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. 2017 Nov-Dec;34(6):527-531.
doi: 10.4103/lungindia.lungindia_39_17.

The emergence of multidrug-resistant Pseudomonas aeruginosa in cystic fibrosis patients on inhaled antibiotics

Atqah AbdulWahab  1 , Khalid Zahraldin  2 , Mazen A Sid Ahmed  3 , Sulieman Abu Jarir  4 , Mohammed Muneer  5 , Shehab F Mohamed  4 , Jemal M Hamid  6 , Abubaker A I Hassan  4 , Emad Bashir Ibrahim  7
Affiliations

The emergence of multidrug-resistant Pseudomonas aeruginosa in cystic fibrosis patients on inhaled antibiotics

Atqah AbdulWahab et al. Lung India. 2017 Nov-Dec.

Abstract

Introduction: Multidrug-resistant Pseudomonas aeruginosa (MDR-PA) is an important and growing issue in the care of patients with cystic fibrosis (CF), and a major cause of morbidity and mortality.

Objective: The objective of the study was to describe the frequency of MDR-PA recovered from the lower respiratory samples of pediatric and adult CF patients, and its antibiotic resistance pattern to commonly used antimicrobial agents including β-lactams, aminoglycosides, and fluoroquinolones.

Materials and methods: The lower respiratory isolates of P. aeruginosa were obtained from inpatients and outpatients CF clinics from a tertiary care teaching hospital for the period from October 2014 to September 2015. The identification and antimicrobial susceptibility for all the isolates were performed by using the BD Phoenix™ and E-test in compliance with Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: A total of 61 P. aeruginosa samples were isolated from thirty CF patients from twenty families. Twelve sputum samples were positive for MDR-PA (seven nonmucoid and five mucoid isolates) from five CF patients (five families) with moderate-to-very severe lung disease given MDR-PA frequency of 19.7%. The median age of the study group was 20 (range 10-30) years. Three CF patients were on chronic inhaled tobramycin and two on nebulized colistin. The antimicrobial patterns of isolates MDR-PA showed the highest rate of resistance toward each gentamycin, amikacin, and cefepime (100%), followed by 91.7% to ciprofloxacin, 75% to tobramycin, 58.3% to meropenem, and 50% to piperacillin-tazobactam. None of the isolates were resistant to colistin during the study period.

Conclusion: The study results emphasize that the emergence of a significant problem in the clinical isolates of P. aeruginosa in CF patients that dictate appropriate attention to the antibiotic management after proper surveillance.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The antimicrobial susceptibility of Pseudomonas aeruginosa from lower respiratory samples of thirty cystic fibrosis patients. COL: Colomycin, PIP-TAZO: Piperacillin-tazobactam, MERO: Meropenem, CIP: Ciprofloxacin, CEF: Cefepime, AMK: Amikacin, GENT: Gentamicin
Figure 2
Figure 2
The antimicrobial pattern of MDR-PA isolates from lower respiratory samples of five cystic fibrosis patients. AMK: Amikacin, GENT: Gentamicin, CEF: Cefepime, CIP: Ciprofloxacin, TOB: Tobramycin, MERO: Meropenem, PIP-TAZO: Piperacillin-tazobactam
See this image and copyright information in PMC

References

    1. WHO. Genomic Resource Centre. Genes and Human Disease. Available from: http://www.who.int/genomics/public/geneticdiseases/en/index2.html .
    1. O’Sullivan BP, Flume P. The clinical approach to lung disease in patients with cystic fibrosis. Semin Respir Crit Care Med. 2009;30:505–13. - PubMed
    1. Ratjen F. Recent advances in cystic fibrosis. Paediatr Respir Rev. 2008;9:144–8. - PubMed
    1. Flume PA, O’Sullivan BP, Robinson KA, Goss CH, Mogayzel PJ, Jr, Willey-Courand DB, et al. Cystic fibrosis pulmonary guidelines: Chronic medications for maintenance of lung health. Am J Respir Crit Care Med. 2007;176:957–69. - PubMed
    1. Que C, Cullinan P, Geddes D. Improving rate of decline of FEV1 in young adults with cystic fibrosis. Thorax. 2006;61:155–7. - PMC - PubMed