Control of a Nosocomial Outbreak due to Multi Drug Resistant Pseudomonas Aeruginosa in a Pediatric Intensive Care Unit

ABSTRACT Two clonally related P seudomonas aeruginosa isolates, recovered from two patients admitted to a pediatric intensive care unit, were found to harbor a new OXA-2 variant (Asn148Asp), designated OXA-161. The plasmid location of bla OXA-161 was demonstrated through electroporation to PAO1, and its codification in a class I integron (together with aacA4) was demonstrated through PCR and sequencing. bla OXA-2 and bla OXA-161 were cloned in parallel to demonstrate the extended-spectrum β-lactamase properties of OXA-161, conferring resistance to ceftazidime and reduced susceptibility to cefepime and aztreonam.

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Antibiotic Susceptibilities of Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii Strains Isolated from Patients in the Pediatric Intensive Care Unit

Turkish Journal of Intensive Care ◽

10.4274/tybd.63825 ◽

2018 ◽

Vol 16 (3) ◽

pp. 109-114 ◽

Cited By ~ 1

Author(s):

Adem Dursun ◽

Serkan Özsoylu ◽

Hüseyin Kılıç ◽

Ayşegül Ulu Kılıç ◽

Başak Nur Akyıldız

Keyword(s):

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Klebsiella Pneumoniae ◽

Acinetobacter Baumannii ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Antibiotic Susceptibilities

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Creation of a Combination Antibiogram for Pseudomonas aeruginosa in a Pediatric Intensive Care Unit

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-26.8.828 ◽

2021 ◽

Vol 26 (8) ◽

pp. 828-833

Author(s):

R. Zachary Thompson ◽

Cheryl L. Sargel ◽

Melissa Moore-Clingenpeel ◽

Todd J. Karsies

Keyword(s):

Cystic Fibrosis ◽

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Susceptibility Pattern ◽

First Line ◽

Resistance Rates ◽

Antimicrobial Regimen

OBJECTIVE This study describes the creation of a combination antibiogram directed toward Pseudomonas aeruginosa to determine the most appropriate empiric antimicrobial regimen(s). METHODS P aeruginosa isolates were collected from all sites between January 2013 and December 2017 for patients admitted to the PICU. Patients with cystic fibrosis and isolates from the same site and susceptibility pattern obtained within 30 days were excluded. β-Lactam susceptibilities were determined and compared with the addition of an aminoglycoside or fluroquinolone and summarized in a combination antibiogram. RESULTS One hundred ninety-nine P aeruginosa isolates were included for analysis. The addition of a second agent to piperacillin-tazobactam was shown to have the most significant improvement among the β-lactams, with 70% susceptibility as monotherapy and increases to above 90% with the addition of an aminoglycoside or fluroquinolone. The addition of an aminoglycoside or fluroquinolone to cefepime and meropenem increased coverage to above 95%. The addition of a second agent was likely to increase susceptibility of a monotherapy backbone; however, as the susceptibility of the first-line agent decreased, the susceptibility of the second agent needed to be higher to achieve a 95% coverage threshold. CONCLUSIONS Our results support use of a second agent to significantly improve the likelihood of appropriate empiric coverage of P aeruginosa. Use of a combination antibiogram may be more beneficial than a simple antibiogram for units with increasing resistance rates, or for coverage of specific resistant organisms.

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