scholarly journals Antimicrobial Susceptibility Trends and Risk Factors for Antimicrobial Resistance in Pseudomonas aeruginosa Bacteremia: 12-Year Experience in a Tertiary Hospital in Korea

2021 ◽  
Vol 36 (43) ◽  
Author(s):  
Jin Suk Kang ◽  
Chisook Moon ◽  
Seok Jun Mun ◽  
Jeong Eun Lee ◽  
Soon Ok Lee ◽  
...  
2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S112-S112
Author(s):  
Jin Suk Kang ◽  
Chisook Moon ◽  
Seok Jun Mun

Abstract Background Bacteremia due to Pseudomonas aeruginosa is associated with high mortality and inappropriate initial antimicrobial therapy leads to worse outcomes. We aimed to analyze clinical characteristics of P. aeruginosa bacteremia and risk factors for antibiotic resistance and investigate their antimicrobial susceptibility trends. Methods We retrospectively reviewed the medical records of patients with P. aeruginosa bacteremia admitted to a tertiary hospital between January 2009 and March 2019. Results A total of 242 patients were identified and the median age was 70 years [interquartile range (IQR) 57.6–75.4]. Hepatobiliary tract (28.5%) was most common primary site of infection, followed by respiratory tract (20.2%) and urinary tract (15.7%). Out of 197 (81.4%) patients treated with susceptible antibiotics and the median duration of active antibiotic therapy was 10 days (IQR 4–15.5). The percentages of susceptible P. aeruginosa to amikacin, aztreonam, cefepime, ceftazidime, ciprofloxacin, colistin, gentamicin, imipenem, meropenem, piperacillin–tazobactam, and ticarcillin-clavulanate were 90.1%, 57.9%, 77.3%, 74.8%, 74.4%, 99.2%, 91.3%, 76.0%, 76.0%, 69.4%, and 51.2%. There were 24.8% carbapenem-resistant P. aeruginosa (CRPA), 36.4% multidrug-resistant P. aeruginosa (MDRPA), and 15.3% extensively drug-resistant P. aeruginosa (XDRPA). Susceptible P. aeruginosa to gentamycin and ticarcillin-clavulanate were significantly decreased in 2014–2019 than that in 2009–2013 (both; P < 0.001). Resistance rates to carbapenems and fluoroquinolones tended to increase over time. CRPA, MDRPA, and XDRPA were significantly associated with delayed active therapy (>48 h) (all; P < 0.001). Independent risk factors for CRPA were urinary tract infection (adjusted odds ratio [aOR], 3.4; 95% confidence interval [CI], 1.5–7.8), underlying hematologic malignancy (aOR, 3.0; 95% CI, 1.1–8.3) and cerebrovascular accident (aOR, 2.6; 95% CI, 1.1–5.9), hospital-acquired infection (aOR, 2.5; 95% CI, 1.0–6.1), and co-colonization with multidrug-resistant organisms (aOR, 2.2; 95% CI, 1.1–4.4). Conclusion The identification of risk factors for antibiotic resistance and analysis of antibiotics susceptibility are useful for early initiation of appropriate antibiotics in patients with P. aeruginosa bacteremia. Disclosures All authors: No reported disclosures.


2014 ◽  
Vol 34 (10) ◽  
pp. 947-952 ◽  
Author(s):  
Daniele C. Beuron ◽  
Cristina S. Cortinhas ◽  
Bruno G. Botaro ◽  
Susana N. Macedo ◽  
Juliano L. Gonçalves ◽  
...  

