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Volume 25, Number 7—July 2019
Synopsis

Carbapenem-Resistant Pseudomonas aeruginosa at US Emerging Infections Program Sites, 2015

Maroya Spalding WaltersComments to Author , Julian E. Grass, Sandra N. Bulens, Emily B. Hancock, Erin C. Phipps, Daniel Muleta, Jackie Mounsey, Marion A. Kainer, Cathleen Concannon, Ghinwa Dumyati, Chris Bower, Jesse Jacob, P. Maureen Cassidy, Zintars Beldavs, Karissa Culbreath, Walter E. Phillips, Dwight J. Hardy, Roberto L. Vargas, Margret Oethinger, Uzma Ansari, Richard Stanton, Valerie Albrecht, Alison Laufer Halpin, Maria Karlsson, J. Kamile Rasheed, and Alexander Kallen
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.S. Walters, J.E. Grass, S.N. Bulens, U. Ansari, R. Stanton, V. Albrecht, A.L. Halpin, M. Karlsson, J.K. Rasheed, A. Kallen); New Mexico Emerging Infections Program, Santa Fe, New Mexico, USA (E.B. Hancock, E.C. Phipps); University of New Mexico, Albuquerque, New Mexico, USA (E.B. Hancock, E.C. Phipps, K. Culbreath); Tennessee Department of Public Health, Nashville, Tennessee, USA (D. Muleta, J. Mounsey, M.A. Kainer); University of Rochester, Rochester, New York, USA (C. Concannon, G. Dumyati, D.J. Hardy); Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA (C. Bower); Atlanta Research and Education Foundation, Decatur (C. Bower); Georgia Emerging Infections Program, Atlanta (C. Bower, J. Jacob); Emory University School of Medicine, Atlanta (J. Jacob); Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy, Z. Beldavs); TriCore Reference Laboratories, Albuquerque (K. Culbreath); Tristar Centennial Medical Center, Nashville (W.E. Phillips, Jr.); Rochester Regional Health, Rochester (R.L. Vargas); Providence Health and Services, Renton, Washington, USA (M. Oethinger)

Main Article

Table 4

Antimicrobial susceptibility of carbapenem-resistant Pseudomonas aeruginosa isolates from incident cases based on testing at local clinical laboratory, by epidemiologic classification, United States, July–October 2015*

Antimicrobial agent No. susceptible/total no. tested (%) Epidemiologic classification, no. susceptible/total no. tested (%)*
 p value
Healthcare-associated Community-associated
Cephalosporins
Any cephalosporin 181/275 (65.8) 153/241 (63.5) 18/21 (85.7) 0.04
Ceftazidime 101/151 (66.9) 89/136 (65.4) 6/6 (100) 0.18†
Cefepime
 146/273 (53.5)
 120/239 (50.2)
 17/21 (81.0)
 0.01
Aminoglycosides
Any aminoglycoside 246/276 (89.1) 212/241 (88.0) 21/21 (100) 0.14†
Amikacin 203/237 (85.7) 179/213 (84.0) 17/17 (100) 0.08†
Gentamicin 162/268 (60.5) 134/234 (57.3) 17/20 (85.0) 0.02
Tobramycin
 118/180 (65.6)
 104/164 (63.4)
 7/7 (100)
 0.10†
Fluoroquinolones
Any fluoroquinolone 96/274 (35.0) 74/240 (30.8) 16/20 (80.0) <0.01
Ciprofloxacin 93/266 (35.0) 71/233 (30.5) 16/19 (84.2) <0.01
Levofloxacin
 29/142 (20.4)
 23/128 (18.0)
 3/5 (60.0)
 0.05†
Other antimicrobials
Aztreonam 63/168 (37.5) 46/146 (31.5) 12/15 (80.0) <0.01
Piperacillin/tazobactam
 134/266 (50.4)
 106/231 (45.9)
 19/21 (90.5)
 <0.01
Resistance
 No. multidrug-resistant/total no. tested (%)
Multidrug-resistant isolates‡ 181/268 (67.5) 167/234 (71.4) 4/20 (20.0) <0.01

*Antimicrobial susceptibilities by epidemiologic classification are restricted to the 281 incident cases with a completed case report form. Healthcare-associated is defined as a case with >1 healthcare risk factor reported; community-associated is defined as a case with no healthcare risk factors reported.
†By Fisher exact test.
‡Defined as an isolate resistant to 1 carbapenem (doripenem, imipenem, meropenem) and nonsusceptible to >1 antimicrobial drug in >2 of the following classes: cephalosporin (ceftazidime, cefepime), aminoglycoside (amikacin, gentamicin, tobramycin), fluoroquinolone (ciprofloxacin, levofloxacin), β-lactamase inhibitor combination (piperacillin-tazobactam), and monobactam (aztreonam).

Main Article

Page created: June 17, 2019
Page updated: June 17, 2019
Page reviewed: June 17, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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