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Survey of multiply resistant Providencia stuartii in a chronic care unit
Abstract:
Providencia stuartii was cultured over a 4-year period from the urinary tract, throat, perineum, axilla and stools of patients in a long-term chronic care unit, the most common site of colonization being the urinary tract. A total of 17 patients had Prov. stuartii bacteraemia and manipulation of the urinary tract preceded bacteraemia in 10 cases. Eighty-two per cent of the patients had long-term urinary tract colonization from 1 month to 4 years. Although most isolates were resistant to all aminoglycosides except amikacin, the organisms were all susceptible to thienamycin, ceftazidime, cefotaxime, ceftizoxime and moxalactam.
Insights
Providencia stuartii commonly colonizes the urinary tract in long-term care patients. Most strains were resistant to aminoglycosides but remained susceptible to newer antibiotics like ceftazidime.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Providencia stuartii is an opportunistic pathogen.
- Long-term care facilities (LTCFs) are prone to endemic infections.
- Urinary tract infections (UTIs) are common in LTCF residents.
Purpose of the Study:
- To investigate the prevalence and characteristics of Providencia stuartii colonization and infection.
- To determine antimicrobial susceptibility patterns of Providencia stuartii isolates.
- To identify risk factors associated with Providencia stuartii bacteremia.
Main Methods:
- Longitudinal study over 4 years in a chronic care unit.
- Culture of various body sites including urine, throat, perineum, axilla, and stools.
- Antimicrobial susceptibility testing using standard microbiological methods.
Main Results:
- Providencia stuartii colonization was most frequent in the urinary tract.
- 82% of patients had long-term urinary tract colonization (1 month to 4 years).
- 17 patients experienced Providencia stuartii bacteremia, often preceded by urinary tract manipulation.
- Most isolates showed resistance to aminoglycosides (except amikacin) but were susceptible to thienamycin, ceftazidime, cefotaxime, ceftizoxime, and moxalactam.
Conclusions:
- Providencia stuartii poses a significant colonization and infection risk in LTCF residents, particularly in the urinary tract.
- Long-term urinary tract colonization is common, with manipulation increasing bacteremia risk.
- Emerging resistance to aminoglycosides necessitates monitoring and highlights the utility of newer beta-lactam antibiotics.