Antimicrobial use and incidence of multidrug-resistant Pseudomonas aeruginosa in a teaching hospital: an ecological approach

Abstract

Introduction: Multidrug-resistant Pseudomonas aeruginosa is a major threat in healthcare settings. The use of antimicrobials can influence the incidence of resistant strains by direct and indirect mechanisms. The latter can be addressed by ecological studies. Methods: Our group attempted to analyze the relation between the use of antipseudomonal drugs and the incidence of MDR-PA among 18 units from a 400-bed teaching hospital. The study had a retrospective, ecological design, comprising data from 2004 and 2005. Data on the use of four antimicrobials (amikacin, ciprofloxacin, ceftazidime and imipenem) were tested for correlation with the incidence of MDR-PA (defined as isolates resistant to the four antimicrobials of interest) in clinical cultures. Univariate and multivariate linear regression analyses were performed. Results: Significant correlations were determined between use and resistance for all antimicrobials in the univariate analysis: amikacin (standardized correlation coefficient = 0.73, p = 0.001); ciprofloxacin (0.71, p = 0.001); ceftazidime (0.61, p = 0.007) and imipenem (0.87, p < 0.001). In multivariate analysis, only imipenem (0.67, p = 0.01) was independently related to the incidence of multidrug-resistant strains. Conclusions: These findings share similarities with those reported in individual-based observational studies, with possible implications for infection control.

Investigation of &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; Resistance Pattern against Antibiotics in Clinical Samples from Iranian Educational Hospital

“…aeruginosa emerged as an important pathogen and was reasonable for nosocomial infections. So, that is one of the important causes of morbidity and mortality among Hospital patients [3] [4] [19]. The current study showed that P. aeruginosa was highly prevalent in clinical samples of urine and pus, was also observed in Arshi, et al and Murase et al study [20] [21].…”

Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit

“…The root causes of the rapid emergence and dissemination of drug-resistant bacteria in hospitals are multifactorial 2,29,30 , including mainly the high selective pressure that results from inappropriate and widespread use of antimicrobial agents particularly in ICUs; cross transmission from patient to patient owing to inconsistent application of appropriate infection control measures; clonal spreading of resistant bacteria and horizontal transfer of resistance genes; and a complex relationship between resistance and use of a variety of antimicrobials 2,29,31 . However, increasing resistance may further drive increased consumption of several so-called last-line antimicrobial agents 2 .…”

Carbohydrate Hydrogels with Stabilized Phage Particles for Bacterial Biosensing: Bacterium Diffusion Studies

“…Interest in Pseudomonas aeruginosa detection has emerged in response to the prevalence of this organism and its status as a clinically important, opportunistic pathogen that infects hosts with compromised immune systems [4,5], which alone is responsible for ca. 15 % of all nosocomial infections in Brazil [1,[6][7][8][9]. Bacterial migration is important in understanding many practical problems ranging from disease pathogenesis to the bioremediation of hazardous wastes in the environment [10,11].…”