Cumulative Antimicrobial Susceptibility Data of Pseudomonas Aeruginosa Isolates from Cystic Fibrosis Patients: 4-Year Experience

Abstract

Objective Pseudomonas aeruginosa is the most important cause of lung infection among cystic fibrosis (CF) patients, and to reduce the severity of the infection, facility-specific cumulative antibiograms could help clinicians in empirical treatment.

Methods Respiratory samples of CF patients between January 2015 and December 2018 were scanned through Laboratory Operating System retrospectively. Demographical data of patients, culture results, and antibiotic susceptibilities are recorded using Microsoft Excel 2010. Cumulative antibiogram data were obtained according to the CLSI M39A4 document.

Results The number of registered patients increased in 4 years from 154 to 253. The mean age of patients varied from 9 to 11.7 (range, 2–42). The ratio of patients with a positive culture for P. aeruginosa increased from 32 to 40%, and the mean patients' age decreased from 16.6 to 11.1 (p <0.05). A total number of 4,146 respiratory samples were analyzed. Sputum samples consisted of 42.5% (n: 1,767) of the samples with a 58.4% isolation rate of P. aeruginosa (n: 1,034). A notable increase of resistance was seen almost all antimicrobials tested by years. The ratio of multidrug-resistant (MDR) P. aeruginosa was 4.1, 10.2, 4.5, and 8.6% in 2015, 2016, 2017, and 2018.

Conclusion Antimicrobial resistance is a challenging problem in CF patients, and surveillance should be done regularly.

Keywords

cystic fibrosis - Pseudomonas aeruginosa - cystic fibrosis - respiratory samples

Publikationsverlauf

Eingereicht: 21. September 2020

Angenommen: 16. Mai 2021

Artikel online veröffentlicht:
07. Juli 2021

• References

• 1 Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 2003; 168 (08) 918-951
• 2 Ehsan Z, Clancy JP. Management of Pseudomonas aeruginosa infection in cystic fibrosis patients using inhaled antibiotics with a focus on nebulized liposomal amikacin. Future Microbiol 2015; 10 (12) 1901-1912
• 3 Hangül M, Pekcan S, Köse M. et al. The incidence of cystic fibrosis in central Anatolia region of Turkey in 2015 and 2016. Balkan Med J 2019; 36: 179-183
• 4 Emerson J, Rosenfeld M, McNamara S, Ramsey B, Gibson RL. Pseudomonas aeruginosa and other predictors of mortality and morbidity in young children with cystic fibrosis. Pediatr Pulmonol 2002; 34 (02) 91-100
• 5 Döring G, Flume P, Heijerman H, Elborn JS. ; Consensus Study Group. Treatment of lung infection in patients with cystic fibrosis: current and future strategies. J Cyst Fibros 2012; 11 (06) 461-479
• 6 Stefani S, Campana S, Cariani L. et al. Relevance of multidrug-resistant Pseudomonas aeruginosa infections in cystic fibrosis. Int J Med Microbiol 2017; 307 (06) 353-362
• 7 Pakyz AL.. Insights from the Society of Infectious Diseases Pharmacists. The utility of hospital antibiograms as tools for guiding empiric therapy and tracking resistance. Pharmacotherapy 2007; 27 (09) 1306-1312
• 8 Atag E, Bas Ikizoglu N, Ergenekon AP. et al. Novel mutations and deletions in cystic fibrosis in a tertiary cystic fibrosis center in Istanbul. Pediatr Pulmonol 2019; 54 (06) 743-750
• 9 Leber AL. Clinical Microbiology Procedures Handbook, 4th ed. In: Gilligan PH, Alby K, York MK. eds. Respiratory Cultures from Cystic Fibrosis Patients. Washington, DC: ASM Press; 2016: 3.11.3.1-3.11.3.2
• 10 CLSI. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data; Approved Guideline. 4th ed. CLSI document M39–A4. Wayne, PA: Clinical and Laboratory Standards Institute; 2014
• 11 Cystic Fibrosis Foundation Patient Registry. 2018 Annual Data Report. Bethesda. Maryland: Cystic Fibrosis Foundation; 2019
• 12 Emaneini M, Kalantar-Neyestanaki D, Jabalameli L, Hashemi M, Beigverdi R, Jabalameli F. Molecular analysis and antimicrobial resistance pattern of distinct strains of Pseudomonas aeruginosa isolated from cystic fibrosis patients in Iran. Iran J Microbiol 2019; 11 (02) 98-107
• 13 Gautam V, Kaza P, Mathew JL, Kaur V, Sharma M, Ray P. Review of a 7-year record of the bacteriological profile of airway secretions of children with cystic fibrosis in North India. Indian J Med Microbiol 2019; 37 (02) 203-209
• 14 Courtois N, Caspar Y, Maurin M. Phenotypic and genetic resistance traits of Pseudomonas aeruginosa strains infecting cystic fibrosis patients: a French cohort study. Int J Antimicrob Agents 2018; 52 (03) 358-364
• 15 Zolin A, Orenti A, Naehrlich L. et al. European Cystic Fibrosis Society Patient Registry (ECFPR) Annual Report. 2018 Available at: https://www.ecfs.eu/sites/default/files/general-content-files/working-groups/ecfs-patient-registry/ECFSPR_Report_2018_v1.4.pdf
• 16 Dogru D, Çakır E, Şişmanlar T. et al. Cystic fibrosis in Turkey: First data from the national registry. Pediatr Pulmonol 2020; 55 (02) 541-548
• 17 Qin X, Zhou C, Zerr DM. et al. Heterogeneous antimicrobial susceptibility characteristics in Pseudomonas aeruginosa isolates from cystic fibrosis patients. MSphere 2018; 3 (02) e00615-e00617