Multidrug-Resistance Genes in Pseudomonas aeruginosa from Wound Infections in a Tertiary Health Institution in Osogbo, Nigeria.

2020 ◽  
Vol 20 ◽  
Author(s):  
Akinloye Ajibola Oluseye ◽  
Adefioye O. Jose ◽  
Adekunle O. Catherine ◽  
Anomneze Benjamin Udodiri ◽  
Makanjuola OB ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Wound Infections ◽  
Extended Spectrum Beta Lactamase ◽  
Carbapenem Resistant ◽  
Amoxicillin Clavulanic Acid ◽  
Mar Index

Background: Multidrug Resistant Pseudomonas aeruginosa (MDRPA) is an ubiquitous opportunistic organism which poses a threat to the management of infections globally. Objectives: The objectives of the current research were to assess the antibiotic resistance profiles as well as Multiple Antibiotic Resistance (MAR) Index of clinical isolates of P. aeruginosa associated with wound infections. Presence of Extended Spectrum Beta Lactamase genes (bla CTX-M, bla SHV and bla TEM) and Carbapenemase genes (bla KPC and blaNDM) were also determined among the isolates. Methods: Swab samples were collected from 255 patients with wound infections. Bacterial identification was done by standard diagnostic tests. The identity of isolates were confirmed by detection of the exoA gene using the PCR technique. Antibiotic susceptibility testing and resistance profile was determined using disc diffusion method. Resistance genes were amplified by the PCR method. Results: A total of 235 (92.2%) bacterial isolates were recovered from the wounds of the 255 patients of these, 124 (52.8%) were Gram-negative bacilli while the remaining 111 (47.2%) were Gram-positive cocci. A total of 69 Pseudomonas aeruginosa strains were recovered from the wound specimens. Imipenem was the most effective antibiotic against these isolates (92.8% isolates were susceptible) while all isolates were resistant to Meropenem, Cefepime, Ticarcillin, Amoxicillin-clavulanic acid, Cefotaxime, Ampicillin and Cefpodoxime. All 69 Pseudomonas aeruginosa isolates were multidrug resistant (MDR). Of the isolates selected for PCR, all were positive for the TEM, CTX-M and SHV genes while, one third was blaKPC and blaNDM producers. Conclusion: This study demonstrated the a high prevalence of carbapenem-resistant strains of P. aeruginosa. Suggesting that there is an urgent need in Nigeria for the enactment and enforcement of policies and necessary laws restricting the availability and indiscriminate use of antibiotics.

scholarly journals Plasmid Profile Analysis of Pseudomonas aeruginosa Isolated from Wound Infections in a General Hospital in Southern Nigeria

2019 ◽  
pp. 1-7
Author(s):  
F. Z. Uyanga ◽  
I. A. Ibanga
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Care Facility ◽  
Health Care Facility ◽  
Plasmid Profile ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Wound Infections ◽  
Open Wound ◽  
Extended Spectrum Beta Lactamase

Background/Purpose: Open wound infection is a serious problem especially with extended-spectrum beta lactamase (ESBL) producing Gram negative bacteria such as P. aeruginosa. The purpose of this research was to identify open wound infections due to Pseudomonas aeruginosa and also determine their plasmid profile. Methods:  A total of 50 Pseudomonas aeruginosa isolates were obtained from clinical wound swabs in a secondary health care facility. Pseudomonas aeruginosa isolates were identified using Microbact 24E system kit. Pseudomonas aeruginosa were isolated and subjected to antibiotic susceptibility testing by disc diffusion method. ESBL production was detected using Double Disk Synergy Test (DDST) and CHROMagar ESBL (France). Six different antibiotic discs were used to determine the susceptibility pattern of the isolates. Plasmids were extracted using ZR plasmid Miniprep classic extraction Kit. Electrophoresis of the DNA was carried out on 0.8% w/v agarose gel. Results: The prevalence of Pseudomonas aeruginosa was 63%. The antibiotic resistance pattern showed that Pseudomonas aeruginosa was highly resistant against cefotaxime (90%), ofloxacin (80%), ceftazidime (55%), azetronam (60%), imipenem (25%), amoxicillin clavulanic acid (35%) and amikacin (30%). Plasmid profile was carried out on 20 selected multidrug resistant isolates; those resistant to three or more classes of antibiotics. Plasmid content of the isolates were found to be 90%. All isolates that had plasmid were resistant to cefotaxim, ceftazidime, azetronam, ofloxacin and amikacin. Conclusion: Antibiotic resistance by P. aeruginosa is increasingly high in wound infections and appears to be linked to the presence of plasmid and ESBL enzymes.

scholarly journals MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

2017 ◽  
Vol 10 (6) ◽  
pp. 78
Author(s):  
Bhuvaneshwari Gunasekar
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Mar Index ◽  
Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of  surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

scholarly journals Molecular detection of antibiotic resistance genes in multidrug-resistant Staphylococcus aureus isolates from dog dental plaque

2019 ◽  
Vol 22 (4) ◽  
pp. 419-427
Author(s):  
S. Nouri Gharajalar ◽  
M. Onsori
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Multiplex Pcr ◽  
Resistance Genes ◽  
Dental Plaque ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Pcr Assay ◽  
Multiplex Pcr Assay

Multidrug resistant Staphylococcus aureus strains are a major health care problem both in humans and animals. In this work we described three multiplex PCR assays for detection of clinically relevant antibiotic resistance genes in S. aureus isolated from dog dental plaques. Thirty dental plaque samples were collected; then cultural, biochemical and molecular tests performed for isolation and identification of S. aureus from samples. The antibiotic susceptibility of the isolates were checked by Kirby Bauer disc diffusion method and the prevalence of antibiotic resistance genes determined using multiplex PCR assay. As a result S. aureus was isolated from 18 dog plaque samples. Fifteen of these isolates were resistant to penicillin. The mecA gene was more prevalent than blaZ among penicillin-resistant bacteria. Ten of the isolates were resistant to tetracycline. The percentage of tetM was higher than tetK among them. Also, 10 of the isolates were resistant to cefazolin among them bla TEM detected in higher rate than blaSHV and blaOXA-1. Hence multiplex PCR assay is a suitable method for detection of antibiotic resistance patterns of S. aureus isolates.

Antibiotic Resistance of Enterobacteriaceae Isolated from Fresh Fruits and Vegetables and Characterization of their AmpC β-Lactamases

2019 ◽  
Vol 82 (11) ◽  
pp. 1857-1863 ◽  
Author(s):  
ZAHRA S. AL-KHAROUSI ◽  
NEJIB GUIZANI ◽  
ABDULLAH M. AL-SADI ◽  
ISMAIL M. AL-BULUSHI
Keyword(s):  
Antibiotic Resistance ◽  
Fruits And Vegetables ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Disk Diffusion Method ◽  
Antibiotic Resistant ◽  
Amoxicillin Clavulanic Acid ◽  
Clinically Significant ◽  
Enterobacter Asburiae

ABSTRACT Enterobacteria may gain antibiotic resistance and be potent pathogens wherever they are present, including in fresh fruits and vegetables. This study tested the antibiotic resistance of enterobacteria isolated from 13 types of local and imported fresh fruits and vegetables (n = 105), using the standard Kirby-Bauer disk diffusion method. Phenotypic and genotypic characterizations of AmpC β-lactamases were determined in cefoxitin-resistant isolates. Ten percent of the enterobacteria tested (n = 88) were pansusceptible, 74% were resistant to at least one antibiotic, and 16% were multidrug resistant. Enterobacteria isolates showed the highest antibiotic resistance against ampicillin (66%), cephalothin (57%), amoxicillin–clavulanic acid (33%), cefoxitin (31%), tetracycline (9%), nalidixic acid (7%), trimethoprim (6%), and kanamycin (5%). Three isolates showed intermediate resistance to the clinically important antibiotic imipenem. Escherichia coli isolated from lettuce exhibited multidrug resistance against five antibiotics. Fifteen isolates were confirmed to have AmpC β-lactamase, using the inhibitor-based test and the antagonism test; the latter test confirmed that the enzyme was an inducible type. Four types of ampC β-lactamase genes (CIT, EBC, FOX, and MOX) were detected in eight isolates: four Enterobacter cloacae isolates and one isolate each of Citrobacter freundii, Enterobacter asburiae, Enterobacter hormaechei, and Enterobacter ludwigii. It was concluded that fresh fruits and vegetables might play a role as a source or vehicle for transferring antibiotic-resistant bacteria that might spread to other countries through exportation. The clinically significant AmpC β-lactamase was rarely documented in the literature on bacteria isolated from fruits and vegetables, and to our knowledge, this is the first report on the detection of an inducible type in such commodities.

scholarly journals Molecular Characterization of invasive Enterobacteriaceae from Pediatric Patients in Central and Northwestern Nigeria

2020 ◽  
Author(s):  
Carissa Duru ◽  
Grace M Olanipekun ◽  
Vivian Odili ◽  
Nicholas J Kocmich ◽  
Amy Rezac ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Treatment Options ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Esbl Production ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Resistance Rates

AbstractBackgroundBacteremia is a leading cause of death in developing countries but etiologic evaluation is infrequent and empiric antibiotics are not evidence-based. Very little is known about the types of extended-spectrum β-lactamases (ESBL) in pediatric bacteremia patients in Nigeria. We evaluated the patterns of ESBL resistance in children enrolled into surveillance for community acquired bacteremic syndromes across health facilities in Central and Northwestern Nigeria.MethodBlood culture from suspected cases of sepsis from children age less than 5 years were processed using automated Bactec® incubator System from Sept 2008-Dec 2016. Enterobacteriacea were identified to the species level using Analytical Profile Index (API20E®) identification strip and antibiotic susceptibility profile was determined by the disc diffusion method. The multidrug resistant strains were then screened and confirmed for extended spectrum beta lactamase (ESBL) production by the combination disc method as recommended by Clinical and Laboratory Standard Institute (CLSI). Real time PCR was used to elucidate the genes responsible for ESBL production characterize the resistance genesResultOf 21,000 children screened from Sept 2008-Dec 2016, 2,625(12.5%) were culture-positive. A total of 413 Enterobacteriaceae available for analysis were screened for ESBL. ESBL production was detected in 160/413(38.7%), comprising Klebsiella pneumoniae 105/160(65.6%), Enterobacter cloacae 21/160(13.1%), Escherichia coli 22/160(13.8%), Serratia species 4/160(2.5%), Pantoea species 7/160(4.4%) and Citrobacter species 1/160(0.6%). Of the 160 ESBL-producing isolates, high resistance rates were observed among ESBL-positive isolates for Ceftriaxone (92.3%), Aztreonam (96.8%), Cefpodoxime (96.25%), Cefotaxime (98.75%) and sulphamethoxazole-trimethoprim (90%), while 87.5 %, 90.63%, and 91.87% of the isolates were susceptible to Imipenem, Amikacin and Meropenem respectively. Frequently detected resistance genes were blaTEM 83.75%) (134/160), and, blaCTX-M 83.12% (133/160) followed by blaSHV genes 66.25% (106/160). Co-existence of blaCTX-M, blaTEM and blaSHV was seen in 94/160 (58.8%), blaCTX-M and blaTEM in 118/160 (73.8%), blaTEM and blaSHV in 97/160 (60.6%) and blaCTX-M and blaSHV in 100/160 (62.5%) of isolates tested.ConclusionOur results indicate a high prevalence of ESBL resistance to commonly used antibiotics in Enterobacteriaceae isolates from bloodstream infections in children in this study. Careful choice of antibiotic treatment options and further studies to evaluate transmission dynamics of resistance genes could help in the reduction of ESBL resistance in these settings.

scholarly journals Antibiotic resistance in uropathogenic enterobacteria

2021 ◽  
Vol 319 ◽  
pp. 01102
Author(s):  
Jamila Hamamouchi ◽  
Aicha Qasmaoui ◽  
Karima Halout ◽  
Réda Charof ◽  
Farida Ohmani
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Mechanisms Of Resistance ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
Public Health Threat ◽  
Amoxicillin Clavulanic Acid ◽  
Epidemic Diseases

Multidrug-resistant Enterobacteriaceae are a major public health threat worldwide. These germs are the most redoubtable because they are producers of beta-lactamases and possess other mechanisms of resistance to many antibiotics. The objective of this work is to identify isolated strains of Enterobacteriaceae and to study their antibiotic resistance profiles, thus contributing to the surveillance of antibioresistance. This is a retrospective study over a period of three years (2018-2020) including urine samples taken in the region of Rabat-Salé-Zaire and examined at the laboratory of Epidemic Diseases in National Institute of Hygiene of Rabat. Enterobacteriaceae were the most frequent germs with a predominance of Escherichia coli (68%) followed by Klebsiella pneumoniae (23%). Extended-spectrum beta-lactamase-producing Enterobacteriaceae accounted for 10.5%. The highest resistance was observed with amoxicillin, followed by ticarcillin, cefalotin, trimethoprim/sulfamethoxazole, amoxicillin+clavulanic acid, nalidixic acid and finally ciprofloxacin and norfloxacin. The aminoglycosides and the 2nd and 3rd cephalosporins were the most active molecules. The sensitivity of imipenem and ertapenem was 100%. This study shows the worrying appearance of resistance to the usual antibiotics in uropathogenic enterobacteria. Rational prescription of antibiotics and monitoring of the evolution of bacterial resistance are necessary in each region.

