Epidemiological study of variations in beta-lactam antibiotic susceptibility of Pseudomonas aeruginosa in two intensive care units
| Autor: | M.C. Julliot, V. Cailleaux, Daniel Talon, Michelle Thouverez, B. Mulin, Gilles Capellier |
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| Rok vydání: | 1998 |
| Předmět: |
Microbiology (medical)
Adult Male Carbapenem Imipenem Genotype medicine.drug_class Antibiotics Cephalosporin Ceftazidime medicine.disease_cause beta-Lactams Microbiology Intensive care polycyclic compounds Medicine Humans Prospective Studies Serotyping business.industry Pseudomonas aeruginosa Drug Resistance Microbial General Medicine biochemical phenomena metabolism and nutrition Middle Aged Anti-Bacterial Agents Intensive Care Units Infectious Diseases Case-Control Studies Female Restriction fragment length polymorphism business Epidemiologic Methods Polymorphism Restriction Fragment Length medicine.drug |
| Zdroj: | The Journal of hospital infection. 37(3) |
| ISSN: | 0195-6701 |
| Popis: | A six-month prospective study was carried out in the medical and surgical intensive care units (ICUs) at Besancon University Hospital to assess the frequency and risk factors for beta-lactam-resistant isolates of Pseudomonas aeruginosa. Clinical samples were screened for P. aeruginosa, and four antibiograms were distinguished using imipenem and ceftazidime, namely: fully susceptible (SS), imipenem-resistant (RS), ceftazidime-resistant (SR), and resistant to both (RR). DraI restriction fragment length polymorphism of isolates from different patients or with different resistance patterns but the same serotype was assessed by pulsed-field gel electrophoresis. One hundred and twenty-one isolates were obtained from 50 of 281 patients, 60.3% were fully susceptible. 19.8% imipenem-resistant, 13.2% ceftazidime-resistant, and 6.6% resistant to both. Antibiotic-resistance was independent of serotype. Twenty-two of 32 imipenem-resistant isolates from six patients were of the same DNA type, and six other isolates from four patients were of a second DNA type. On only one occasion did a clonally defined strain develop imipenem resistance. By contrast ceftazidime-resistant strains had differing DNA types, but had been originally ceftazidime-susceptible in seven of 12 patients. Reversion of imipenem resistant strains to susceptibility occurred in one patient, and of ceftazidime-resistant strains in five patients. Case-control studies identified prior antibiotic therapy as a risk factor in colonization with resistant strains. Resistance to imipenem followed imipenem therapy, and resistance to ceftazidime followed use of weakly anti-pseudomonal beta-lactam antibiotics. The major route of spread of imipenem-resistant strains was cross-colonization. Thus, assuming appropriate isolation, a carbapenem should be preferred to an extended-spectrum cephalosporin to treat pseudomonas infections in ICU patients. |
| Databáze: | OpenAIRE |
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