Pseudomonas aeruginosa in the ICU: prevalence, resistance profile, and antimicrobial consumption

Ribeiro, Ághata Cardoso da Silva; Crozatti, Márcia Terezinha Lonardoni; Silva, Adilson Aderito da; Macedo, Rodrigo Spineli; Machado, Antônia Maria de Oliveira; Silva, Antonio Távora de Albuquerque

doi:10.1590/0037-8682-0498-2018

Cited by 28 publications

(33 citation statements)

References 10 publications

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“…The ICUs are the major sources of dissemination of multidrug-resistant organisms, where the selection pressure is the highest for the emergence of resistance. The nosocomial infection rate in ICUs is 2–5 times higher than that in the general (non-ICU) hospital population 16 . Interestingly, in our study, all carbapenem-resistant P. aeruginosa strains were isolated from patients hospitalized in the ICU, indicating that in this hospital, the frequency of these strains is restricted to the ICU.…”

Section: Discussionmentioning

confidence: 87%

Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units

Souza

Rossato

Brito

et al. 2021

Rev. Inst. Med. trop. S. Paulo

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Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the bla KPC-2 and bla TEM genes were identified in three isolates (11%) and bla SHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using opr D-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.

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Section: Discussionmentioning

confidence: 87%

Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units

Souza

Rossato

Brito

et al. 2021

Rev. Inst. Med. trop. S. Paulo

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“…Phage population is huge and full of novel genes whose functions are essentially unknown [ 17 ], and, for this reason, they are considered the “dark matter” of the biological universe [ 18 ]. P. aeruginosa has evolved over time, becoming progressively more resistant to the available antibiotics, and is now considered one of the six most dangerous pathogens responsible for hospital-acquired infections [ 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Bacteriophage-Based Biosensing of Pseudomonas aeruginosa: An Integrated Approach for the Putative Real-Time Detection of Multi-Drug-Resistant Strains

et al. 2021

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During the last decennium, it has become widely accepted that ubiquitous bacterial viruses, or bacteriophages, exert enormous influences on our planet’s biosphere, killing between 4–50% of the daily produced bacteria and constituting the largest genetic diversity pool on our planet. Currently, bacterial infections linked to healthcare services are widespread, which, when associated with the increasing surge of antibiotic-resistant microorganisms, play a major role in patient morbidity and mortality. In this scenario, Pseudomonas aeruginosa alone is responsible for ca. 13–15% of all hospital-acquired infections. The pathogen P. aeruginosa is an opportunistic one, being endowed with metabolic versatility and high (both intrinsic and acquired) resistance to antibiotics. Bacteriophages (or phages) have been recognized as a tool with high potential for the detection of bacterial infections since these metabolically inert entities specifically attach to, and lyse, bacterial host cells, thus, allowing confirmation of the presence of viable cells. In the research effort described herein, three different phages with broad lytic spectrum capable of infecting P. aeruginosa were isolated from environmental sources. The isolated phages were elected on the basis of their ability to form clear and distinctive plaques, which is a hallmark characteristic of virulent phages. Next, their structural and functional stabilization was achieved via entrapment within the matrix of porous alginate, biopolymeric, and bio-reactive, chromogenic hydrogels aiming at their use as sensitive matrices producing both color changes and/or light emissions evolving from a reaction with (released) cytoplasmic moieties, as a bio-detection kit for P. aeruginosa cells. Full physicochemical and biological characterization of the isolated bacteriophages was the subject of a previous research paper.

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“…Due to the continuous formation of drug-resistant strains and constant improvements in drug resistance, P. aeruginosa has become one of the most serious conditional pathogens of acquired infections in hospitals [8 9]. Particularly, in the intensive care unit (ICU), the increasing number of multi-drug resistant P. aeruginosa causing pneumonia has challenged the application of antibiotics [10]. Pulmonary immunity plays a vital role in ghting against pulmonary respiratory pathogens; simultaneously, diverse in ammatory regulators (like growth factors, cytokines, and chemokines) regulate the responses to an injury or infection [11].…”

Section: Introductionmentioning

confidence: 99%

Contribution of IL-38 in Lung Immunity During Pseudomonas Aeruginosa-Induced Pneumonia

Wei

Chen

Wang

2021

Preprint

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Objective: Interleukin-38 (IL-38), a new type of cytokine, is involved in processes such as tissue repair, inflammatory response, and immune response. However, its function in pneumonia caused by Pseudomonas aeruginosa is still unclear.Methods: In this study, we detected circulating IL-38 in adults affected by pneumonia caused by P. aeruginosa. The P. aeruginosa-induced pneumonia WT murine model was adopted to evaluate the effect of IL-38 on Treg differentiation, cell apoptosis, survival, tissue damage, inflammation, and bacterial removal.Results: IL-38 is insufficiently secreted in patients who died of P.A. pneumonia.Recombinant IL-38 improved survival, whereas anti-IL-38 antibody reduced survival in the experimental pneumonia murine model. IL-38 exposure reduced the inflammatory response, as suggested by the lung injury, and reduced cytokine levels (IL-1β, IL-6, IL-17A, TNF-α, and CXCL-1, but not IL-10). It also increased bacterial clearance and reduced cell apoptosis in the lungs. Furthermore, IL-38 was shown to reduce TBK1 expression in vitro when naïve CD4+ T lymphocytes were differentiated to Tregs and played a protective role in P.A. pneumonia.Conclusions: To summarize, the above findings provide additional insights into the mechanism of IL-38 in the treatment of P.A. pneumonia.

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Pseudomonas aeruginosa in the ICU: prevalence, resistance profile, and antimicrobial consumption

Cited by 28 publications

References 10 publications

Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units

Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units

Bacteriophage-Based Biosensing of Pseudomonas aeruginosa: An Integrated Approach for the Putative Real-Time Detection of Multi-Drug-Resistant Strains

Contribution of IL-38 in Lung Immunity During Pseudomonas Aeruginosa-Induced Pneumonia

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