scholarly journals Prevalence and Characteristics of Metallo-beta Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Somayeh Safarirad ◽  
Mohsen Arzanlou ◽  
Jafar Mohammadshahi ◽  
Hamid Vaez ◽  
Amirhossin Sahebkar ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Continuous Monitoring ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
Clonal Relatedness ◽  
Synergy Test ◽  
Highly Virulent

Background: Carbapenems are the most commonly administered drugs for the treatment of multidrug-resistant Pseudomonas aeruginosa (MDR-P. aeruginosa) infections. However, carbapenem-resistant P. aeruginosa is spreading rapidly and has led to a new threat to human health worldwide. Objectives: The current study aimed to determine the prevalence of imipenem-resistant P. aeruginosa, detect metallo-β-lactamase (MBL)-producer isolates, and evaluate their clonal relationships in strains isolated from patients referring to the hospitals of Ardabil city, Iran. Methods: The resistance rate to imipenem was evaluated using the disk diffusion method. Double-disk synergy test and PCR technique were used for phenotypic and genotypic screening of MBL-positive P. aeruginosa, respectively. Ultimately, ERIC-PCR and MLST methods were used for assessing clonal relatedness among the isolates. Results: The prevalence of imipenem-resistant P. aeruginosa strains was estimated at 57.1% (48 out of 84 isolates). In addition, 45 (93.7%) out of 48 imipenem-resistant P. aeruginosa isolates were phenotypically screened as MBL-positive, among which 16 (35.5%) and three (6.6%) isolates harbored blaIMP and blaVIM-1 genes, respectively. However, blaNDM, blaSIM-2, blaSPM, and blaGIM-1 genes were not detected in this study. MBL-producing P. aeruginosa strains were divided into 42 ERIC-PCR types. Based on the results of MLST, P. aeruginosa ST235 was the only identified sequence type. Conclusions: Our results revealed a high and alarming prevalence of imipenem-resistant and blaIMP-positive P. aeruginosa ST235 at Ardabil hospitals. Continuous monitoring is essential to control the further spread of this highly virulent and drug-resistant clone.

scholarly journals Prevalence of class 1 and 2 integrons among the multidrug resistant uropathogenic strains of Escherichia coli

2017 ◽  
Vol 9 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Haddadi Azam ◽  
Somayeh Mikaili Ghezeljeh ◽  
Shavandi Mahmoud
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Integrase Gene ◽  
Class 1 ◽  
Tract Infections

Abstract Background Multidrug resistance is a serious problem in the treatment of urinary tract infections. Horizontal gene transfer, directed by strong selective pressure of antibiotics, has resulted in the widespread distribution of multiple antibiotic resistance genes. The dissemination of resistance genes is enhanced when they are trapped in integrons. Objectives To determine the prevalence of integrons among multidrug resistant Escherichia coli strains collected from regional hospitals and private clinical laboratories in Alborz province. Methods The susceptibility of 111 clinical Escherichia coli isolates was tested using a Kirby–Bauer disk diffusion method for common antibiotics. Isolates were screened for the production of extended spectrum β-lactamases (ESBLs) using a double disk synergy test. The existence of integrons was confirmed by amplification of the integrase gene and their class determined via analysis of PCR products by PCR-RFLP. Results Isolates showed the highest resistance to amoxicillin. Nitrofurantoin, amikacin, and ceftizoxime were the most effective antibiotics in vitro. Eighty-eight isolates of 111 (79%) were resistant to more than three unrelated drugs. We found 30% of the multidrug resistant isolates harbor integrons. Class 1 and 2 integrons were detected in 25 and 1 isolates, respectively. ESBL screening of strains showed 45 isolates (40%) were positive; 22% of the ESBL-positive isolates carried class 1 integrons and the frequency of MDR in ESBLpositive isolates was 93%. Conclusion The existence of integrons in only 29.5% of multidrug resistant isolates showed that besides integrons, antibiotic resistance genes were probably carried on other transferable elements lacking integrons, such as transposons or plasmids.

scholarly journals Carbapenem and colistin-resistant bacteria in North Lebanon: Coexistence of mcr-1 and NDM-4 genes in Escherichia coli

