Invasive device-associated infections caused by Pseudomonas aeruginosa in critically ill patients: evolution over 10...

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Antimicrobial Resistance

Background:

• Invasive device-associated infections pose significant challenges in intensive care units (ICUs).
• Pseudomonas aeruginosa is a common pathogen in healthcare-associated infections, often exhibiting antimicrobial resistance.
• Longitudinal data are crucial for understanding trends in pathogen prevalence and resistance patterns.

Purpose of the Study:

• To assess the trends in invasive device-associated infections caused by Pseudomonas aeruginosa over a decade (2007-2016).
• To analyze the prevalence of antimicrobial resistance in Pseudomonas aeruginosa isolates from Spanish ICUs.
• To identify shifts in leading pathogens and the emergence of multidrug-resistant strains.

Main Methods:

• Retrospective analysis of data from the ENVIN-HELICS registry.
• Inclusion of data from 200 Spanish intensive care units.
• Assessment of pathogen prevalence and antimicrobial susceptibility testing results over a 10-year period.

Main Results:

• Pseudomonas aeruginosa was a leading cause of infections, though Escherichia coli became predominant in the final two years.
• The incidence of P. aeruginosa infections remained relatively stable between 12.0% and 14.6%.
• Significant increases in resistance to imipenem, meropenem, ceftazidime, cefepime, and piperacillin-tazobactam were observed, alongside rising multidrug-resistant, extensively drug-resistant, and pandrug-resistant strains.

Conclusions:

• Antimicrobial resistance in Pseudomonas aeruginosa is a growing concern in Spanish ICUs.
• The increasing resistance to key anti-pseudomonal agents necessitates vigilant monitoring and antimicrobial stewardship.
• Shifts in pathogen dominance highlight the dynamic nature of ICU-acquired infections.