The objective of this study was to evaluate herd management practices and mastitis treatment procedures as risk factors associated with Staphylococcus aureus antimicrobial resistance. For this study, 13 herds were selected to participate in the study to evaluate the association between their management practices and mastitis treatment procedures and in vitro antimicrobial susceptibility. A total of 1069 composite milk samples were collected aseptically from the selected cows in four different periods over two years. The samples were used for microbiological culturing of S. aureus isolates and evaluation of their antimicrobial susceptibility. A total of 756 samples (70.7%) were culture-positive, and S. aureus comprised 27.77% (n=210) of the isolates. The S. aureus isolates were tested using the disk-diffusion susceptibility assay with the following antimicrobials: ampicillin 10mg; clindamycin 2μg; penicillin 1mg; ceftiofur 30μg; gentamicin 10mg; sulfa-trimethoprim 25μg; enrofloxacin 5μg; sulfonamide 300μg; tetracycline 30μg; oxacillin 1mg; cephalothin 30μg and erythromycin 5μg. The variables that were significantly associated with S. aureus resistance were as follows: the treatment of clinical mastitis for ampicillin (OR=2.18), dry cow treatment for enrofloxacin (OR=2.11) and not sending milk samples for microbiological culture and susceptibility tests, for ampicillin (OR=2.57) and penicillin (OR=4.69). In conclusion, the identification of risk factors for S. aureus resistance against various mastitis antimicrobials is an important information that may help in practical recommendations for prudent use of antimicrobial in milk production.


2018 ◽  
Vol 12 (08) ◽  
pp. 616-624
Author(s):  
Ashika Singh-Moodley ◽  
Adriano Duse ◽  
Preneshni Naicker ◽  
Ranmini Kularatne ◽  
Trusha Nana ◽  
...  

Introduction: Antimicrobial resistant bacterial infections are widespread globally and increases in antimicrobial resistance presents a major threat to public health. Pseudomonas aeruginosa is an opportunistic healthcare-associated pathogen with high rates of morbidity and mortality and an extensive range of resistance mechanisms. This study describes the antibiotic susceptibility profiles of P. aeruginosa isolates from patients with bacteraemia submitted by sentinel laboratories in South Africa from 2014 to 2015. Methodology: Organism identification and antimicrobial susceptibility testing were done using automated systems. Molecular methods were used to detect common resistance genes and mechanisms. Results: Overall the susceptibility was high for all antibiotics tested with a decrease over the two-year period. There was no change in the MIC50 and MIC90 breakpoints for all antibiotics from 2014 to 2015. The MIC50 was within the susceptible breakpoint range for most antibiotics and the MIC90 was within the susceptible breakpoint range for colistin only. Phenotypically carbapenem non-susceptible isolates harboured the following plasmid-mediated genes: blaVIM (n = 81, 12%) and blaGES (n = 6, 0.9%); blaNDM (n = 4, 0.6%) and blaOXA-48 and variants (n = 3, 0.45%). Porin deletions were observed in one meropenem non-susceptible isolate only, and multi-drug resistance efflux pumps were expressed in the majority of the non-susceptible isolates investigated. BlaVEB-1, blaIMP and blaKPC were not detected. Conclusion: The prevalence of resistance to commonly used antibacterial agents was low for P. aeruginosa isolates and similarly, tested resistance mechanisms were detected in a relatively small proportion of isolates. Findings in this study represent baseline information for understanding antimicrobial susceptibility patterns in P. aeruginosa isolates from blood. Our surveillance report may assist in contributing to hospital treatment guidelines.


2020 ◽  
Author(s):  
Yanbin Chang ◽  
Daiqin Zhang ◽  
Siqiang Niu ◽  
Qian Chen ◽  
Qiuxia Lin ◽  
...  

Abstract Purpose: Elizabethkingia anophelis (E. anophelis) is an important extensively drug-resistant (XDR) pathogen to which there are limited therapeutic options. E. anophelis is perpetually misidentified as Elizabethkingia meningoseptica (E. meningoseptica) by conventional methods. Consequently, this study reassessed risk factors for infection and mortality, antimicrobial susceptibility patterns and carbapenem resistance mechanisms of E. anophelis.Methods: This retrospective case–control study was conducted to reveal the risk factors associated with E. anophelis infection and in-hospital mortality from 2015–2019 in a university tertiary hospital in southwest China using univariable and multivariable logistic-regression analysis. Case patients infected with E. anophelis isolates and controls patients with non-E. anophelis infections were compared at a ratio of 1:3 during the same time period. We employed the broth microdilution method to investigate the antimicrobial susceptibility profiles of 39 E. anophelis strains. PCR amplification, DNA sequencing and gene cloning were used to investigate the mechanisms of carbapenem resistance in E. anophelis.Results: We collected 39 non-repetitive E. anophelis isolates over the study period. Multivariate analysis indicated that coronary artery disease, chronic obstructive pulmonary disease, surgery in the past 6 months, anemia and systemic steroid use were independent risk factors for the acquisition of E. anophelis. Additionally, anemia was the only independent risk factor associated with in-hospital mortality in patients with E. anophelis infections. E. anophelis isolates showed high in-vitro susceptibility towards minocycline (100%) and piperacillin/tazobactam (71.8%), but were resistant to colistin, fosfomycin, ceftazidime/avibactam and aztreonam/avibactam. Additionally, we show that two metallo-β-lactamases (MBLs) BlaB and GOB, are responsible for carbapenem resistance and the serine-β-lactamase, CME, is functionally involved in resistance to cephalosporins and monobactams. Importantly, the various putative efflux pumps in E. anophelis are not responsible for resistance. Conclusion: Our findings will help clinicians identify high-risk patients and suggest that minocycline should be considered as an antibiotic therapeutic option for infections caused by E. anophelis. Additionally, carbapenem resistance in E. anophelis isolates is mainly associated with the MBLs, BlaB and GOB.