2021 ◽  
Vol 15 (07) ◽  
pp. 934-342
Author(s):  
Charbel Al-Bayssari ◽  
Tania Nawfal Dagher ◽  
Samar El Hamoui ◽  
Fadi Fenianos ◽  
Nehman Makdissy ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Ionization Time ◽  
E Coli ◽  
Flight Mass Spectrometry ◽  
Carbapenem Resistant ◽  
The Matrix

Introduction: The increasing incidence of infections caused by multidrug-resistant bacteria is considered a global health problem. This study aimed to investigate this resistance in Gram-negative bacteria isolated from patients hospitalized in North-Lebanon. Methodology: All isolates were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was achieved using disk diffusion, E-test and Broth microdilution methods. Phenotypic detection of carbapenemase was carried out using the CarbaNP test. RT-PCR, standard-PCR and sequencing were performed to detect resistance genes and oprD gene. Conjugal transfer was carried out between our isolates and Escherichia coli J53 to detect the genetic localization of resistance genes. MLST was conducted to determine the genotype of each isolate. Results: Twenty-three carbapenem-resistant Enterobacterales of which eight colistin-resistant Escherichia coli, and Twenty carbapenem-resistant Pseudomonas aeruginosa were isolated. All isolates showed an imipenem MIC greater than 32 mg/mL with MICs for colistin greater than 2 mg/L for E. coli isolates. All the Enterobacterales isolates had at least one carbapenemase-encoding gene, with E. coli isolates coharboring blaNDM-4 and mcr-1 genes. Moreover, 16/20 Pseudomonas aeruginosa harbored the blaVIM-2 gene and 18/20 had mutations in the oprD gene. MLST revealed that the isolates belonged to several clones. Conclusions: We report here the first description in the world of clinical E. coli isolates coharboring blaNDM-4 and mcr-1 genes, and K. pneumoniae isolates producing NDM-6 and OXA-48 carbapenemases. Also, we describe the emergence of NDM-1-producing E. cloacae in Lebanon. Screening for these isolates is necessary to limit the spread of resistant microorganisms in hospitals.

scholarly journals 2291. Evaluation of Multidrug-Resistant Pseudomonas aeruginosa Isolates in Patients Receiving Ceftolozane/tazobactam

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S785-S785
Author(s):  
Emily C Bodo ◽  
Aisling Caffrey ◽  
Vrishali Lopes ◽  
Jaclyn A Cusumano ◽  
Laura A Puzniak ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Retrospective Study ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Veterans Affairs ◽  
Carbapenem Resistant ◽  
Clinical Culture ◽  
Resistance Rates ◽  
Lactamase Inhibitor

Abstract Background Multidrug-resistant (MDR) Pseudomonas aeruginosa is a challenging pathogen to treat. Ceftolozane/tazobactam (C/T) is a combination cephalosporin and β-lactamase inhibitor that has demonstrated activity against MDR P. aeruginosa, including carbapenem-resistant isolates. The objective of this study was to evaluate multidrug resistance in P. aeruginosa isolates obtained from patients treated with C/T across the Veterans Affairs (VA) Healthcare System nationally. Methods Hospitalized patients who received at least 1 dose of CT between January 2015 and April 2018 and had a positive P. aeruginosa culture were included in this retrospective study. Culture source and antimicrobial susceptibility reports were assessed for each P. aeruginosa isolate. Isolates were categorized as multidrug-resistant based on the Centers for Disease Control (CDC) definition. Resistance rates were categorized by source of culture. Results We identified 174 positive P. aeruginosa cultures among 154 patients who received at least one dose of C/T during the study period. The most common sources of isolates were lung (40% of patients), urine (21%), skin and soft tissue (15%), blood (14%), and bone/joint (14%). Most patients (98.1%) had isolates that were MDR, with high rates of carbapenem (84.4%), extended-spectrum cephalosporin (82.5%), and fluoroquinolone (79.9%) resistance. In this cohort, 50.6% of patients received at least one antibiotic prior to initiating C/T to which their clinical culture was not susceptible. Conclusion Antibiotic resistance was high in this cohort of patients with P. aeruginosa, and as a result, use of non-susceptible antibiotics occurred in 50.6% of patients before C/T was started. The high carbapenem resistance rates are of great clinical concern, but highlight an area of utilization for C/T given its activity against carbapenem-resistant P. aeruginosa. Disclosures All authors: No reported disclosures.

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