2017, Number 2
Rev Acta Médica 2017; 18 (2)
Resistance of Pseudomonas aeruginosa strains in critically-ill patients
Hart CM, Martínez BML, González MA, Montes de Oca MZ
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ABSTRACTIntroduction: Pseudomonas aeruginosa is a multiresistant pathogen that causes serious infections in hospitalized patients. Objective: To analyze the resistance of this microorganism to the main antimicrobials. Methods: An observational cross-sectional cohort study was carried out with 117 strains isolated from patients hospitalized in Hermanos Ameijeiras Hospital during the years 2015 and 2016. Results: The majority of the strains came from the critically-ill patient attention units, 66 (56.41 %), being these where the highest percentage of resistance was found. The isolation was more frequent from endotracheal secretions, 43 (38.00 %), and blood cultures, 28 (25.00 %). Strains isolated from blood cultures were observed to be more sensitive than those isolated from other biological sources. Generally speaking, resistance to ceftazidime was 49.57 %; cefepime, 48.71 %; aztreonam, 63.24 %; gentamicin, 42.73 %; ciprofloxacin, 54.7 %; meropenem, 41.8 %; and imipenem, 33.33 %. On the other hand, the Vitek2 Compact team detected that against the β- lactam family, 40 (34.18 %) strains showed high level of resistance and carbapenemes resistance (impermeability). For aminoglycosides, 50 (42.73 %) strains showed resistant phenotypes (GEN, NET, AMI, TOB) (GEN NET AMI). For quinolones, 66 (56.41 %) behaved with resistant phenotypes. For tetracycline and polypeptides, most of the phenotypes were wild with 116 (99.14 %) and 91 (77.77 %) strains, respectively. Conclusions: The strains analyzed showed very high resistance levels for all the antibiotics tested, highlighting the increase of resistance against meropenem, imipenem and colistin. Among the resistance phenotypes detected against the β- lactam family, the following stand out: high level of resistance and carbapenemes resistance (impermeability); for the aminoglycosides (GEN, NET, AMI, TOB) (GEN NET AMI), the quinolones behaved with resistant phenotypes, whereas for tetracycline and polypeptides most phenotypes were wild.