Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 12 , ISSUE 1 ( March, 2008 ) > List of Articles

RESEARCH ARTICLE

Correlation between antibiotic use and changes in susceptibility patterns of Pseudomonas aeruginosa in a medical-surgical intensive care unit

Hatem Kallel, Fouzia Mahjoubi, Hassen Dammak, Mabrouk Bahloul, Chokri Ben Hamida, Hedi Chelly, Noureddine Rekik, Adnene Hammami, Mounir Bouaziz

Keywords : Ciprofloxacin, use, imipenem, P. aeruginosa, resistance

Citation Information : Kallel H, Mahjoubi F, Dammak H, Bahloul M, Hamida CB, Chelly H, Rekik N, Hammami A, Bouaziz M. Correlation between antibiotic use and changes in susceptibility patterns of Pseudomonas aeruginosa in a medical-surgical intensive care unit. Indian J Crit Care Med 2008; 12 (1):18-23.

DOI: 10.4103/0972-5229.40945

License: CC BY-ND 3.0

Published Online: 01-03-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Context: Multiple surveillance programmes have reported a decline in antibiotic susceptibility of P. aeruginosa. Aim: Our study aimed to study the relationship between the use of antipseudomonal drugs and the development of resistance of P. aerogenosa to these drugs. Setting and Design: Our study is retrospective. It was conducted in a medical surgical intensive care unit during a five-year period (January 1 st, 1999 to December 31, 2003), which was divided into 20 quarters. We had monitored the use of antipseudomonal agents and the resistance rates of P. aeruginosa to these drugs. Statistical Methods: The associations between use and resistance were quantified using non-partial and partial correlation coefficients according to Pearson and Spearman. Results: Over the study period, the most frequently used antipseudomonal agent was Imipenem (152 ± 46 DDD/1000 patients-day) and the resistance rate of P. aeruginosa to Imipenem was 44.3 ± 9.5% (range, 30 and 60%). In addition, Imipenem use correlated significantly with development of resistance to Imipenem in the same (P < 0.05) and in the following quarter (P < 0.05); and Ciprofloxacin use correlated significantly with resistance to Ciprofloxacin in the following quarter (P < 0.05). However, use of Ceftazidime or Amikacine had no apparent association with development of resistance. Conclusion: We conclude that the extensive use of imipenem or ciprofloxacin in intensive care units may lead to the emergence of imipenem- and ciprofloxacin-resistant strains of P. aeruginosa and that antibiotic prescription policy has a significant impact on P. aeruginosa resistance rates in an intensive care unit.


PDF Share
  1. Predominant pathogens found in the European prevalence of infection in intensive care study. Eur J Clin Microbiol Infect Dis 1996;5:281-5.
  2. Frequency of isolation and antimicrobial resistance of gram-negative and gram-positive bacteria from patients in intensive care units of 25 European university hospitals participating in the European arm of the SENTRY Antimicrobial Surveillance Program 1997-1998. Eur J Clin Microbiol Infect Dis 2001;20:617-25.
  3. A surveillance study of antimicrobial resistance of gram-negative bacteria isolated from intensive care units in eight hospitals in Turkey. J Antimicrob Chemother 1999;43:373-8.
  4. Prevalence of hospital-acquired infection in a Tunisian hospital. J Hosp Infect 2005;59:343-7.
  5. Resistance to imipenem among selected gram-negative bacilli in the United States. Infect Control Hosp Epidemiol 1992;13:10-4.
  6. Imipenem resistance among gram-negative bacilli. Eur J Clin Microbiol Infect Dis 19941;3:203-4.
  7. Influence of previous exposure to antibiotic therapy on the susceptibility pattern of Pseudomonas aeruginosa bacteremic isolates. Clin Infect Dis 2001;33:1859-64.
  8. Acquisition of multidrug-resistant Pseudomonas aeruginosa in patients in intensive care units: Role of antibiotics with antipseudomonal activity. Clin Infect Dis 2004;38:670-7.
  9. Consumption of imipenem correlates with beta-lactam resistance in Pseudomonas aeruginosa. Antimicrob Agents Chemother 2002;46:2920-5.
  10. Associations between antibiotic use and changes in susceptibility patterns of Pseudomonas aeruginosa in a private, university-affiliated teaching hospital: An 8-year-experience: 1995-2002. Int J Antimicrob Agents 2004;24:346-51.
  11. Emergence of antibiotic-resistant Pseudomonas aeruginosa: Comparison of risks associated with different antipseudomonal agents. Antimicrob Agents Chemother 1999;43:1379-82.
  12. “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis 2004;38:S341-5.
  13. Pseudomonas. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, editors. Manual of clinical microbiology. 7 th ed. ASM Press: Washington, DC; 1999. p. 517-25.
  14. Antibacterial susceptibility tests: Dilution and disk diffusion methods. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, editors. Manual of clinical microbiology. 7 th ed. ASM Press: Washington, DC; 1999. p. 1526-43.
  15. Predominant pathogens found in the European Prevalence of Infection in Intensive Care Study. Eur J Clin Microbiol Infect Dis 1996;15:281-5.
  16. Antibiotic consumption, bacterial resistance and their correlation in a Swiss university hospital and its adult intensive care units. Scand J Infect Dis 2003;35:843-50.
  17. Imipenem-resistant Pseudomonas aeruginosa: Risk factors and antibiotic susceptibility patterns. Clin Infect Dis 1997;25:1094-8.
  18. Citywide clonal outbreak of multiresistant Acinetobacter baumannii and Pseudomonas aeruginosa in Brooklyn, NY: The preantibiotic era has returned. Arch Intern Med 2002;162:1515-20.
  19. Colistin: The revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 2005;40:1333-41.
  20. Colistin as a salvage therapy for nosocomial infections caused by multidrug-resistant bacteria in the ICU. Int J Antimicrob Agents 2006;28:366-9.
  21. Antimicrobial usage and resistance trend relationships from the MYSTIC Programme in North America (1999-2001). J Antimicrob Chemother 2004;53:290-6.
  22. Evaluation of the antibiotics consumption in a Tunisian university hospital. Tunis Med 2005;83:110-3.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.