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Pharmaceuticals 2010, 3(4), 1070-1083; doi:10.3390/ph3041070
Article

Lessons Learned from Surveillance of Antimicrobial Susceptibilities of Pseudomonas aeruginosa at a Large Academic Medical Center

1,2,*  and 2,3
Received: 17 December 2009; in revised form: 22 March 2010 / Accepted: 1 April 2010 / Published: 1 April 2010
(This article belongs to the Special Issue Antibiotics)
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Abstract: This research report assessed the differences in resistance rates and antimicrobial usage-versus-susceptibility relationships of Pseudomonas aeruginosa found in various hospital patient care areas. A simplified case control study was also performed to identify patient-specific risk factors associated with cefepime-resistant P. aeruginosa isolates. Last, we determined the consequence of combining mucoid and non-mucoid derived antimicrobial susceptibilities of P. aeruginosa into hospital antibiograms. Overall, susceptibility rates remained lower in the intensive care units (ICUs) compared to the non-ICU patient care areas, except for cefepime over the last time period. Cefepime utilization and antimicrobial-resistance rates among P. aeruginosa isolates had a significant relationship. Decreased meropenem exposure was associated with lower resistance rates relative to cefepime. Risk factors independently associated with cefepime-resistant P. aeruginosa were structural lung disease, ICU admission, recent third generation cephalosporin use, frequent hospital admission and non-urine isolates. Large and statistically significant differences were observed between non-mucoid and combined percent susceptibility data for aminoglycosides. To control antimicrobial resistance and optimize initial empiric antimicrobial therapy, antimicrobial susceptibility and utilization patterns in specific patient care areas should be monitored and risk factors for antimicrobial resistance should be assessed. Mucoid strains of P. aeruginosa should not be included into antimicrobial susceptibility data as this may underestimate activity of most antipseudomonal agents.
Keywords: Pseudomonas aeruginosa; antimicrobials; antibiotics; bacterial resistance; cefepime; antimicrobial stewardship; antibiogram Pseudomonas aeruginosa; antimicrobials; antibiotics; bacterial resistance; cefepime; antimicrobial stewardship; antibiogram
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Heintz, B.H.; Halilovic, J. Lessons Learned from Surveillance of Antimicrobial Susceptibilities of Pseudomonas aeruginosa at a Large Academic Medical Center. Pharmaceuticals 2010, 3, 1070-1083.

AMA Style

Heintz BH, Halilovic J. Lessons Learned from Surveillance of Antimicrobial Susceptibilities of Pseudomonas aeruginosa at a Large Academic Medical Center. Pharmaceuticals. 2010; 3(4):1070-1083.

Chicago/Turabian Style

Heintz, Brett H.; Halilovic, Jenana. 2010. "Lessons Learned from Surveillance of Antimicrobial Susceptibilities of Pseudomonas aeruginosa at a Large Academic Medical Center." Pharmaceuticals 3, no. 4: 1070-1083.


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