Related Experiment Videos
Persistence of a multidrug-resistant Pseudomonas aeruginosa clone in an intensive care burn unit
P R Hsueh1, L J Teng, P C Yang
1Department of Laboratory Medicine, National Taiwan University Hospital, Taipei.
Abstract:
Long-term colonization of various body sites with a multidrug-resistant Pseudomonas aeruginosa clone (resistant to piperacillin, cefoperazone, ceftazidime, aztreonam, imipenem, cefepime, cefpirome, ofloxacin, ciprofloxacin, minocycline, and aminoglycosides) with subsequent severe infections in burn patients has not been reported previously. Thirty-nine isolates of multidrug-resistant P. aeruginosa (resistant to ceftazidime and at least three of the agents listed above) recovered from various clinical samples from three patients in an intensive care burn unit from April 1997 to May 1997 and seven preserved isolates recovered from six patients in other medical wards at National Taiwan University Hospital from April 1996 to May 1997 were studied for their epidemiological relatedness. The epidemic could be attributed to a multidrug-resistant P. aeruginosa clone belonging to serogroup O:F (serogroup O:4) by means of antimicrobial susceptibility testing, O serogrouping, and analysis of the randomly amplified polymorphic DNA patterns generated by arbitrarily primed PCR of the isolates. The epidemic strain persisted in the three patients for weeks to months; in the meantime, these patients had received multiple antimicrobial agents for the management of intervening episodes of invasive infections (bacteremia, ventilator-associated pneumonia, and/or catheter-related sepsis) caused by this strain, as well as concomitant infections due to other organisms. The strain had been isolated only once previously, from a burn patient who was on the unit in December 1996. The present report, describing a small outbreak due to P. aeruginosa, documents the fact that a single clone of multidrug-resistant P. aeruginosa can cause long-term persistence in different body sites of burn patients and that the colonization can subsequently result in various severe infections.
Insights
A multidrug-resistant Pseudomonas aeruginosa clone caused persistent colonization and severe infections in burn patients. This study highlights the long-term impact of a single clone in intensive care settings.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Epidemiology
Background:
- Long-term colonization by multidrug-resistant Pseudomonas aeruginosa (MDRP) in burn patients leading to severe infections is a significant clinical concern.
- Previous reports have not detailed persistent colonization with a specific MDRP clone across multiple body sites in burn patients.
Purpose of the Study:
- To investigate the epidemiological relatedness of multidrug-resistant Pseudomonas aeruginosa isolates from burn patients.
- To identify the characteristics of a specific MDRP clone responsible for persistent colonization and severe infections in intensive care unit (ICU) burn patients.
Main Methods:
- Antimicrobial susceptibility testing was performed on 39 MDRP isolates from three ICU burn patients and seven preserved isolates from other wards.
- O serogrouping and randomly amplified polymorphic DNA (RAPD) analysis using arbitrarily primed PCR were employed to determine epidemiological relatedness.
- Isolates were characterized based on resistance to piperacillin, cefoperazone, ceftazidime, aztreonam, imipenem, cefepime, cefpirome, ofloxacin, ciprofloxacin, minocycline, and aminoglycosides.
Main Results:
- A single multidrug-resistant Pseudomonas aeruginosa clone, belonging to serogroup O:F (O:4), was identified as the cause of the outbreak.
- This epidemic strain demonstrated persistence in three burn patients for weeks to months, despite multiple antimicrobial treatments.
- The clone was associated with severe invasive infections including bacteremia, ventilator-associated pneumonia, and catheter-related sepsis.
Conclusions:
- A single clone of multidrug-resistant Pseudomonas aeruginosa can establish long-term colonization at various body sites in burn patients.
- Such persistent colonization by MDRP can lead to the development of severe, recurrent infections.
- This finding underscores the importance of infection control measures to prevent the spread and persistence of MDRP clones in healthcare settings, particularly in ICUs.