Abstract
Background: Pseudomonas aeruginosa represents, among the nosocomial pathogens, one of the most serious threats, both for the severity of its clinical manifestations and its ability to develop complex profiles of resistance; Methods: we retrospectively collected the data of 21 patients admitted to a tertiary-care University Hospital of Rome with infections due to XDR-P. aeruginosa isolates during the second half of 2020; Results: in our institution, the percentage of XDR-P. aeruginosa isolates is 3.1%. None of the patients was admitted to the intensive care unit at the moment of the infection’s onset. Susceptibility to colistin was preserved in all the tested isolates. Rates of resistance to ceftolozane/tazobactam and ceftazidime/avibactam in these XDR strains were consistent; Conclusions: XDR-P. aeruginosa can be a threatening problem even outside the ICUs, especially in frail patients in wards with features of long-term acute care hospitals. In such a setting, ceftolozane/tazobactam and ceftazidime/avibactam should be administered with caution taking into account the microbiological susceptibility results. Colistin, even with its known safety and efficacy limits, could represent the only available therapeutic option due to its highly preserved susceptibility against XDR isolates of P. aeruginosa.
Highlights
Pseudomonas aeruginosa (PA) is a common nosocomial pathogen worldwide and it represents one of the most challenging microorganisms to face in clinical practice due to its intrinsic resistance and its extraordinary ability to develop additional resistance through selection of chromosomal mutations and acquisition of resistance genes [1]
Through the daily microbiological report of multidrugresistant (MDR) or extensively drug-resistant (XDR) isolates delivered by the Microbiology Laboratory, data of 21 patients admitted to a tertiary-care at the University Hospital of Rome (Fondazione Policlinico Universitario Agostino Gemelli IRCCS) with documented XDR-Pseudomonas aeruginosa isolates from 1 June to 31 December 2020
Our data show that XDR-PA can be a threatening problem even outside the Intensive Care Unit (ICU), especially in some wards that simulate the picture of long-term acute care hospitals: facilities specialized in the treatment of patients with serious medical conditions that no longer need intensive care but require more than they can receive in a rehabilitation center
Summary
Pseudomonas aeruginosa (PA) is a common nosocomial pathogen worldwide and it represents one of the most challenging microorganisms to face in clinical practice due to its intrinsic resistance and its extraordinary ability to develop additional resistance through selection of chromosomal mutations and acquisition of resistance genes [1]. Pseudomonas aeruginosa represents, among the nosocomial pathogens, one of the most serious threats, both for the severity of its clinical manifestations and its ability to develop complex profiles of resistance; Methods: we retrospectively collected the data of 21 patients admitted to a tertiary-care University Hospital of Rome with infections due to XDR-P. aeruginosa isolates during the second half of 2020; Results: in our institution, the percentage of XDR-P. aeruginosa isolates is 3.1%. Rates of resistance to ceftolozane/tazobactam and ceftazidime/avibactam in these XDR strains were consistent; Conclusions: XDR-P. aeruginosa can be a threatening problem even outside the ICUs, especially in frail patients in wards with features of long-term acute care hospitals. In such a setting, ceftolozane/tazobactam and ceftazidime/avibactam should be administered with caution taking into account the microbiological susceptibility results. Even with its known safety and efficacy limits, could represent the only available therapeutic option due to its highly preserved susceptibility against XDR isolates of P. aeruginosa
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