Universidade Federal de Uberlândia, Minas Gerais. Institute of Biomedical Sciences, Laboratory of Molecular Microbiology, Uberlândia-Minas Gerais, Brazil.
Clinical Hospital, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
J Infect Dev Ctries. 2024 Aug 31;18(8):1227-1232. doi: 10.3855/jidc.18400.
Multi-drug-resistant (MDR) Pseudomonas aeruginosa is a dangerous pathogen causing nosocomial infection, particularly in low- and middle-income countries like Brazil. This retrospective study at a Brazilian university hospital examined the relationship between antimicrobial use and MDR-P. aeruginosa.
Data was collected from 358 patients with non-repetitive P. aeruginosa infections from 2009 to 2019. Antibiotic use was measured in grams and expressed as defined daily dose (DDD) per 1000 patient-days for meropenem, imipenem, polymyxin, and tigecycline.
Extensively drug-resistant (XDR) P. aeruginosa occurred in 36.1%, and MDR in 32.6% of cases. Risk factors for XDR infection were hospitalization prior to infection (OR = 0.9901), intensive care unit (ICU) admission (OR = 0.4766), previous antibiotic use (OR = 1.4417), and use of cefepime (OR = 0.3883). Over the ten-year period, utilization of the monitored antibiotics increased, and there was a positive correlation between the rise in MDR-P. aeruginosa and the consumption of ceftriaxone, imipenem, meropenem, and polymyxin B. The 30-day mortality rate was 40.0% for all patients and 41.0% for those infected with XDR-P. aeruginosa.
This study highlights the negative impact of the indiscriminate use of antimicrobials, which has led to a significant increase in multidrug-resistant P. aeruginosa strains in hospitals.
多重耐药（MDR）铜绿假单胞菌是一种危险的病原体，可引起医院感染，尤其是在巴西等中低收入国家。巴西一家大学医院的这项回顾性研究调查了抗菌药物使用与 MDR-P. aeruginosa 之间的关系。
从 2009 年至 2019 年，收集了 358 例非重复铜绿假单胞菌感染患者的数据。将美罗培南、亚胺培南、多黏菌素和替加环素的使用量以克为单位进行测量，并表示为每 1000 个患者天的限定日剂量（DDD）。
广泛耐药（XDR）铜绿假单胞菌的发生率为 36.1%，MDR 为 32.6%。XDR 感染的危险因素包括感染前住院（OR=0.9901）、入住重症监护病房（ICU）（OR=0.4766）、既往抗生素使用（OR=1.4417）和头孢吡肟使用（OR=0.3883）。在十年期间，监测抗生素的使用量增加，MDR-P. aeruginosa 的上升与头孢曲松、亚胺培南、美罗培南和多黏菌素 B 的消耗呈正相关。所有患者的 30 天死亡率为 40.0%，XDR-P. aeruginosa 感染者的死亡率为 41.0%。
本研究强调了抗生素滥用的负面影响，这导致医院中多药耐药铜绿假单胞菌菌株显著增加。
