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Volume 41, Number 6, December 2008

Antimicrobial therapy and control of multidrug-resistant Pseudomonas aeruginosa bacteremia in a teaching hospital in Taiwan


Ching-Hsiang Leung, Nai-Yu Wang, Chang-Pan Liu, Li-Chuan Weng, Feng-Chih Hsieh, Chun-Ming Lee
Division of Endocrinology and Metabolism, Department of Medicine, Microbiology Section, Department of Medical Research, and Division of Infectious Diseases, Department of Medicine, Mackay Memorial Hospital; Mackay Medicine Nursing and Management College; and Taipei Medical University, Taipei, Taiwan

Received: December 1, 2007    Revised: January 9, 2008    Accepted: February 28, 2008   

 

Corresponding author:

Dr. Chun-Ming Lee, MD, Division of Infectious Diseases, Department of Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Chun-San N. Road, Taipei, Taiwan. E-mail: Dr. Chun-Ming Lee This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Background and purpose: 

The emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa is a challenging clinical problem. This study investigated the source of an outbreak of MDR P. aeruginosa infections and the role of combination therapy in its management.
 



 

Methods:

MDR P. aeruginosa isolates were collected at the MacKay Memorial Hospital, Taipei, Taiwan, and antibiotic synergy was investigated based on antibiotic susceptibility tests using a combination of antibiotics. Isolates of patients with MDR P. aeruginosa bacteremia were selected for genetic analysis by pulsed-field gel electrophoresis.
 



 

Results:

A combination of ceftazidime, amikacin, and sulbactam had significant synergistic effects against bloodstream MDR P. aeruginosa isolates and was more beneficial clinically compared with other antibiotic combinations. The major source of MDR P. aeruginosa infection was located and stringent infection control measures were enforced.



 

Conclusion:

The results of this study suggest that use of triple antimicrobial therapy (ceftazidime, amikacin, and sulbactam) can be a useful alternative treatment for MDR P. aeruginosa infection in certain circumstances.



 

Key words:

Anti-infective agents; Bacteremia; Colistin; Drug resistance, multiple; Pseudomonas aeruginosa; Sulbactam

 



 

J Microbiol Immunol Infect. 2008;41:491-498.