Surveillance of multi-drug resistant Pseudomonas aeruginosa in an urban tertiary-care teaching hospital.
Antimicrobial resistance in Pseudomonas aeruginosa is a serious clinical problem. To determine the incidence of multi-drug resistant P. aeruginosa, resistance rates of P. aeruginosa clinical isolates against commonly used antibiotics were evaluated for the period 1998 to 2002. Multi-drug resistance was defined as resistance to at least three of the four drugs, ceftazidime, imipenem, ciprofloxacin, and tobramycin. Resistance to most anti-pseudomonal agents has increased by >20% over the five-year period, with dramatic increases observed with fluoroquinolones, tobramycin, and imipenem (resistance increased by 34-37%). In 1998, 78% of isolates were susceptible to all four anti-pseudomonal agents and no isolate was considered multi-drug resistant. However, in 2002, only 27% of isolates were sensitive to all four of the drugs and 32% were considered multi-drug resistant. Multi-drug resistance in individual institutions may be significantly higher than rates reported in nationwide surveillance studies and may more accurately reflect the true magnitude of local resistance problems. On-going surveillance within individual institutions is critical for the selection of appropriate empiric antimicrobial therapy.
Jung
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Antimicrobial Research Laboratory, Department of Clinical Pharmacy, School of Pharmacy, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Campus Box C-238 Denver, CO 80262, USA. rosejung@uchsc.edu
Fish
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Obritsch
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MacLaren
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D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002442:Ceftazidime / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D003120:Colorado / Q000453:epidemiology; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination / Q000494:pharmacology; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D015994:Incidence; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D018571:Sentinel Surveillance; D014031:Tobramycin / Q000494:pharmacology; D018440:beta-Lactam Resistance / Q000187:drug effects
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D015378:Imipenem; D002442:Ceftazidime; D014031:Tobramycin