Article Text

  1. S. Jayawardena1,
  2. E. Akinyemi1,
  3. K. F. Kong2,
  4. S. Indulkar3,
  5. R. Yusupov1
  1. 1Coney Island Hospital, Brooklyn, NY
  2. 2Florida International University, Miami, FL
  3. 3Maimonides Medical Center, Brooklyn, NY


Introduction Although Pseudomonas aeruginosa is generally a commensal organism it is a major opportunistic bacterial pathogen in nosocomial infections. To ensure optimal efficiency of antibiotic treatment, antibiotic susceptibility tests must be performed and interpreted with caution before prescription.

Purpose To determine the antibiotic sensitivity of P. aeruginosa isolated from endotracheal tubes and to design an optimum antibiotic regimen that could be used to effectively treat infections with Pseudomonas.

Method A 3-year retrospective study was done on the tracheal aspirates in all the intubated patients. A total of 240 P. aeruginosa positive cultures were identified using Gram staining and specific culturing techniques. Subsequently, the antibiotic sensitivity of these isolates was assayed. The MIC of was checked with ceftazidime (third-generation cephalosporin), cefepime (fourth-generation cephalosporin), piperacillin, piperacillin-tazobactam, ticarcillin-clavulanate, imipenem, amikacin, gentamicin, and tobramycin.

Results In our study, 64% of the P. aeruginosa isolates were sensitive to ceftazidime, and 23% were resistant However, when the MIC of a fourth-generation cephalosporin, cefepime, was determined, only 36% of the P. aeruginosa isolates were sensitive and 25% were resistant. Among the antipseudomonal beta-lactams, 50% of the P. aeruginosa isolates were sensitive to piperacillin and 45% were resistant. Among the combined regimens piperacillin-tazobactam was the most potent drug; 73% of the isolates were sensitive and 25% were resistant. P. aeruginosa was more resistant ticarcillin-clavulanate; 52% of the isolates were resistant. Fifty percent of the isolates were sensitive to imipenem. Among the aminoglycosides, P. aeruginosa isolates were most sensitive to amikacin (86%), followed by tobramycin (64%) and gentamicin (27%).

Conclusion In our study, it was demonstrated that P. aeruginosa was one of the most common pathogens isolated from tracheal aspirates. Resistance against beta-lactam antibiotics varies from 23% to 50%. In our study, antipseudomonal beta-lactams were shown to be superior to the cephalosporins and carbepenem. In addition, combinatory piperacillin-tazobactam regimen and amikacin from the aminoglycoside group of antibiotics were the most effective antibiotics against P. aeruginosa.

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