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High Rates of Extensively Drug-Resistant Pseudomonas aeruginosa in Children with Cystic Fibrosis

Juan C Gutiérrez-Santana1,2, Armando Gerónimo-Gallegos3, Mónica B Martínez-Corona4

  • 1Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico, Mexico. biol.jcgutierrez@gmail.com.

Current Microbiology
|October 8, 2022
PubMed

Insights

Extensively drug-resistant Pseudomonas aeruginosa is a growing concern in children with cystic fibrosis, with high rates found in recurrent infections. Antibiotic effectiveness is declining, necessitating careful treatment strategies.

Area of Science:

  • Medical Microbiology
  • Pediatric Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Pseudomonas aeruginosa exhibits high adaptability, leading to antibiotic-resistant strains, a significant global health issue.
  • Pediatric patients with cystic fibrosis (CF) are particularly vulnerable to recurrent infections by resistant bacteria.

Purpose of the Study:

  • To determine the prevalence and distribution of extensively drug-resistant (XDR) P. aeruginosa in pediatric CF patients with recurrent infections.
  • To evaluate the current efficacy of common antibiotics used in eradication therapy at a specialized Mexican children's institute.

Main Methods:

  • Molecular identification and Random Amplified Polymorphic DNA (RAPD-PCR) genotyping of 118 P. aeruginosa isolates from 25 children with CF (2015-2019).
  • Antimicrobial susceptibility testing was performed on all isolates.

Main Results:

  • 84 distinct RAPD profiles were observed, indicating potential cross-infection between siblings.
  • 42.4% of isolates were multi-drug resistant (MDR), and 12.7% were XDR.
  • In vitro susceptibility was observed for ceftazidime (77.1%) and amikacin (51.7%), though amikacin efficacy is concerning.

Conclusions:

  • The high frequency of XDR P. aeruginosa in pediatric CF patients is alarming, mirroring resistance patterns typically seen in adults.
  • The declining efficacy of antibiotics like amikacin highlights the urgent need for judicious antibiotic use to prevent further resistance.
  • Effective strategies are crucial to combat the worsening antibiotic resistance crisis in pediatric CF care.

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