2021 ◽  
Vol 9 (3) ◽  
pp. 152
Author(s):  
Imaculata Sonia Vidaryo Lameng ◽  
Ni Nyoman Sri Budayanti ◽  
Luh Inta Prilandari ◽  
I Ketut Agus Indra Adhiputra

Pseudomonas aeruginosa is one of the gram-negative bacteria that causes infection in the Intensive Care Unit (ICU) which is easily resistant. Patients infected with carbapenem-resistant P. aeruginosa are predicted to have a poor prognosis. This study aims to know the resistance profile of meropenem-resistant P. aeruginosa in the ICU. The results of this study can be used as a measure on the success of antimicrobial resistance control, infection control programs and become a reference for empirical therapy in the ICU. This study used a cross-sectional retrospective descriptive research method and was carried out at the Clinical Microbiology Laboratory of Sanglah Hospital Denpasar for three years, from 2018 to 2020. The results showed 38 of the 93 isolates of P. aeruginosa in the ICU were resistant to meropenem and were derived from sputum and urine. The percentage of meropenem-resistant P. aeruginosa isolates was higher in the multi-drug-resistant group and mostly came from sputum specimens. In 2018, Non-MDR meropenem-resistant P. aeruginosa isolates was that 100% sensitive to all other antibiotics used to treat P. aeruginosa infections, including; ceftazidime, cefepime, ciprofloxacin, gentamicin, amikacin, and piperacillin-tazobactam. In 2019 no meropenem-resistant P. aeruginosa isolates were found. In 2020, its sensitivity to antibiotics ceftazidime and piperacillin-tazobactam was 20.0%, ciprofloxacin 60.0% and to antibiotics gentamicin and amikacin 100%. MDR meropenem-resistant P. aeruginosa isolates in 2018 were still sensitive to ceftazidime (15.4%) and amikacin (69.2%) antibiotics, while in 2019 they were only sensitive to amikacin (37.5%). In 2020, P. aeruginosa isolates were sensitive to the antibiotics ceftazidime and cefepime (11.1%), piperacillin-tazobactam (22.2%), and amikacin (88.9%). Amikacin may be the choice of treatment for MDR meropenem-resistant P. aeruginosa.


2019 ◽  
Vol 39 (10) ◽  
pp. 816-822
Author(s):  
Juan P. Giraldo-Cardona ◽  
Daniela Gualdrón-Ramírez ◽  
Iliana Chamorro-Tobar ◽  
Adriana Pulido-Villamarín ◽  
Natalia Santamaría-Durán ◽  
...  

