Related Experiment Videos
[Pseudomonas aeruginosa: a multicenter study in 136 hospitals in Spain]
E Bouza1, F Garcia-Garrote, E Cercenado
1Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid. ebouza@microb.net
Abstract:
A cooperative group of 136 Spanish hospitals identified 1014 isolates of P. aeruginosa in one week. It was estimated that Spanish microbiology laboratories identified 168 P. aeruginosa isolates per 100,000 inhabitants population and year (25 isolates for every 1,000 hospital admissions/year). P. aeruginosa was recovered in 5.3% of all the samples with bacterial isolates. Seventy-five percent of samples containing P. aeruginosa came from the lower respiratory tract, wound exudates, abscesses and urine. The three most common serotypes present in Spain were found to be 0:1, 0:4 and 0:11 and constituted more than 50% of all isolates. The antimicrobials active against more than 85% of all the isolates included: ceftazidime (85.2%), piperacillin-tazobactam (92.8%), imipenem (86.2%), meropenem (92.2%) amikacin (91.4%) and tobramycin (91.2%). The study showed a high rate of resistance to ciprofloxacin (22.7%) and gentamicin (31.1%). Of the 529 patients who underwent clinical follow-up, 25.5% showed P. aeruginosa colonization and the remaining 74.5% had clinical infections. We estimated an incidence rate of 88.4 patients infected with P. aeruginosa per 100,000 inhabitants and year (13.8 cases per 1000 hospital admissions and year). Overall, 42% were community acquired. The overall mortality in this study was 15%, and mortality attributable to P. aeruginosa infections was 5%. After logistical regression analysis, the two independent predictors of mortality were the presence of a rapidly fatal underlying condition and the presence of bacteremia. In Spain, P. aeruginosa is much more than a cause of severe nosocomial infections in immunocompromised patients.
Insights
Pseudomonas aeruginosa (P. aeruginosa) is a significant pathogen in Spain, frequently causing infections in the respiratory tract and urine. High resistance rates to certain antibiotics were observed, impacting patient outcomes.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen frequently associated with healthcare-associated infections.
- Understanding the epidemiology and antimicrobial resistance patterns of P. aeruginosa is crucial for effective patient management.
Purpose of the Study:
- To determine the incidence, serotype distribution, and antimicrobial susceptibility of P. aeruginosa in Spanish hospitals.
- To identify risk factors for mortality in patients with P. aeruginosa infections.
Main Methods:
- A multicenter study involving 136 Spanish hospitals.
- Collection and analysis of 1014 P. aeruginosa isolates over one week.
- Clinical follow-up of 529 patients to assess outcomes and identify mortality predictors.
Main Results:
- P. aeruginosa was isolated from 5.3% of bacterial samples, predominantly from the lower respiratory tract, wounds, abscesses, and urine.
- Serotypes O:1, O:4, and O:11 were most common, accounting for over 50% of isolates.
- High activity (>85%) was observed for ceftazidime, piperacillin-tazobactam, imipenem, meropenem, amikacin, and tobramycin, but resistance to ciprofloxacin (22.7%) and gentamicin (31.1%) was notable.
- The incidence of P. aeruginosa infection was estimated at 88.4 per 100,000 inhabitants annually.
- Mortality attributable to P. aeruginosa was 5%, with bacteremia and rapidly fatal underlying conditions as independent predictors.
Conclusions:
- P. aeruginosa is a prevalent pathogen in Spain, with significant rates of community-acquired infections.
- Antimicrobial resistance patterns necessitate careful selection of empirical therapy.
- Effective management strategies should address risk factors such as bacteremia and underlying severe conditions.