Risk Factors for Acquisition of Multidrug-Resistant Pseudomonas aeruginosa Producing SPM Metallo-β-Lactamase

Abstract

To evaluate risk factors for colonization or infection due to multidrug-resistant Pseudomonas aeruginosa (MDRPa) carrying the bla SPM gene (SPM-MRDPa) among hospitalized patients, we undertook a case control study at a 480-bed, tertiary-care university hospital. Two different case definitions were used. In the first definition, a case patient (SPM case patient) was defined as a patient who had at least one isolate of SPM-MDRPa (14 patients). In the second, a case patient (non-SPM case patient) was defined as a patient who had at least one isolate of non-SPM-MDRPa (18 patients). For each case patient, we selected two controls, defined as a patient colonized and/or infected by a non-MDRPa isolate during the same study period and with the closest duration of hospitalization until the isolation of P. aeruginosa as cases. The use of quinolones was the single independent predictor of colonization and/or infection by bla SPM MDRPa (odds ratrio [OR] ‫؍‬ 14.70, 95% confidence interval [95% CI] ‫؍‬ 1.70 to 127.34, P ‫؍‬ 0.01), whereas the use of cefepime was the single predictor of colonization and/or infection by non-bla SPM MDRPa (OR ‫؍‬ 8.50, 95% CI ‫؍‬ 1.51 to 47.96, P ‫؍‬ 0.01). The main risk factor for MDRPa was a history of antibiotics usage. Stratification of risk factor analysis by a precise mechanism of resistance led us to identify a specific antibiotic, a quinolone, as a predictor for SPM-MDRPa.

Determinação da resistência antimicrobiana associada em isolados clínicos de Staphylococcus aureus e Pseudomonas aeruginosa em um hospital público de Goiânia, Estado de Goiás

“…A multirresistência para Staphylococcus aureus foi definida como resistência à oxacilina e três ou mais dos seguintes agentes: eritromicina, clindamicina, rifampicina, gentamicina, tetraciclina e sulfametoxazol-trimetoprim 10 e para Pseudomonas aeruginosa a resistência a pelo menos três dos seguintes antibióticos: amicacina, gentamicina, aztreonam, ceftazidima, cefepima, ciprofloxacina, imipenem, meropenem, piperacilina-tazobactam ou ticarcilina-clavulanato 21 .…”

“…antimicrobianos e elevadas taxas de resistência adquirida a várias drogas disponíveis 21 . O uso indiscriminado e/ou inadequado de antimicrobianos pode favorecer a taxa de resistência à droga em questão ou à outra relacionada, dificultando o controle de microrganismos multirresistentes 3 .…”

Bactericidal Activity in Filtrated Supernatant of Streptococcus Sanguinis against Multidrug-Resistant Pseudomonas Aeruginosa

“…Low-dose macrolide therapy is commonly used to treat patients with chronic pulmonary infection, but there is some concerning the bacteria developing resistance to these drugs. Recently, treatment has become difficult due to nosocomial infections caused by multidrug-resistant P. aeruginosa (MDRP) (Basustaoglu et al 1995;D'Agata 2004;Nouer et al 2005;Rossoline and Mantengoli 2005;Bonomo and Szabo 2006;Paterson 2006;Hachem et al 2007).…”

Metallobeta-Lactamase Enzymes and Antibiotic Susceptibilities in Strains of Pseudomonas Aeruginosa Isolated from Intensive Care Units in Turkey

“…This is due to the production of metallobeta-lactamase enzyme. [3][4][5][6][7][8][9][10] Metallobeta-lactamase enzymes consist of four enzyme groups-IMP, VIM, SPM and GIM series. 3 Especially in Mediterranean countries, enzymes in VIM series are more common than the others are.…”

“…have been reported in Turkey and other countries, leading to considerable concern. [3][4][5][6][7][8][9][10] The aim of this study was to determine the frequency of metallobeta-lactamase (MBL) enzymes in P. aeruginosa strains resistant to imipenem in various regions of Turkey using the imipenem and imipenem+EDTA combined disk method. Additionally, to determine the minimum inhibitory concentration (MIC) levels of those strains for aztreonam, polymyxin, colistin, and rifampin with the E-test method.…”