The influence of metallo- -lactamase production on mortality in nosocomial Pseudomonas aeruginosa infections

Abstract

MBL-PA infections resulted in higher mortality rates most likely related to the severity of these infections and less frequent early institution of appropriate antimicrobial therapy. Empirical treatments should be reviewed at institutions with high prevalence of MBL.

Detection of SPM and IMP metallo-β-lactamases in clinical specimens of Pseudomonas aeruginosa from a Brazilian public tertiary hospital

“…2 Pseudomonas aeruginosa is one of the most common causes of nosocomial infections, persisting at hospital environment and acquiring mobile elements of resistance. 3 The emergency of MBL in clinical isolates of P. aeruginosa is worrisome, due to the reduction of therapeutic options and the spreading ability of this bacterium. In addition, longer length of hospital stay and high mortality rates are associated to MBL producing P. aeruginosa infections.…”

“…In addition, longer length of hospital stay and high mortality rates are associated to MBL producing P. aeruginosa infections. 3 Besides β-lactam resistance, P. aeruginosa susceptible only to colistin or polymyxin B has been described [3][4][5] in several infectious processes, which demand the increase use of these drugs. An accurate, easy-to-perform and fast phenotypic test to detect MBL is concentrations (MIC) ranging from 0.094 to 2; MIC 50 : 0.5; MIC 90 : 1.5 µg/mL; 100% susceptible].…”

“…10 MBL rate found here is higher than that one reported by Viana Vieira et al 14 (7.5%), but it is lower than those published by other Brazilian researchers (35.9 to 80.4%). 9-11,18-20 Zavascki et al 3 found 30 P. aeruginosa only susceptible to polymyxin B among 86 MBL producing strains and the bla SPM gene was detected in all the 14 strains randomly selected, and Camargo, Bruder-Nascimento, Mondelli et al…”

“…Early identification of MBL in clinical specimens is important to provide correct antimicrobial therapy guidance, once appropriate therapy implementation can nullify the worst prognostic of MBL producing P. aeruginosa. 3 When detected, it is possible to avoid the dissemination of such strains among patients [7][8][9] and to avoid the MBL genetic determinants spread to different species of Gram-negative bacteria, as Enterobacteriaceae. 6 The contention of MBL producing P. aeruginosa is highly recommended, because patient-to-patient transmission may lead these strains to be endemic in such institution 3 or among different hospitals.…”

In Vitro Antibacterial Activity of a New Cephalosporin, FR295389, against IMP-type Metallo-β-lactamase-producers

“…In P. aeruginosa, a leading cause of nosocomial infections, MBLs pose serious therapeutic problems because treatment options are usually limited due to a combination of inherent resistance to many antimicrobial agents and its ability to develop resistance [3,4]. Recent studies have reported that MBL production caused a higher mortality rate because of the inappropriateness of early therapy [5,6], indicating a critical need for new agents effective against MBLproducing strains.…”