ABSTRACT: To determine Salmonella spp. prevalence/seroprevalence, antimicrobial resistance patterns and risk factor identification associated with its presence in Colombian swine farms. 504 samples (Faeces, swabs and environment samples) were obtained from 21 farms distributed in four geographical regions in Colombia. Salmonella spp. microbiological and molecular detection were determined by two Salmonella spp. MDS3M™ and MALDI-TOF MS assays, respectively. In addition, for serological evaluation 231 serum samples were analyzed employing ELISA Salmonella Pigtype®-Salmonella Ab (QUIAGEN®). Additionally, 41 isolates were tested for antimicrobial susceptibility using broth microdilution technique (Panel B1016-180 Beckman Coulter NC72®) and verified with WHONET 2016 software. Risk factors were assessed from a survey and analyzed for statistical significance by U Mann-Whitney test. An 8.9% prevalence (n=45) and 38.1% (n=88) seroprevalence were determined. All isolates presented 100% antimicrobial susceptibility against amikacin. However, resistance against penicillin, tetracycline, cefuroxime and trimethoprim/sulfamethoxazole was present in more than 50% of evaluated strains. Risk factors associated with Salmonella spp. presence were surface water use, rough-surfaced on floors, presence of hoppers as feeders and worker’s boots. Bacteria were present in animals and environmental samples from evaluated farms. Animal contact and/or exposure with the microorganism were also evident in obtained serological response. Bacteria presence depended on management practices and infrastructure, likewise antibiotic use, supplemented in the diet may have induced an increase in Salmonella spp. antimicrobial resistance.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0257272
Author(s):  
Habtamu Mekonnen ◽  
Abdurahaman Seid ◽  
Genet Molla Fenta ◽  
Teklay Gebrecherkos

Introduction Hospital admitted patients are at increased risk of nosocomial infections (NIs) with multi-drug resistant (MDR) pathogens which are prevalent in the hospital environment. Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii) are common causes of NIs worldwide. The objective of this study is to determine antimicrobial resistance profiles and associated factors of Acinetobacter spp and P. aeruginosa NIs among hospitalized patients. Methods A cross-sectional study was conducted at Dessie comprehensive specialized hospital, North-East Ethiopia, from February 1 to April 30, 2020. A total of 254 patients who were suspected of the bloodstream, urinary tract, or surgical site nosocomial infections were enrolled consecutively. Socio-demographic and other variables of interest were collected using a structured questionnaire. Specimens were collected and processed following standard microbiological procedures. Antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Data were analyzed with SPSS version 23 and p-value < 0.05 was considered statistically significant. Results Overall, 13% of patients had nosocomial Acinetobacter spp and/or P. aeruginosa infections. The culture positivity rate was 16(6.3%) for Acinetobacter spp and 18(7.1%) for P. aeruginosa. Patients admitted in the surgical ward (Adjusted odds ratio (AOR):10.66;95% confidence interval (CI):1.22–93.23), pediatric ward (AOR:14.37;95%CI:1.4–148.5), intensive care unit (AOR:41.93;95%CI:4.7–374.7) and orthopedics (AOR:52.21;95%CI:7.5–365) were significantly at risk to develop NIs compared to patients admitted in the medical ward. Patients who took more than two antimicrobial types at admission were 94% (AOR:0.06; 95% CI:0.004–0.84) times more protected from NIs compared to those who did not take any antimicrobial. About 81% of Acinetobacter spp and 83% of P. aeruginosa isolates were MDR. Amikacin and meropenem showed promising activity against Acinetobacter spp and P. aeruginosa isolates. Conclusion The high prevalence of MDR Acinetobacter spp and P. aeruginosa nosocomial isolates enforce treating of patients with NIs based on antimicrobial susceptibility testing results.


Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1426
Author(s):  
Atsushi Uda ◽  
Katsumi Shigemura ◽  
Koichi Kitagawa ◽  
Kayo Osawa ◽  
Mari Kusuki ◽  
...  

Since 2014, several global and national guidelines have been introduced to address the problem of antimicrobial resistance. We conducted a campaign in a tertiary hospital to promote appropriate quinolone use through educational lectures in 2018. The aim of this retrospective study was to evaluate the changes in the following: prescription characteristics, trend of oral quinolone use, and antibiotic susceptibility of bacteria from 2013 to 2020. Antimicrobial use was assessed as days of therapy per 1000 patient-days. We found a significant reduction in unnecessary antibiotic prescriptions between December 2013 and December 2020. Significant negative trends were detected in the use of quinolones over 8 years (outpatients, coefficient = −0.15655, p < 0.001; inpatients, coefficient = −0.004825, p = 0.0016). In particular, the monthly mean use of quinolones among outpatients significantly decreased by 11% from 2013 to 2014 (p < 0.05) and reduced further by 31% from 2017 to 2020 (p < 0.001). A significant positive trend was observed in the susceptibility of Pseudomonas aeruginosa to levofloxacin (p < 0.001). These results demonstrate that the use of oral quinolones was further reduced following educational intervention and the bacterial susceptibility improved with optimal quinolone usage compared to that in 2013.


