Emerging Infectious Diseases (Jul 2019)

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

  • Maroya Spalding Walters,
  • 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,
  • Alexander Kallen

DOI
https://doi.org/10.3201/eid2507.181200
Journal volume & issue
Vol. 25, no. 7
pp. 1281 – 1288

Abstract

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Pseudomonas aeruginosa is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. During July–October 2015 in the United States, we piloted laboratory-based surveillance for carbapenem-resistant P. aeruginosa (CRPA) at sentinel facilities in Georgia, New Mexico, Oregon, and Tennessee, and population-based surveillance in Monroe County, NY. An incident case was the first P. aeruginosa isolate resistant to antipseudomonal carbapenems from a patient in a 30-day period from any source except the nares, rectum or perirectal area, or feces. We found 294 incident cases among 274 patients. Cases were most commonly identified from respiratory sites (120/294; 40.8%) and urine (111/294; 37.8%); most (223/280; 79.6%) occurred in patients with healthcare facility inpatient stays in the prior year. Genes encoding carbapenemases were identified in 3 (2.3%) of 129 isolates tested. The burden of CRPA was high at facilities under surveillance, but carbapenemase-producing CRPA were rare.

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