[Gastrointestinal carriage of Pseudomonas aeruginosa in children residing in chronic care institutes in Jerusalem: high prevalence and high rates of antibiotic resistance].
BACKGROUND
Pseudomonas aeruginosa carriage in the gastrointestinal tract is uncommon in healthy children. Children living in chronic care institutions are often carriers of P. aeruginosa in the respiratory tract, but data is lacking regarding gastrointestinal carriage in these children.


OBJECTIVE
To examine the carriage rate of P. aeruginosa in children living in chronic care institutions in Jerusalem and to assess resistance rates of the bacteria to different classes of antibiotics.


METHODS
Rectal swabs were taken from all children residing in two chronic care institutions in Jerusalem: "St. Vincent" and "Aleh". The swabs were examined for presence of Pseudomonas aeruginosa. The authors used disk diffusion technique and E Test to assess resistance for different antibiotics.


RESULTS
Gastrointestinal carriage of P. aeruginosa was detected in 37 out of 125 of the children (30%); 16% of the P. aeruginosa isolates were resistant to carbapenems; 16% were resistant to aminoglycosides, 14% to ureidopenicillins and 11% to quinolones. All isolates were sensitive to ceftazidime and colistin. In 84% of the isolates, the minimal inhibitory concentration (MIC) for meropenem was significantly lower than the MIC for imipenem.


CONCLUSIONS
P. aeruginosa is a common colonizer of the gastrointestinal tract of children living in chronic care institutions. Empiric antibiotic treatment against P. aeruginosa should be considered when treating children with acute gastrointestinal pathologies. Antibiotic resistance, and particularly carbapenem resistance, is common in this population. There is a significant difference between the MICs for imipenem and meropenem. Future studies are needed to understand the clinical significance of this finding.
Megged
Orli
O
Pediatric Department and Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem. orlimegged@yahoo.com
Schlesinger
Yechiel
Y
Attias
Denise
D
Rudensky
Bernard
B
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002228:Carbenicillin / Q000627:therapeutic use*; D002648:Child; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D007557:Israel / Q000453:epidemiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012007:Rectum / Q000382:microbiology; D014505:Urban Population / Q000706:statistics & numerical data
D000900:Anti-Bacterial Agents; D015378:Imipenem; D002228:Carbenicillin