Pseudomonas aeruginosa infection in inpatients of different profiles: clinical and microbiological aspects


DOI: https://dx.doi.org/10.18565/epidem.2022.12.1.87-92

Matievskaya N.V., Volosach O.S., Kuzmich I.A.

1) Grodno State Medical University, Grodno, Republic of Belarus; 2) Grodno Regional Infectious Diseases Clinical Hospital; Grodno, Republic of Belarus
Objective. To provide the clinical characteristics of patients with Pseudomonas aeruginosa infection, by taking into account the antibiotic resistance of isolated P. aeruginosa strains.
Subjects and methods. The investigators retrospectively analyzed clinical data on 79 patients, in whom P. aeruginosa was isolated from their various biological material samples, by taking into account the antibiotic resistance of the isolates.
Results. Pseudomonas aeruginosa infection is equally common in males and females; it can be recorded in both children and adults. Patients with Pseudomonas aeruginosa infection caused by antibiotic-resistant strains of P. aeruginosa were found to have underlying chronic diseases, such as diabetes mellitus, chronic obstructive pulmonary disease, chronic pyelonephritis, anemia, malignant tumors, bedsores, and urinary catheters. In 11.3% of patients, antibiotic-resistant strains of P. aeruginosa were isolated from the biological material collected within 48 hours after admission to hospital, indicating that they had a healthcare-associated infection prior to hospitalization. P. aeruginosa was established to be susceptible in vitro to polymyxins (86.1%), amikacin (81.0%), tobramycin (68.2%), levofloxacin (61.5%), meropenem (60.8%), imipenem (49.4%), doripenem (53.1%), ceftazidim (55.7%), cefepime (34.2%), and cefoperazone (24.2%).
Conclusion. Among the P. aeruginosa strains isolated from inpatients, antibiotic-resistant strains prevailed, amounting to 78.5%. According to the monitoring results, polymyxins remain the drug of choice for severe invasive infections caused by antibiotic-resistant P. aeruginosa strains, to which the highest frequency of susceptibility was noted.

Literature


1. Бабаян Б.Г., Саргсян А.С., Багдасарян С.А., Мелкумян М.А., Давидян Т.С., Оганесян Н.А., Оганесян А.М. Исследования стабильности плазмид антибиотикорезистентности у почвенных условно-патогенных штаммов Stenotrophomonas и Pseudomonas. Авиценна 2019; (38): 13–7. Babajan B.G., Sargsjan A.S., Bagdasarjan S.A., Melkumjan M. A., Davidjan T.S., Oganesjan N.A., Oganesjan A.M. [The research of stability of antibiotic resistance plasmids in soil opportunistic pathogenic strains of Stenotrophomonas and Pseudomonas]. Avicenna 2019; (38): 13–7. (In Russ).


2. Галстян Г.М., Клясова Г.А., Катрыш С.А., Золо­товская И.К., Галстян А.Г., Городецкий В.М. Этиология нозокомиальных пневмоний у онкогематологических больных в отделении реанимации и интенсивной терапии. Клиническая микробиология и антимикробная химиотерапия 2011; 3(13): 231–40.

Galstyan G.M., Klyasova G.A., Katrysh S.A., Zolotovskaya I.K., Galstyan A.G., GorodeckyV.M. [Hospital-Acquired Pneumonia in Patients with Hematological Malignancies in an ICU]. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya 2011; 3(13): 23–40. (In Russ.).


3. Земко В.Ю., Окулич В.К., Дзядзько А.М. Мониторинг антибиотикорезистентности микроорганизмов в отделении реанимации и интенсивной терапии многопрофильного стационара. Трансплантология 2018; 10(4): 284–97. DOI:10.23873/2074-0506-2018-10-4-284-297

Zemko V.Yu., Okulich V.K., Dzjadz’ko A.M. [Monitoring the antibiotic resistance in the intensive care unit of a multidisciplinary hospital]. Transplantologiya 2018; 10(4): 284–97. (In Russ.). DOI:10.23873/2074-0506-2018-10-4-284-297


4. Илюкевич Г.В. Синегнойная инфекция: в новый век со старой проблемой. Мед. новости 2004; (12): 3–8

Iljukevich G.V. [Pseudomonas aeruginosa: in a new century with an old problem]. Mednovosti 2004; (12): 3–8. (In Russ.).


5. Ионов П.М., ЕлькинА.В., Дейнега И.В., Яковлев Г.А., Шевцова М.А.Этиология и клинические формы нагноительных заболеваний легких и плевры у ВИЧ-инфицированных больных. Вестник хирургии имени И.И. Грекова 2019; 178(4): 10–4. DOI:10.24884/0042-4625-2019-178-4-10-14

Ionov P.M., El’kinA.V., Dejnega I.V., Jakovlev G.A., Shevcova M.A. [Etiology and clinical forms of lungs and pleura suppurative diseases of HIV-infected patients]. Grekov’s Bulletin of Surgery 2019; 178(4):10–4. (In Russ.). DOI:10.24884/0042-4625-2019-178-4-10-14


6. Осипов В.А., Тапальский Д.В., Склеенова Е.Ю., Романов А.В., Жаворонок С.В. Клональное распространение штаммов Pseudomonas aeruginosa – продуцентов металло-бета-лактамаз на территории Беларуси. Иммунопатология, аллергология,, инфектология 2012; (4): 92–7.

Osipov V.A., Tapal’skij D.V., Skleenova E.Ju., Romanov A.V., Zhavoronok S.V. [Clonal spreading of Pseudomonas aeruginosa strains metallobetalactamasesproducers in territory of Belarus] Immunopathology, allergology, infectology 2012; (4): 92–7. (In Russ.).


7. Фокин А.А., Галкин Д.В., Мищенко В.М., Муравьев А.А., Козлов Р.С.; исследовательская группа «МИКС-07». Уроки эпидемио.микробиология и антимикробная химиотерапия 2008; 10(1): 4–14

Fokin A.A., Galkin D.V., Mishhenko V.M., Murav’jov A.A., Kozlov R.S., issledovatel’skaja gruppa «MIKS-07». [Lessons from epidemiological studies of nosocomial infections in Russia]. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya 2008; 10(1): 4–14. (In Russ.).


8 ​Соловей Н.В. Клиническое значение антибиотикорезистентных штаммов Pseudomonas aeruginosa, выделяемых в первые дни госпитализации пациента в больничные организации здравоохранения. Клиническая инфектология и паразитология 2014; 1(8): 36–44

Solovey N.V. [The clinical value of antibiotic resistance of Pseudomonas aeruginosa strains which were diagnosed in the first days of patient’s admission to the hospitals]. Clinical Infectology and Parasitology 2014; 1 (08): 36–44. (In Russ.).


9. Хабалова Н.Р., Кафтырева Л.А. Pseudomonas aeruginosa как этиологический фактор внутрибольничных инфекций в отделениях реанимации и интенсивной терапии: микробиологические и эпидемиологические особенности. Владикавказский медико-биологический вестник 2012; 15(23): 149–59

Habalova N.R., Kaftyreva L.A. [Pseudomonas aeruginosa as the etiologic agent of intrahospital infections in reanimation and intensive therapy departments: microbiological and epidemiological features]. Vladikavkazskiy mediko-biologicheskiy vestnik 2012; 15 (23): 149–59. (In Russ.).


10. Bedard E., Prevost M., Deziel E. Pseudomonas aeruginosa in premise plumbing of large buildings. Microbiology Оpen 2016; 5(6): 937–56.


11. Zhang Y., Li Y., Zeng J., Chang Y., Han S., Zhao J.et al. Risk Factors for Mortality of Inpatients with Pseudomonas aeruginosa Bacteremia in China: Impact of Resistance Profile in the Mortality. Infect. Drug Resist. 2020;13:4115–23. doi: 10.2147/IDR.S268744. eCollection 2020. PMID: 33209041


12. Zaragoza R., Vidal-Cortés P., Aguilar G., Borges M., Diaz E., Ferrer R.et al. Update of the treatment of nosocomial pneumonia in the ICU. Crit Care 2020; 24(1): 383. doi: 10.1186/s13054-020-03091-2. PMID: 32600375


13. Torres A., Carlet J. European Task Force on Ventilator-associated pneumonia. Eur. Respir. J. 2001; 17(5): 1034–45. doi: 10.1183/09031936.01.17510340


14. Van Delden C., Igewski B. Cell-to-cell signaling and Pseudomonas aeruginosa infections. Emerg. Infect. Dis. 1998; (4): 551–60.


15. Vincent J.-L., Rello J., Marshall J., Silva E., Anzueto A., Martin C.D.et al. International study ofthe prevalence and outcomes of infection in intensive care units. EPIC II Group of Investigators. JAMA 2009; 302 (21): 2323–9.


16. Zilberberg M.D., Shorr A.F. Prevalence of multidrug-resistant Pseudomonas aeruginosa and carbapenem-resistant Enterobacteriaceae among specimens from hospitalized patients with pneumonia and bloodstream infections in the United States from 2000 to 2009. J. Hosp. Med. 2013; (8): 559–63.


17. Иванов Д.В., Егоров А.М. Распространение и механизмы резистентности микроорганизмов, продуцирующих бета-лактамазы. Фенотипический скрининг продуцентов металло-бета-лактамаз (карбапенемаз подкласса в1) штаммов бактерий рода Pseudomonas при внутрибольничных инфекциях. Биомедицинская химия 2007; 53(6): 653–61.

Ivanov D.V., Egorov A.M. [Distribution and mechanisms of resistance of microorganisms producing beta-lactamases. Phenotypic screening of producers of metallo-beta-lactamases (carbapenemases, subclass B1) strains of bacteria of the genus Pseudomonas in nosocomial infections]. Biomedical Chemistry 2007; 53(6): 653–61. (In Russ.).


18. Харченко Л.А. Синегнойная палочка: современные реальности антибактериальной терапии. Медицина неотложных состояний 2015; 1 (64): 164–8.

Harchenko L.A. [Pseudomonas aeruginosa: modern realities of antibiotic therapy]. Medicina neotlozhnyh sostojanij 2015; 1 (64): 164–8. (In Russ).


About the Autors


Professor Natalya V. Matsiyeuskaya, MD, Heard, Department of Infectious Diseases, Grodno State Medical University, Grodno, Belarus; natamati@mail.ru; http://orcid.org/0000-0001-8492-6377
Olga S. Volosach,– Cand. Med. Sci., Associated Professor, Department of Infectious Diseases, Grodno State Medical University, Grodno, Belarus; o.vol@tut.by; http://orcid.org/0000-0002-3612-5003
Irina A. Kuzmich Heard, Clinical-Diagnostic Laboratory, Grodno Regional Infectious Diseases Clinical Hospital, Grodno, Belarus; ira0807@mail.ru


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