Prevalence of Multidrug-Resistant Pseudomonas aeruginosa in Patients with Nosocomial Infections at a University Hospital in Egypt, with Special Reference to Typing Methods

Introduction: The widespread use of tigecycline raises the question of increasing infection rates of Pseudomonas aeruginosa (PA) in ICUs which are not affected by this antibiotic. Objective: The aim of this study was to determine if treatment with tigecycline is a risk factor for PA infection in ICU patients. Methodology: A retrospective and observational study was conducted at Erciyes University Hospital, Turkey, between 2008 and 2010. The Erciyes University Hospital is a 1300-bed tertiary care facility. The patients included in this study were hospitalized in four adult ICUs. Patients with PA infections (case group) were compared with patients with nosocomial infection other than PA (control group). Results: A total of 1,167 patients with any nosocomial infections were included in the study. Two hundred and seventy eight (23.8%) of the patients had PA infection during their ICU stay. Fifty nine patients (21.2%) in the case group received tigecycline before developing PA infections, which were found to be significantly more frequent than in the controls (p < 0.01). Multivariate analysis showed that risk factors for PA infection were previous tigecycline use (4 times), external ventricular shunt (4.2 times), thoracic drainage catheter (2.5 times) and tracheostomy (1.6 times). Conclusion: Our results contribute to the need for new studies to determine the safety of tigecycline use, especially for the treatment of critically ill patients. Since tigecycline seems to be an alternative for the treatment of multidrug resistant (MDR) microorganisms, rational use of this antibiotic in ICU patients is essential.

Download Full-text

Molecular epidemiology of multidrug-resistant Pseudomonas aeruginosa in a French university hospital

Journal of Hospital Infection ◽

10.1016/j.jhin.2010.06.007 ◽

2010 ◽

Vol 76 (4) ◽

pp. 316-319 ◽

Cited By ~ 18

Author(s):

P. Cholley ◽

H. Gbaguidi-Haore ◽

X. Bertrand ◽

M. Thouverez ◽

P. Plésiat ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Molecular Epidemiology ◽

Multidrug Resistant ◽

University Hospital

Download Full-text

P1359 Clonal types and serotypes of multidrug-resistant Pseudomonas aeruginosa isolates spread in a university hospital in Greece

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(07)71199-8 ◽

2007 ◽

Vol 29 ◽

pp. S377

Author(s):

E. Drougka ◽

T. Panagea ◽

V. Chini ◽

A. Foka ◽

M. Christofidou ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Multidrug Resistant ◽

University Hospital

Download Full-text

Frequency and Antimicrobial Susceptibility Pattern of Pseudomonas Aeruginosa in Human Pus Samples at Holy Family Hospital Rawalpindi

Open Access Journal of Microbiology & Biotechnology ◽

10.23880/oajmb-16000189 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1-8

Author(s):

Kazmi A

Keyword(s):

Pseudomonas Aeruginosa ◽

Nosocomial Infections ◽

Antibiotic Susceptibility ◽

Antimicrobial Agents ◽

Antibiotic Sensitivity ◽

Recovery Process ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Cross Sectional ◽

