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[Nosocomial respiratory infection caused by Pseudomonas cepacia in immunocompromised hosts]
J Fujita1, K Negayama, K Takigawa
1First Department of Internal Medicine, Kagawa Medical School.
Abstract:
Pseudomonas cepacia is a gram negative rod, having no fermentative activity on glucose. This organism was detected in the sputum, throat swab, or throat washing of 22 inpatients treated between January, 1990, and December, 1990, at the First Department of Internal Medicine, Kagawa Medical School. The primary diseases for which these 22 patients were hospitalized were leukemia in 12, malignant lymphoma in 5, lung cancer in 2, myelodysplastic syndrome in 1, and embryonal cell carcinoma in 1. Twelve of the 22 patients had episodes of pneumonia which complied clinically with the diagnostic criteria provided to facilitate the National Nosocomial Infection Study. The complication of pneumonia occurred in 7 patients with leukemia, 2 with malignant lymphoma, 2 with lung cancer, and 1 with myelodysplastic syndrome. In 10 of these 12 patients, the organism was detected before the onset of pneumonia. All 22 patients in whom the organism was demonstrated had received antibiotics. The antibiotics which was most frequently used to treat these patients 1 month before detection of Pseudomonas cepacia were amikacin and ceftizoxime, which were used in 13 patients. Of the antibiotics in which the susceptibility to Pseudomonas cepacia was, evaluated, minocycline was effective in 100% (21/21), ceftazidime in 50% (11/22), and ofloxacin in 27.3% (6/22). Physicians should be especially aware of the possibility of colonization and nosocomial respiratory infection by Pseudomonas cepacia in patients with severe underlying diseases.
Insights
Pseudomonas cepacia, a bacterium, was found in hospitalized patients with severe illnesses, often preceding pneumonia. Minocycline showed high effectiveness against this organism.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Pseudomonas cepacia is a gram-negative bacterium.
- This organism can cause nosocomial infections, particularly respiratory infections.
- Patients with severe underlying diseases are at higher risk for colonization and infection.
Purpose of the Study:
- To investigate the incidence and clinical significance of Pseudomonas cepacia detection in hospitalized patients.
- To identify risk factors and associated conditions, such as pneumonia.
- To evaluate the antibiotic susceptibility of Pseudomonas cepacia.
Main Methods:
- Retrospective analysis of 22 patients from whom Pseudomonas cepacia was detected in sputum, throat swab, or throat washing.
- Review of patient medical records, including primary diagnoses and antibiotic treatments.
- Clinical assessment of pneumonia development and antibiotic susceptibility testing.
Main Results:
- Pseudomonas cepacia was detected in 22 inpatients between January and December 1990.
- The majority of patients had underlying conditions like leukemia or malignant lymphoma.
- Twelve patients developed pneumonia, with the organism often detected prior to pneumonia onset. Minocycline demonstrated 100% effectiveness against the isolated strains.
Conclusions:
- Pseudomonas cepacia colonization and nosocomial respiratory infection are potential risks for severely ill patients.
- Awareness of this pathogen is crucial for timely diagnosis and management.
- Minocycline appears to be a highly effective antibiotic against Pseudomonas cepacia.