Antimicrobial susceptibility survey of Pseudomonas aeruginosa strains isolated from clinical sources.
A two-year prospective study of 554 Pseudomonas aeruginosa isolates was recovered from various clinical sources throughout Trinidad, and their resistance patterns to antipseudomonal antimicrobial agents were determined. Of the 554 P. aeruginosa isolates, 20.6% (114/554) were community isolates, 17.3% (96/554) from the intensive care unit (ICU), 10.1% (56/554) from the nursery, and the remaining 52% (288/554) were from other hospital inpatient services. Respiratory tract infections were the predominant source of P. aeruginosa isolates from the ICU--46.9% (45/96)--and nursery--21.4% (12/56), whereas wounds were the principal source of P. aeruginosa from the surgical services--77.0% (141/183). Community isolates of P. aeruginosa were predominantly from ear--100% (51/51)--and urinary tract infections--35.5%, (33/93). The overall prevalence of resistance was low for both hospital isolates (13.9%) and community isolates (3.8%). All community isolates were fully sensitive to four of the nine antimicrobials tested. Resistance rates among community strains ranged from 2.6% (ciprofloxacin and ceftazidime) to 12.3% for piperacillin. All isolates from hospital were fully sensitive to imipenem, but resistance rates for the other drugs ranged between 2.5% and 27.3%. The study showed that the overall resistance pattern of P. aeruginosa was relatively low. This is an encouraging observation but invites caution since resistance to the newly introduced drug, cefepime, has now emerged within the hospital environment and may present serious therapeutic problems within the near future. Policies governing the use of antimicrobials in many institutions are lacking. Such policies must be instituted in order to limit the spread of resistance and also to reduce the emergence of resistance to newly commissioned drugs within the country.
Orrett
Fitzroy A
FA
Department of Paraclinical Sciences, Unit of Pathology and Microbiology, University of the West Indies and the Microbiology Laboratory, Diagnostic Laboratories, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago. drfao4301@yahoo.com
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D006801:Humans; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime