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Pseudomonas aeruginosa resistance rates in association with level of hospital care: data from the EARSS

Abstract number: 1732_238

Tiemersma E.W., van de Sande N., Kahlmeter G., de Kraker M., Monen J., Grundmann H., participants EARSS

Objective:Pseudomonas aeruginosa (PAE) is known to cause problems mainly in severely immunocompressed patients. This frequently involves multiresistance phenotypes. PAE resistance rates can reach levels of over 10%. Since July 2005, EARSS has been collecting antimicrobial susceptibility testing (AST) data from invasive PAE isolates. Here, we report for the first time the data for 2006 and relate these to hospital characteristics. We investigated the potential importance of levels of hospital care.

Methods: Participating laboratories carry out routine AST for invasive PAE isolates. Data are collected at national level and are forwarded to the EARSS database. AST data and information on hospital characteristics were available for 2,316 isolates from 262 hospitals in 20 countries. AST data included aminopenicillins, ceftazidim, fluoroquinolones, aminoglycosides and carbapenems. Multiple drug resistance was defined as resistance to all 5 drug classes. A logistic model was used to test the association between resistance and hospital characteristics (two-sided p-value <0.05). Hospital characteristics included were type (university/teaching, general/secondary and other), presence of (neonatal) intensive care units (ICUs), and transplants, burns and heamatology units, number of beds, and number of ICU beds.

Results: A significant proportion of isolates was resistant against piperacillin (± tazobactam) (14.5%), ceftazidim (13.6%), fluoroquinolones (25.0%), aminoglycosides (19.7%) and/or carbapenems (16.7%). Multiple drug resistance occurred in 4.7% of all isolates, although proportions varied between countries. All multiple drug resistant isolates originated from hospitals with ICUs, although not all isolates originated from patients being treated at ICUs. Resistance rates in hospitals were associated with the number of intensive-care beds and presence of a neonatal ICU (p < 0.0001) only. None of the other hospital characteristics influenced the resistance rates.

Conclusions: An important proportion of PAE isolates was found resistant to multiple drugs. The proportion of multiple drug resistance was associated with the number of ICU beds and presence of a neonatal ICU. Hospital types (university, general, other) were not associated to PAE resistance, which might reflect differences in definition of hospital type.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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