Association between antibiotic use and changes in susceptibility patterns of Pseudomonas aeruginosa in an intensive care burn unit: a 5-year study, 2000-2004.

This study aimed to evaluate the relationship between antimicrobial resistance in Pseudomonas aeruginosa and annual antibiotic use in a burn unit. From 1 January 2000 to 31 December 2004, 203 non-repetitive strains of Ps. aeruginosa were recovered from various clinical specimens. Antimicrobial susceptibility testing was performed using the disc diffusion method, and susceptibility data were interpreted according to break points recommended by the French Society of Microbiology. The antibiotic consumption for imipenem, ceftazidime, cefotaxime, piperacillin-tazobactam, ofloxacin, ciprofloxacin, gentamicin and amikacin was calculated with antimicrobial density. The relationship between antibiotic use and the resistance of Ps. aeruginosa was analysed. The consumption of ceftazidime and amikacin showed no association with resistance. A statistically significant relationship was observed between increasing use of ciprofloxacin and the incidence of resistant Ps. aeruginosa to this antibiotic (rs=0.89, p=0.05), and a significant correlation between ciprofloxacin consumption and resistance to imipenem was noted (rs=0.89, p=0.043). Restricted use of ciprofloxacin during 2003 and 2004 was followed by a significant decrease of resistance in Ps. aeruginosa. Our report illustrates the major role of ciprofloxacin in the emergence of resistant Ps. aeruginosa.

[Epidemiological profile and antibiotic susceptibility of Pseudomonas aeruginosa isolates within the burned patient hospitalized in the intensive care burn unit]. / Profil epidemiologique et sensibilite aux antibiotiques des souches de Pseudomonas aeruginosa isolees dans un service de reanimation des brules.

BACKGROUND: Pseudomonas aeruginosa plays a predominant role as an etiological agent involved in serious infections in burned patients. Treatment of these infections is frequently complicated by antibiotic resistance, a problem that is is increasing in recent years. AIM: The objective of this study is to analyze epidemiological profile and antibiotic susceptibility of P. aeruginosa isolates within the burned patients admitted in our intensive care department. METHODS: During a period of 4 years (2000/2003), 828 burn patients were admitted. RESULTS: The survey of antibiotic susceptibility of P. aeruginosa showed high percentages of resistance to the different antibiotics. 60.9% of strains were resistant to piperacillin, 53.4% to ceftazidime, 37.6% to imipenem, 70.6% to cefsulodine, 59.3% to tobramycin, 80% to gentamicin, 62.4% to amikacin and 53.4% to ciprofloxacin. CONCLUSION: It is necessary to implement urgent measures to prevent the spreading of this multiresistant strain. These measures include: sensible limitation of the use of antimicrobial agent, strict disinfection and hygienic procedures.

[Bacteriological profile of bacteremias in badly burnt patients]. / Profil bacteriologique des bacteriemies chez les brules.

The purpose of this work is to study the bacteriological profiles of germ responsible for bacteriemas / septicemias in badly burnt patients hospitalized in burns utis, in order to guide better the antibiotherapy of first intention. During the period of survey going from January 1st, 2001 to December 31st,2002 71 patients had one or several episodes of bateremia. The average burnt cutaneous surface was 48.7%. All collected bacteriemas were contacted in hospial. Empirical antbiotheray was effective in 30 patients. The hospital stay for this group was long: 45 to 86 days. Acinetobacter baumannii was the most incriminated germ(20.3%), followed klebsiella pneumoniea (12.7%). The frequency of resistance was variable according to the considered species.