Management strategies for severe Pseudomonas aeruginosa infections

Do Rego, Hermann; Timsit, Jean-François

doi:10.1097/qco.0000000000000981

Cited by 4 publications

(3 citation statements)

References 149 publications

(158 reference statements)

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“…Furthermore, none of the Pseudomonas spp was resistant to amikacin and imipenem. It has been reported in the literature that imipenem represents the 'reserved' drug for treatment of infections caused by multidrugresistant Pseudomonas spp (18). Similarly, amikacin is a broad-spectrum antibiotic that is effective against MDR GNB such as Pseudomonas spp and Acinetobacter spp (19).…”

Section: Discussionmentioning

confidence: 99%

Aerobic vaginitis in women seen at the laboratory of the university hospital of Befelatanana, Antananarivo, Madagascar

Rakotovao-Ravahatra,

Razanadrakoto,

Rafaramalala

et al. 2024

Af J Clin Exp Micro

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Background: Vaginitis is common in women. The present study aims to identify the factors associated with aerobic vaginitis (AV) in women and evaluate the antibiotic resistance of bacteria responsible for this vaginitis.Methodology: This was a retrospective cross-sectional study of 840 patients and analysis of the results of their cytobacteriological examinations of cervicovaginal samples from January 01, 2020 to December 31, 2022 at the Centre Hospitalier Universitaire Joseph Raseta Befelatanana (CHUJRB) laboratory, Antananarivo, Mada- gascar.Results: Among the 840 patients, 35 had aerobic vaginitis, giving the prevalence of AV of 4.2%. Enterococcal vaginitis was the most common, representing 48.6% (n=17) cases of AV. Regarding associated factors, there was no significant difference in the prevalence of AV between women under age of 40 (4.4%, 29/653) and women over age of 40 years (3.2%, 6/187) (p=0.539); hospitalized (6.6%, 10/152) and non-hospitalized outpatients (3.6%, 25/688) (p=0.115); and pregnant (4.2%, 8/192) and non-pregnant women (4.2%, 27/648) (p=1.000). The antibiotic resistance varies from 0% (vancomycin) to 90.0% (penicillin G) for the Gram-positive bacteria and 0% (imipenem and amikacin) to 100% (cotrimoxazole, ciprofloxacin, cefixime) for Gram-negative bacteria (Pseudomonas spp)Conclusion: Cytobacteriological examination of cervicovaginal specimens in cases of genital disorders is necessary to improve the management of patients with AV in Madagascar. Similarly, empirical treatment should be properly guided and self-medication avoided, in order to limit the emergence of multidrug-resistant bacteria. Contexte: La vaginite est fréquente chez les femmes. La présente étude vise à identifier les facteurs associés à la vaginite aérobie (AV) chez la femme et à évaluer la résistance aux antibiotiques des bactéries responsables de cette vaginite. Méthodologie: Il s'agit d'une étude transversale rétrospective portant sur 840 patientes et analyse des résultats de leurs examens cytobactériologiques de prélèvements cervico-vaginaux du 01 janvier 2020 au 31 décembre 2022 au laboratoire du Centre Hospitalier Universitaire Joseph Raseta Befelatanana (CHUJRB), Antananarivo, Madagascar. Résultats: Parmi les 840 patientes, 35 avaient une vaginite aérobie, soit une prévalence d'AV de 4,2%. La vaginite à entérocoques était la plus courante, représentant 48,6% (n=17) des cas d'AV. Concernant les facteurs associés, il n’y avait pas de différence significative dans la prévalence de l’AV entre les femmes de moins de 40 ans (4,4%, 29/653) et les femmes de plus de 40 ans (3,2%, 6/187) (p=0,539); patients hospitalisés (6,6%, 10/152) et non hospitalisés (3,6%, 25/688) (p=0,115); et les femmes enceintes (4,2%, 8/192) et non enceintes (4,2%, 27/648) (p=1.000). La résistance aux antibiotiques varie de 0% (vancomycine) à 90,0% (pénicilline G) pour les bactéries à Gram positif et de 0% (imipénème et amikacine) à 100% (cotrimoxazole, ciprofloxacine, céfixime) pour les bactéries à Gram négatif (Pseudomonas spp). Conclusion: L'examen cytobactériologique des prélèvements cervico-vaginaux en cas de troubles génitaux est nécessaire pour améliorer la prise en charge des patients atteints d'AV à Madagascar. De même, le traitement empirique doit être correctement guidé et l’automédication évitée, afin de limiter l’émergence de bactéries multirésistantes.