Resistant Strains

Background: Nosocomial infections are great threat for hospitalized patients and Pseudomonas aeruginosa has emerged as one of the most potent nosocomial pathogens along with its diverse mechanisms to counter the various antimicrobial agents such as aminoglycosides, fluoroquinolones, monobactems, third generation cephalosporins, carbapenams and broad- spectrum penicillins. P. aeruginosa is one of the well-known pyogenic bacteria and is 3rd leading cause of pyogenic infections with the variable frequency depending on geographical region and clinical setting. P. aeruginosa is intimately associated with pyogenic nosocomial infections. Objectives: Since multidrug resistant strains of P. aeruginosa have posed serious threats and are frequently implicated in nosocomial infections. Methods: Pus swab were sampled under aseptic conditions and cultured on blood and Muller Hinton agar. Gram reaction, pigment production, Oxidase, indole reaction and citrate test were used to confirm isolate. Antibiotic susceptibility was performed b Kirby Bauer technique. Results compiled by us in this cross sectional study, showed 58 cases of P. aeruginosa out of 289 cases. This included 43% males and 57% females. Majority of the patients were of young age, with mean age 38 years. Antibiotic sensitivity revealed resistance to gentamicin was 50%, amikacin was 64%, ciprofloxacin and Aztronem 66%, Cefaparazone 69%, Tzaocin 71% and meropenem and sulzone was 79%. While Colistin and Ceftazidime were the most effective in 85% and 89% of cases respectively. The multidrug resistant strains of P. aeruginosa infections accounted for 32.76% of total P. aeruginosa infections. This study reveals high prevalence of multidrug resistant organisms at the set of our study. Based on this study, we suggest adopting the strategies to minimize the risk of nosocomial infections to slow down the rapidly growing multidrug resistance. These strategies may include, stricter antiseptic measures, fastening the recovery process and reducing the hospital stay and considering other alternates. Besides this, we would like to suggest the precise use of antibiotic susceptibility facility to reduce the nosocomial infection associated complications.

Download Full-text

A 5- Year Surveillance of Nosocomial Infections in a University Hospital: A Retrospective Analysis

10.21203/rs.3.rs-415656/v1 ◽

2021 ◽

Author(s):

Ilknur Erdem ◽

Ilker Yildirim ◽

Birol Safak ◽

Ritvan Karaali ◽

Berna Erdal ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Acinetobacter Baumannii ◽

Intensive Care Units ◽

Nosocomial Infections ◽

Antimicrobial Agents ◽

Public Health Problem ◽

University Hospital ◽

Esherichia Coli ◽

Study Results

Abstract OBJECTIVE: ‘Nosocomial infections’ or ‘healthcare associated infections’ are a significant public health problem around the world. This study aimed to assess the rate of culture confirmed nosocomial infections (NIs), frequency of nosocomial pathogens and the antimicrobial resistance patterns of bacterial isolates in a University Hospital. METHODS: A retrospective evaluation of NIs in a tertiary hospital, between the years 2015 and 2019 in Tekirdag, Turkey. RESULTS : During the five years, the overall incidence rates (NI/100) and incidence densities (NI/1000 days of stay) of NIs were 2.04% (range 1.76-2.41/100) and 3.50/1000 patients-days (range 2.85-4.64/1000), respectively. 57.4 % of the infections were originated from the Intensive Care Units. The most common NIs according to the primary sites were bloodstream infections (55.3 %) and, pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram negative bacteria, 24.9% of Gram positive bacteria and 7.6 % of candida. The most frequently isolated causative agents were Esherichia coli (16.7%) and Pseudomonas aeruginosa (15.7%). The rate of extended spectrum beta-lactamase production among E. coli isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of Pseudomonas aeruginosa; 95.1% among isolates of Acinetobacter baumannii, 18.2% among isolates of Klebsiella pneumoniae. Colistin resistance was 2.4% among isolates of Acinetobacter baumannii. Vancomycin resistance was 5.3% among isolates of Enterococci.CONCLUSION: Our study results demonstrates the microorganisms of isolated from Intensive Care Units demonstrates high level resistance to many antimicrobial agents. The rising in incidence of multidrug-resistant microorganisms indicate that more interventions are urgently needed to reduce NIs in our ICUs.

Download Full-text

Otitis External Infections Among Jordanian Patients with Emphasis on Pathogenic Characteristics of Pseudomonas aeruginosa Isolates

The Open Microbiology Journal ◽

10.2174/1874285801913010292 ◽

2019 ◽

Vol 13 (1) ◽

pp. 292-296

Author(s):

Lubna Y. ALjaafreha ◽

Mohmmed Tawalbeh ◽

Asem A. Shehabi

Keyword(s):

Pseudomonas Aeruginosa ◽

Virulence Genes ◽

Multidrug Resistant ◽

University Hospital ◽

Biochemical Tests ◽

Accurate Identification ◽

Antimicrobial Resistance Genes ◽

Positive Growth ◽

Staphylococcus Epidermis ◽

Bacteria And Fungi

Introduction: Otitis external infection is an inflammation of the ear canal frequently caused by Pseudomonas aeruginosa, followed by Staphylococcus epidermis and Staphylococcus auerus. Objective: This study investigated the spectrum of bacterial and fungal agents that cause otitis external infection in Jordanian patients with an emphasis on important antimicrobial resistance genes and putative virulence factors of P. aeruginosa isolates using molecular PCR methods. Methods: A total of 128 ear swab samples were obtained from outpatients with otitis external infection of Ear-Nose-Throat Clinic (ENT) from the Jordan University Hospital (JUH). All samples were cultured for bacteria and fungi and their growth was identified by macroscopic and microscopic examination as well as recommended biochemical tests. Results: Positive growth of bacteria and fungi were found in 105/128 (82%) of the examined cases. A total of 28 (22%) of the recovered organisms from ear samples were P. aeruginosa. A total of 11/28 (39%) of P. aeruginosa isolates were Multidrug-Resistant (MDR) which are resistant to three or more antibiotic classes. Both blaIMP-15 and VIM genes were not detected, while KPC genes were found in 57% among all isolates. The rates of the potential virulence genes found among 28 P. aeruginosa isolates were as follows: lasB, algD, toxA, exoU PilB and exoS at 100%, 100%, 82%, 72%, 54% and 25%, respectively. All isolates produced beta hemolysis on both human and sheep blood agar and showed either the pigment pyoverdin (57.1%) or pyocyanin (42.8%). Conclusion: Accurate identification of the causative agent of otitis external infection and its susceptibility to antibiotics especially P.aeruginosa is highly important for successful treatment. No significant relationship has been found between MDR P. aeruginosa and the presence of virulence genes.

Download Full-text

Combined Resistance to Ceftolozane-Tazobactam and Ceftazidime-Avibactam in Extensively Drug-Resistant (XDR) and Multidrug-Resistant (MDR) Pseudomonas aeruginosa: Resistance Predictors and Impact on Clinical Outcomes besides Implications for Antimicrobial Stewardship Programs

Antibiotics ◽

10.3390/antibiotics10101224 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1224

Author(s):

Marianna Meschiari ◽

Gabriella Orlando ◽

Shaniko Kaleci ◽

Vincenzo Bianco ◽

Mario Sarti ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Antimicrobial Stewardship ◽

Multivariable Analysis ◽

Multidrug Resistant ◽

University Hospital ◽

Attributable Mortality ◽

Retrospective Case ◽

Comorbidity Score ◽

Charlson Comorbidity Score ◽

Clinical Surveillance

A retrospective case-control study was conducted at Modena University Hospital from December 2017 to January 2019 to identify risk factors and predictors of MDR/XDR Pseudomonas aeruginosa (PA) isolation with resistance to ceftazidime/avibactam (CZA) and ceftolozane/tazobactam (C/T), and of mortality among patients infected/colonized. Among 111 PA isolates from clinical/surveillance samples, 60 (54.1%) were susceptible to both drugs (S-CZA-C/T), while 27 (24.3%) were resistant to both (R-CZA-C/T). Compared to patients colonized/infected with S-CZA-C/T, those with R-C/T+CZA PA had a statistically significantly higher Charlson comorbidity score, greater rate of previous PA colonization, longer time before PA isolation, more frequent presence of CVC, higher exposure to C/T and cephalosporins, longer hospital stay, and higher overall and attributable mortality. In the multivariable analysis, age, prior PA colonization, longer time from admission to PA isolation, diagnosis of urinary tract infection, and exposure to carbapenems were associated with the isolation of a R-C/T+CZA PA strain, while PA-related BSI, a comorbidity score > 7, and ICU stay were significantly associated with attributable mortality. C/T and CZA are important therapeutic resources for hard-to-treat PA-related infections, thus specific antimicrobial stewardship interventions should be prompted in order to avoid the development of this combined resistance, which would jeopardize the chance to treat these infections.

Download Full-text