Carbapenem-Resistant Pseudomonas aeruginosa at US Emerging Infections Program Sites, 2015

Abstract

Pseudomonas aeruginosa is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. During July–October 2015 in the United States, we piloted laboratory-based surveillance for carbapenem-resistant P. aeruginosa (CRPA) at sentinel facilities in Georgia, New Mexico, Oregon, and Tennessee, and population-based surveillance in Monroe County, NY. An incident case was the first P. aeruginosa isolate resistant to antipseudomonal carbapenems from a patient in a 30-day period from any source except the nares, rectum or perirectal area, or feces. We found 294 incident cases among 274 patients. Cases were most commonly identified from respiratory sites (120/294; 40.8%) and urine (111/294; 37.8%); most (223/280; 79.6%) occurred in patients with healthcare facility inpatient stays in the prior year. Genes encoding carbapenemases were identified in 3 (2.3%) of 129 isolates tested. The burden of CRPA was high at facilities under surveillance, but carbapenemase-producing CRPA were rare.

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

“…Since Pseudomonas aeruginosa is the main pathogens of healthcare-associated infection (HAI) [4], and Pseudomonas aeruginosa infections are often challenging to treat because of its intrinsic nonsusceptibility to many antimicrobials. Pseudomonas aeruginosa causes an estimated 51,000 HAI in the United States annually and was the third most common gram-negative cause of selected HAI [5]. The increasing rate of carbapenem-resistant Pseudomonas aeruginosa worldwide limiting its therapeutic options as well as increasing costs and risk of mortality [6,7].…”

“…The increasing rate of carbapenem-resistant Pseudomonas aeruginosa worldwide limiting its therapeutic options as well as increasing costs and risk of mortality [6,7]. Carbapenems are considered by WHO as critically important antimicrobials CIAs and have become important antimicrobials for serious Pseudomonas aeruginosa infections [5,7].…”

A Study on Burden of Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii Infections in a Tertiary Care Hospital of Eastern India

“…These are difficult to treat as Pseudomonas aeruginosa is intrinsically resistant to many antimicrobial drugs as well as it shows various other resistance mechanisms and have different virulence factors, making carbapenems crucial in its clinical management. 1 Acinetobacter baumannii can acquire resistance to multiple classes of antimicrobial drugs, making them a major treatment challenge. 2 The spread of these infections are also difficult to control because it can survive for prolonged periods on environmental surfaces.…”

“…These are carbapenemaseproducing CRPsA (CP-CRPsA). 1,9 Chromosomal mediated mechanism are specific for each carbapenems, such as, loss of porin (oprD) contributing to imipenem resistance and the overexpression of efflux pumps contributing to meropenem resistance. 9 Depending on these above mechanisms of carbapenem resistance, clinical isolates exhibit different types of resistance phenotypes such as type I (imipenem resistant meropenem susceptible -IRMS), type II (meropenem resistant imipenem susceptible -MRIS) and type III (imipenem resistant meropenem resistant -RMR).…”

“…9 The major CP-CRPsA identified are Verona Integron Mediated (VIM) MBL, the Klebsiella pneumoniae carbapenemase (KPC), imipenem (IMP-1) MBL, New Delhi MBL (NDM) and oxacillinases (OXA-48, 181). 1 A study from 14 countries in Europe showed that the prevalence of metallo-β-lactamase (MBL) producing P. aeruginosa increased from 12.3% in 2010 to 30.6% in and it is increasing day by day. 10 Carbapenem resistance in Acinetobacter baumannii is a big concern and Metallo-β-lactamases (VIM, IMP, SIM) have been reported worldwide, especially in Asia and western Europe, and confer resistance to all β-lactams except aztreonam.…”