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Section: Discussionmentioning

confidence: 99%

Aerobic vaginitis in women seen at the laboratory of the university hospital of Befelatanana, Antananarivo, Madagascar

Rakotovao-Ravahatra,

Razanadrakoto,

Rafaramalala

et al. 2024

Af J Clin Exp Micro

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“…Diese unbekannten Mechanismen sind z.B. bei Pseudomonas aeruginosa und Enterobacteriaceae der Gruppe 3 häufig [40‒42]. Ein Routinealgorithmus, der unseren Entscheidungsbaum für HAP und VAP im Krankenhaus Bichat (Paris, Frankreich) darstellt, ist in Abbildung 1 dargestellt.…”

Section: Ausblickunclassified

Bedeutung der Multiplex-PCR für die Therapie der schweren bakteriellen Lungenentzündung

Dessajan,

Timsit

2024

Kompass Pneumol

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Eine Lungenentzündung ist eine häufige und schwere Erkrankung, die eine schnelle und wirksame Behandlung erfordert. Die Diagnose von Patienten mit schwerer bakterieller Lungenentzündung und die rasche Auswahl einer geeigneten antimikrobiellen Therapie, die innerhalb der ersten Behandlungsstunden eingeleitet werden muss, erfordern fortschrittliche, schnelle und genaue Instrumente. Zwei molekulare Multiplex-Tests, Unyvero HPN und FilmArray Pneumonia+ Panel, wurden unter Verwendung der Multiplex-Polymerase-Kettenreaktion (mPCR) entwickelt, um Krankheitserreger und ihre wichtigsten Mechanismen der Antibiotikaresistenz in Atemwegsproben von Patienten schnell zu identifizieren. Die Leistungsbewertung dieser Tests zeigte starke Korrelationen mit den Referenztechniken. Eine gute Kenntnis der Indikationen, Ziele und Grenzen dieser Tests ist jedoch unerlässlich. Die Zusammenarbeit mit Mikrobiologen ist daher für ihren angemessenen Einsatz von entscheidender Bedeutung. Unter diesen Bedingungen und bei standardisiertem Management können diese Schnelltests das therapeutische Management schwerer Lungenentzündungen schneller und präziser sowie mit einer Breitspektrum-Antibiotikatherapie verbessern. Weitere randomisierte kontrollierte Studien sind notwendig, um die vielen offenen Fragen zu molekularen Multiplex-Schnelltests in der Diagnose und Therapie der schweren Lungenentzündung zu klären. Diese narrative Übersichtsarbeit befasst sich mit dem aktuellen Wissensstand sowie den Vor- und Nachteilen dieser Tests und schlägt Lösungen für ihre routinemäßige Anwendung vor.

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“…Key elements to know are that mPCR is not able to diagnose ampC production, impermeability or efflux pump mechanisms of resistance. These undetected mechanisms are common for example in Pseudomonas aeruginosa and group 3 Enterobacterales [40][41][42]. A routine algorithm representing our decision tree for HAP and VAP at Bichat Hospital (Paris, France) is depicted in Figure 1.…”

Section: Perspectivesmentioning

confidence: 99%

Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia

Dessajan,

Timsit

2024

Antibiotics

Self Cite

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Pneumonia is a common and severe illness that requires prompt and effective management. Advanced, rapid, and accurate tools are needed to diagnose patients with severe bacterial pneumonia, and to rapidly select appropriate antimicrobial therapy, which must be initiated within the first few hours of care. Two multiplex molecular tests, Unyvero HPN and FilmArray Pneumonia+ Panel, have been developed using the multiplex polymerase chain reaction (mPCR) technique to rapidly identify pathogens and their main antibiotic resistance mechanisms from patient respiratory specimens. Performance evaluation of these tests showed strong correlations with reference techniques. However, good knowledge of their indications, targets, and limitations is essential. Collaboration with microbiologists is, therefore, crucial for their appropriate use. Under these conditions, and with standardized management, these rapid tests can improve the therapeutic management of severe pneumonia faster, more precisely, and with narrow-spectrum antibiotic therapy. Further randomized controlled trials are needed to address the many unanswered questions about multiplex rapid molecular testing during the diagnosis and the management of severe pneumonia. This narrative review will address the current knowledge, advantages, and disadvantages of these tests, and propose solutions for their routine use.

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Management strategies for severe Pseudomonas aeruginosa infections

Cited by 4 publications

References 149 publications

Aerobic vaginitis in women seen at the laboratory of the university hospital of Befelatanana, Antananarivo, Madagascar

Aerobic vaginitis in women seen at the laboratory of the university hospital of Befelatanana, Antananarivo, Madagascar

Bedeutung der Multiplex-PCR für die Therapie der schweren bakteriellen Lungenentzündung

Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia

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