Susceptibility of Pseudomonas aeruginosa to antibiotics isolated from patients of french intensive care units during 1998.: Resistance phenotypes to β-lactams.: ESCRIME study

Pseudomonas aeruginosa is responsible for nosocomial infections and demonstrates many types of resistance mechanisms to antibiotics. Thus, in vitro susceptibility survey are frequently required. In this study, susceptibility has been assessed on 105 non redundant consecutive strains isolated from ICU's in 18 general hospitals, from 01.02.98 to 30.06.98. Only clinically significant samples have been considered. MICs have been measured for nine beta-lactams, three aminoglycosides, one fluoroquinolone and colistine. For ticarcilline resistant strains, phenotype has been assessed on Mueller-Hinton medium supplemented with beta-lactamases inhibitor. Transferable beta-lactamases has been identified using pl and PCR. MIC 50 and MIC 90 (mg/L) for beta-lactams are the following (MIC 50 --> 90) : ticarcilline (16 --> 512), ticarcilline + clavulanic acid (16 --> 512), piperacilline (4 --> 512), piperacilline + tazobactam (4 --> 64), aztreonam (4 --> 16), cefsulodine (4 --> 32), ceftazidime (2 --> 16), cefepime (4 --> 16), imipeneme (1 --> 8). For aminoglycosides : gentamicine (2 --> 32), tobramycine (1 --> 32), amikacine (4 --> 16). For ciprofloxacine (0.25 --> 32) and colistine (0.5 --> 2). According to CA-SFM break points recommendations, 50% of isolated strains are resistant to gentamicine, one out of three for ticarcilline + clavulanic acid (29%), one out of four for tobramycine (25%) and ciprofloxacine (25%), one out of ten for amikacine (9%), tazocilline (8%) and imipeneme (9%.). Resistance to ceftazidime and aztreonam is uncommon (respectively 2%-1%) and never observed for cefepim. For ticarcilline resistant strains, (38% of total isolates) the following phenotypes have been detected. 6.7% non enzymatic resistance, 15.2% transferable lactamase (TEM 4.8%, CARB 4.8%, TEM + CARB 4.8% and OXA-10 and derivated 0.9%) and 16.2% high level cephalosporinase. Extended-spectrum beta-lactamase has never been detected. TEM beta-lactamase is associated with resistance to amikacine and ciprofloxacine. (C) 2002 Editions scientiliques et medicales Elsevier SAS.