ABSTRACT
Retrospective study of antimicrobial susceptibility of 1.943 Pseudomonas aeruginosa clinical isolates to amikacin, tobramycin, gentamicin, ceftazidime, cefepime, meropenem, piperacillin-tazobactam and ciprofloxacin during a five year period. The percentage of resistance went from 2.07% to amikacin from 15.89% to ciprofloxacin. These percentages showed differences depending on the extra or intrahospital origin, departments and samples. Isolates from hospital patients were significantly more resistant than the ones from ambulatory patients (p < or = 0.001;tobramycin,13.74% vs 5.05%; gentamicin, 13.74% vs 8.26%; ceftazidime, 12.67% vs 4.24%; cefepime, 11.48% vs 7.07%; meropenem, 8.57% vs 2.06%), except for amikacin (1.98% vs 2.2%, p=0.74), piperacillin/ tazobactam (6.07% vs 4.55%, p=0.14) and ciprofloxacin (17.17% vs 13.97%, p=0.06).Critical care department and respiratory samples showed the highest resistance percentages while surgery department and invasive samples showed the lowest. Multidrug-resistance was found in 4.8% of the isolates. When comparing our data with those from our previous study (1992-2003), we observed a significant reduction in antibiotic resistance to amikacin (7.74% vs 2.07%, p<0.001), tobramycin (13.61% vs 10.26%, p<0.001), gentamicin (30.85% vs 14.73%, p<0,001), ceftazidime (14.63% vs 9,28%, p<0.001), cefepime (12.31% vs 9.71%, p=0.005), and meropenem (7.74% vs 2.07%, p=0.001); and there were no changes in resistance to piperacillin-tazobactam (4.26% vs 5.46%, p=0,06) and ciprofloxacin (16.02% vs 15.89%, p=0.89). In the last years, the susceptibility pattern of P. aeruginosa to antimicrobial agents has changed in our health district, and it is very different from the one described in national studies so it would be very important to monitor susceptibility of clinical isolates periodically.
Subject(s)
Anti-Bacterial Agents/pharmacology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/drug effects , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Drug Resistance, Bacterial , Drug Resistance, Multiple, Bacterial , Female , Hospitalization , Humans , Infant , Infant, Newborn , Intensive Care Units , Male , Microbial Sensitivity Tests , Middle Aged , Pseudomonas Infections/drug therapy , Respiratory System/microbiology , Spain , Young AdultABSTRACT
Estudio retrospectivo de la resistencia de 1.943 aisladosclínicos de Pseudomonas aeruginosa a amikacina, tobramicina,gentamicina, ceftazidima, cefepima, meropenem, piperacilina-tazobactam y ciprofloxacino durante un periodo de 5años.La resistencia global osciló desde el 2,07% para amikacinaal 15,89% para ciprofloxacino con diferencias según la procedenciadel paciente, servicios y muestras: los aislamientos depacientes ingresados fueron significativamente más resistentesque los de los ambulatorios, (p≤0,001: tobramicina, 13,74%vs 5,05%; gentamicina, 13,74% vs 8,26%; ceftazidima, 12,67%vs 4,24%; cefepima, 11,48% vs 7,07%; meropenem, 8,57% vs2,06%), salvo para amikacina (1,98% vs 2,2%, p=0,74), piperacilina/tazobactam (6,07% vs 4,55%, p=0,14) y ciprofloxacino(17,17% vs 13,97%, p=0,06). Los servicios de críticos y lasmuestras respiratorias presentaron las tasas más altas de resistenciamientras que los servicios quirúrgicos y las muestras invasivaspresentaron la mejor sensibilidad. Un 4,8% de los aislamientosfueron multirresistentes.Comparado con nuestro anterior estudio (1.992-2.003)observamos un descenso significativo de resistencia a amikacina(7,74% vs 2,07%, p<0,001), tobramicina (13,61% vs10,26%, p<0,001), gentamicina (30,85% vs 14,73%, p<0,001)ceftazidima (14,63% vs 9,28%, p<0,001), cefepima (12,31% vs9,71%, p=0,005) y meropenem (8,84% vs 5,96%, p=0,001) y semantienen piperacilina/tazobactam (4,26% vs 5,46%, p=0,06)y ciprofloxacino (16,02% vs 15,89%, p=0,89).En nuestra zona se ha producido en los últimos años uncambio en los patrones de susceptibilidad de P. aeruginosa,alejado del descrito a nivel nacional, lo que incide en la importanciadel seguimiento local periódico de la susceptibilidad delos aislados clínicos(AU)
Retrospective study of antimicrobial susceptibility of1.943 Pseudomonas aeruginosa clinical isolates to amikacin,tobramycin, gentamicin, ceftazidime, cefepime,meropenem, piperacillin-tazobactam and ciprofloxacinduring a five year period.The percentage of resistance went from 2.07% toamikacin from 15.89% to ciprofloxacin. These percentagesshowed differences depending on the extra or intrahospitalaryorigin, departments and samples. Isolatesfrom hospital patients were significantly more resistantthan the ones from ambulatory patients (p≤0.001:tobramycin,13.74% vs 5.05%; gentamicin, 13.74% vs8.26%; ceftazidime, 12.67% vs 4.24%; cefepime, 11.48%vs 7.07%; meropenem, 8.57% vs 2.06%),except for amikacin(1.98% vs 2.2%, p=0.74), piperacillin/tazobactam(6.07% vs 4.55%, p=0.14) and ciprofloxacin (17.17% vs13.97%, p=0.06). Critical care department and respiratorysamples showed the highest resistance percentageswhile surgery department and invasive samples showedthe lowest. Multidrug-resistance was found in 4.8% ofthe isolates.When comparing our data with those from our previousstudy (1992-2003), we observed a significant reductionin antibiotic resistance to amikacin (7.74% vs2.07%, p<0.001), tobramycin (13.61% vs 10.26%,p<0.001), gentamicin (30,85% vs 14.73%, p<0,001), ceftazidime(14.63% vs 9,28%, p<0.001), cefepime (12,31%vs 9.71%, p=0.005), and meropenem (7.74% vs 2.07%,p=0.001); and there were no changes in resistance to piperacillin-tazobactam (4.26% vs 5.46%, p=0,06) and ciprofloxacin (16.02% vs 15.89%, p=0.89).In the last years, the susceptibility pattern of P. aeruginosato antimicrobial agents has changed in our healthdistrict, and it is very different from the one describedin national studies so it would be very important tomonitore susceptibility of clinical isolates periodically(AU)
