Healthcare-associated Infections by Pseudomonas aeruginosa and Antimicrobial Resistance in a Public Hospital from Alagoas (Brazil)

Infecções Associadas à Assistência à Saúde por Pseudomonas aeruginosa e Resistência Antimicrobiana em Hospital Público de Alagoas (Brasil)

Maria Anilda dos Santos Araújo1; Joiciane Santos Rodrigues1; Teresa de Lisieux Guedes Ferreira Lobo2; Fernanda Cristina de Albuquerque Maranhão3
1 Tiradentes University Center, Maceio, AL, Brazil.
2 Institute of Pharmaceutical Sciences, Federal University of Alagoas, Maceio, AL, Brazil.
3 Institute of Biological and Health Sciences, Federal University of Alagoas, Maceio, AL, Brazil.
DOI: 10.1900/JBPML.2022.58.447

Introduction: Pseudomonas aeruginosa infections are common worldwide, affecting mainly hospitalized patients and causing healthcareassociated infections (HAIs), with a high frequency of antibiotic resistance and complicated outcomes.
Objective: To investigate the P. aeruginosa frequency in HAIs in a medium/high-complexity hospital in Alagoas (Brazil) and the antibiotic susceptibility profiles of the strains.
Methods: A retrospective cross-sectional study was conducted from January 2013 to December 2014, when P. aeruginosa related-HAIs were evaluated after automated identification (Vitek®2) and documental analysis.

Results: Seventy-eight samples were positive for P. aeruginosa, with 37 (47.4%) isolates from patients of the general Intensive Care Unit (ICU) and 13 (16.7%) from the surgical unit. Tracheal secretion (25.6%), wound secretions (20.5%) and sputum (18.0%) were the main positive biological samples. Among 68 strains tested, 73.53% showed resistance to aztreonam, while cefepime, ceftriaxone and cefotaxime were not effective for any isolates (all resistant). High resistance to carbapenems imipenem (61.76%) and meropenem (55.88%) was observed, as well as 46 isolates resistant to piperacillin/tazobactam (67.64%); 47 (60.2%) from the general ICU and neonatal ICU were resistant to all antibiotics tested (MDR profile), except for colistin.
Conclusion: Our results indicated antibiotic-resistant P. aeruginosa highly present in ICU and the therapy with aminoglycosides and colistin as important choices in cases with failure against P. aeruginosa isolates. A constant screening of multidrug-resistant P. aeruginosa is necessary for the control in the hospital environment, evaluating the antibiotic susceptibility to guide the therapeutic choice.
Key words: Pseudomonas aeruginosa; antimicrobial resistance; healthcare-associated infections; ICU.