Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T07:32:01.266Z Has data issue: false hasContentIssue false

The Impact of Ertapenem Use on the Susceptibility of Pseudomonas aeruginosa to Imipenem A Hospital Case Study

Published online by Cambridge University Press:  02 January 2015

Ana Lucia L. Lima*
Affiliation:
Institute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
Priscila R. Oliveira
Affiliation:
Institute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
Adriana P. Paula
Affiliation:
Institute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
Karine Dal-Paz
Affiliation:
Institute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
Flavia Rossi
Affiliation:
Microbiology Laboratory, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
Arnaldo V. Zumiotti
Affiliation:
Institute of Orthopedics and Traumatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
*
Alameda Gabriel Monteiro da Silva, 429, São Paulo, Brazil01414-000) allm.lima@uol.com.br)

Abstract

We sought to evaluate the indirect impact of ertapenem use for the treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae infections in our hospital on the susceptibility of Pseudomonas aeruginosa to imipenem. The use of ertapenem was mandated for treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae infections in the absence of nonfermenting gram-negative bacilli for 1 year. The use of imipenem was restricted. Imipenem consumption decreased 64.5%. Ertapenem consumption was 42.57 defined daily doses per 1,000 patient-days. None of the 18 P. aeruginosa isolates recovered after ertapenem introduction were imipenem-resistant, compared with 4 of the 20 P. aeruginosa isolates recovered in the previous year.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.European Antimicrobial Resistance Surveillance System. Dutch National Institute for Public Health and the Environment (RIVM) annual reports. Available at: http://www.rivm.nl/earss/result/Monitoring_reports/Annual_reports.jsp. Accessed May 5, 2008.Google Scholar
2.Hsueh, PR, Chen, WH, Luh, KT. Relationships between antimicrobial use and antimicrobial resistance in gram-negative bacteria causing nosocomial infections from 1991-2003 at a university hospital in Taiwan. Int J Antimicrob Agents 2005;26:463472.Google Scholar
3.Shah, P, Isaacs, RD. Ertapenem, the first of a new group of carbapenems. J Antimicrob Chemother 2003;52:538542.Google Scholar
4.Livermore, D, Mushtaq, S, Warner, M. Selectivity of ertapenem for Pseudomonas aeruginosa mutants cross-resistant to other carbapenems. J Antimicrob Chemother 2005;55:306311.Google Scholar
5.Brink, A, Feldman, C, Grolman, DC, et al. Appropriate use of the carbapenems. S Afr Med J 2004;94:857861.Google Scholar
6.Rossi, F, Baguero, F, Hsueh, P, et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother 2006;58:205210.Google Scholar
7.DiNubile, M, Friedland, I, Chan, CY, et al. Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: observations from two randomized comparative clinical trials of ertapenem therapy. Eur J Clin Microbiol Infect Dis 2005;24:443449.Google Scholar
8.Goff, DA, Mangino, J. Ertapenem: no effect on gram-negative susceptibilities to imipenem. J Infect 2008;57:123127.Google Scholar
9.Lima, AL, Oliveira, PR, Paula, AP, et al. Influence of ertapenem administration on the incidence of carbapenem-resistant Pseudomonas aeruginosa. Braz J Infect Dis 2008;12:105106.Google Scholar
10.Marra, AR, Wey, SB, Castelo, A, et al. Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum β-lac-tamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence. BMC Infectious Diseases 2006;6:2431.Google Scholar
11.Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Wayne, PA: CLSI, 2006:M100S16.Google Scholar