Author(s):  
Ali Alyahawi ◽  
Abdul Monem Alhomidi ◽  
Nawal Al-Henhena

Pseudomonas aeruginosa is clinically significant and opportunistic pathogenthat causes infections in hospitalized patients. Antibiotic resistance is a major concern in clinical practice. The ongoing emergence of resistant strains that cause nosocomial infections contributes substantially to the morbidity and mortality of hospitalized patients. Objective of present study was to estimate the prevalence of Pseudomonas aeruginosa and the antimicrobial resistance patterns of P. aeruginosa isolates from hospitalized patients. The study was performed at microbiology department of a local hospital in Sana’a, Yemen. All the patients' samples of hospital departments from January, 2017 to December, 2017 were included. A Total of 2079 samples were collected during the study period. Among them, 193 strains of Pseudomonas spp. were isolated. One hundred ninety three isolates of P. aeruginosa were isolated from different clinical specimens and fully characterized by standard bacteriological procedures. Antimicrobial susceptibility pattern of each isolates was carried out by the Kirby-Bauer disk diffusion method as per CLSI guidelines. Majority of P. aeruginosa were isolated from Sputum, followed by urine specimens. The isolate pathogen showed the highest sensitive to Meropenem (85.5%), followed by Amikacin (80.5%), Imipenem (80.0%), and Piperacillin/tazobactam (77.2). The highest frequency of resistance (96.2%) was observed with amoxicillin /clavulinic Acid followed by cefuroxime 94.6%, ampicillin/ sulbactam 94.5%, Co-Trimoxzole 80.5%, and norfloxacin 54%. The result confirmed the occurrence of drug resistance strains of P. aeruginosa. Meropenem, imipenem, and amikacin, were found to be the most effective antimicrobial drugs. It therefore calls for a very judicious, appropriate treatment regimens selection by the physicians to limit the further spread of antimicrobial resistance P. aeruginosa.


Author(s):  
Qasem Buhaibeh ◽  
Tawfik Dhaiban ◽  
Eiman Alyafei ◽  
Amjad Salman Al-Jundi Abdulsalam

Background: Otitis Media (OM) common diseases affecting children below 5 years of age with a harmful effect on their hearing and health status. Data about the bacterial profile and current antimicrobial resistance status of Otitis Media in the region is scarce. Objective of this study determine the causative organisms of Otitis Media and antimicrobial  susceptibility patterns among children in a Primary Health Care Corporation (PPHC) centers, Qatar.Methods: A cross-sectional study was conducted in PPHC from Jan 2016 to Dec 2017. A total of 181 patients with Otitis Media presented to PHCC centers were enrolled in the study. Socio-demographic and clinical data were documented and analysed.Results: A total of 181 children, an almost equal number of male (49.7%) and female (50.3%) participants were involved in the study. 51.4% of participants were ≤5 years of age. Bacteria isolated were: Pseudomonas Aeruginosa (27.6%), Hemophilus Influenza (13.3%), Staphylococcus Aureus (11.6%), Methicillin-Resistant Staphylococcus Aureus (MSRA) (11.0%), Streptococcus Pyogenes (10.5%), Streptococcus Pneumonia (6.6%), Moraxella Catarrhalis (2.2%), Klebsiella Pneumonia (0.6%). The sensitivity of Pseudomonas Aeruginosa was (100%) to cotrimoxazole, vancomycin, and piperacillin, (96%) to cefepime and gentamicin, and was (88.2%) to ciprofloxacin. MRSA sensitivity was (100%) to vancomycin, rifampicin, and teicoplanin, (89%) to clindamycin.Conclusion: Pseudomonas Aeruginosa was the most frequent isolated bacteria. An overall antimicrobial resistance pattern seen in bacteria isolates ranges from 0% to 66.7%. The antimicrobial-resistant rate was observed for Ampicillin, Augmentin, and cefuroxime whereas ciprofloxacin, cefepime, chloramphenicol, cotrimoxazole, gentamicin, vancomycin, and amikacin were found effective for the isolated resistant bacteria.


Sign in / Sign up

Export Citation Format

Share Document