critical need to strengthen infection prevention and control measures together with robust antimicrobial stewardship programs. Molecular characterization of this PDR strain will yield further details regarding its virulence and genotyping.Keywords: Pseudomonas aeruginosa, burn wound, antimicrobial resistance, CHUK, Rwanda