Ability of an antibiogram to predict Pseudomonas aeruginosa susceptibility to targeted antimicrobials based on hospital day of isolation - PubMed (original) (raw)

Ability of an antibiogram to predict Pseudomonas aeruginosa susceptibility to targeted antimicrobials based on hospital day of isolation

Deverick J Anderson et al. Infect Control Hosp Epidemiol. 2012 Jun.

Abstract

Objective: To determine the utility of an antibiogram in predicting the susceptibility of Pseudomonas aeruginosa isolates to targeted antimicrobial agents based on the day of hospitalization the specimen was collected.

Design: Single-center retrospective cohort study.

Setting: A 750-bed tertiary care medical center.

Patients and methods: Isolates from consecutive patients with at least 1 clinical culture positive for P. aeruginosa from January 1, 2000, to June 30, 2007, were included. A study antibiogram was created by determining the overall percentages of P. aeruginosa isolates susceptible to amikacin, ceftazidime, ciprofloxacin, gentamicin, imipenem-cilastin, piperacillin-tazobactam, and tobramycin during the study period. Individual logistic regression models were created to determine the day of infection after which the study antibiogram no longer predicted susceptibility to each antibiotic.

Results: A total of 3,393 isolates were included. The antibiogram became unreliable as a predictor of susceptibility to ceftazidime, imipenem-cilastin, piperacillin-tazobactam, and tobramycin after day 10 and ciprofloxacin after day 15 but longer for gentamicin (day 21) and amikacin (day 28). Time to unreliability of the antibiogram varied for antibiotics based on location of isolation. For example, the time to unreliability of the antibiogram for ceftazidime was 5 days (95% confidence interval [CI], <1-8) in the intensive care unit (ICU) and 12 days (95% CI, 7-21) in non-ICU hospital wards (P = .003).

Conclusions: The ability of the antibiogram to predict susceptibility of P. aeruginosa decreases as duration of hospitalization increases.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. D.J.A. has received research funding from Merck and Pfizer, has participated on the speaker’s bureau for Merck, and has received publication royalties from UpToDate Online. R.D. has received research funding from Merck/Schering-Plough, has participated on the speaker’s bureaus for Cubist and Merck/Schering-Plough, and has received publication royalties from UpToDate Online. All other authors report no conflicts of interest relevant to this article. All authors submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and the conflicts that the editors consider relevant to this article are disclosed here.

Figures

FIGURE 1

FIGURE 1

Selection of Pseudomonas aeruginosa isolates for inclusion in analyses.

FIGURE 2

FIGURE 2

Time to unreliability of the antibiogram as a predictor for Pseudomonas aeruginosa susceptibility to ciprofloxacin (CIP).

Similar articles

Cited by

References

    1. Wisplinghoff H, Bischoff T, Tallent S, Seifert H, Wenzel R, Ed-mond M. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39:309–317. - PubMed
    1. Pittet D, Li N, Woolson RF, Wenzel RP. Microbiological factors influencing the outcome of nosocomial bloodstream infections: a 6-year validated, population-based model. Clin Infect Dis. 1997;24:1068–1078. - PubMed
    1. Neuhauser MM, Weinstein RA, Rydman R, Danziger LH, Karam G, Quinn JP. Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use. JAMA. 2003;289:885–888. - PubMed
    1. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med. 1999;27:887–892. - PubMed
    1. Diekema DJ, Pfaller MA, Jones RN, et al. Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997. Clin Infect Dis. 1999;29:595–607. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources