Abstract/References

Drug resistance of Pseudomonas aeruginosa based on the isolation sites and types of gastrointestinal diseases: An observational study

Hironori Tsujimoto, Yuji Fujikura, Taka-aki Hamamoto, Hiroyuki Horiguchi, Risa Takahata, Yusuke Ishibashi, Takao Sugihara, Keita Kouzu, Yujiro Itazaki, Sei-ichiro Fujishima, Koichi Okamoto, Yoshiki Kajiwara, Susumu Matsukuma, Hideki Ueno

Abstract

Introduction: We investigated the drug resistance status of Pseudomonas aeruginosa (P. aeruginosa) focusing on its isolation sites and types of diseases.

Materials and methods: A microbiological laboratory database was searched to identify all clinical cultures positive for P. aeruginosa.　Clinicopathologic features and susceptibility of P. aeruginosa to any antibiotics were evaluated in patients admitted to the division of upper (Upper-GI group) or lower gastrointestinal surgery (Lower-GI group).　In addition, we investigated the susceptibility of P. aeruginosa to any antibiotics based on the isolation site.

Results:P. aeruginosa was frequently detected in the sputum and urine of the Upper-GI and Lower-GI groups, respectively.　Among P. aeruginosa isolates from drain discharge, a significantly higher rate of resistance to imipenem, amikacin, and ciprofloxacin was observed; among P. aeruginosa isolates from wounds, a substantially higher proportion had resistance to imipenem and cefozopran in the Upper-GI group.　However, there was no difference between the two groups in the drug resistance of P. aeruginosa isolated from urine, sputum, blood, and ascites.　P. aeruginosa isolated from sputum showed more resistance to imipenem and ciprofloxacin than those isolated from other sites.

Conclusion: There were significant differences in the drug resistance of P. aeruginosa based on the isolation sites and types of diseases.

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References

1. Kunz Coyne AJ, El Ghali A, Holger D, Rebold N, Rybak MJ.　Therapeutic Strategies for Emerging Multidrug-Resistant Pseudomonas aeruginosa.　Infect Dis Ther, 11:661-682, 2022.
2. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al.　Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria:an international expert proposal for interim standard definitions for acquired resistance.　Clin Microbiol Infect, 18:268-281, 2012.
3. Vaez H, Salehi-Abargouei A, Ghalehnoo ZR, Khademi F.　Multidrug Resistant Pseudomonas aeruginosa in Iran:A Systematic Review and Metaanalysis.　J Glob Infect Dis, 10:212-217, 2018.
4. Ichihara M, Ogino T, Fujii M, Haraguchi N, Takahashi H, Miyoshi N, et al.　Usefulness of Bacterial Culture of Drainage Fluid for Predicting Surgical Site Infection After Crohn’s Disease Surgery.　Ann Gastroenterol Surg, 6:375-385, 2022.
5. Chang Y, Jeon K, Lee SM, Cho YJ, Kim YS, Chong YP, et al.　The Distribution of Multidrug-resistant Microorganisms and Treatment Status of Hospital-acquired Pneumonia/Ventilator-associated Pneumonia in Adult Intensive Care Units:a Prospective Cohort Observational Study.　J Korean Med Sci, 36:e251, 2021.
6. Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, et al.　Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017.　JAMA, 323:1478-1487, 2020.
7. Abubakar U, Al-Anazi M, Alanazi Z, Rodriguez-Bano J.　Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens:A systematic review.　J Infect Public Health, 16:320-331, 2022.
8. Oliveira ABS, Sacillotto GH, Neves MFB, Silva A, Moimaz TA, Gandolfi JV, et al.　Prevalence, outcomes, and predictors of multidrug-resistant nosocomial lower respiratory tract infections among patients in an ICU.　J Bras Pneumol, 49:e20220235, 2023.
9. CLSI.　Performance standards for antimicrobial susceptibility testing.　In:CLSI supplement M100.　32nd ed.　Clinical and Laboratory Standards Institute; 2022.
10. Haghi F, Zeighami H, Monazami A, Toutouchi F, Nazaralian S, Naderi G, et al.　Diversity of virulence genes in multidrug resistant Pseudomonas aeruginosa isolated from burn wound infections.　Microb Pathog, 115:251-256, 2018.
11. Blanchard AC, Rooney AM, Yau Y, Zhang Y, Stapleton PJ, Horton E, et al.　Early detection using qPCR of Pseudomonas aeruginosa infection in children with cystic fibrosis undergoing eradication treatment.　J Cyst Fibros, 17:723-728, 2018.
12. Palacios-Baena ZR, Giannella M, Manissero D, Rodriguez-Bano J, Viale P, Lopes S, et al.　Risk factors for carbapenem-resistant Gram-negative bacterial infections:a systematic review.　Clin Microbiol Infect, 27:228-235, 2021.
13. Tsujimoto H, Takahata R, Nomura S, Kumano I, Matsumoto Y, Yoshida K, et al.　Predictive value of pleural and serum interleukin-6 levels for pneumonia and hypo-oxygenations after esophagectomy.　J Surg Res, 182:e61-67, 2013.
14. Livermore DM.　Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa:our worst nightmare? Clin Infect Dis, 34:634-640, 2002.
15. Havens TN, Rosen DA, Rivera-Spoljaric K.　Airway multidrug-resistant organisms in a population of tracheostomy and chronic ventilator-dependent children at a tertiary care pediatric hospital.　Pediatr Pulmonol, 58:26-34, 2023.

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