Problems of the treatment of pneumonia caused by pseudomonas aeruginosa
DOI:
https://doi.org/10.34287/MMT.3(42).2019.15Abstract
Pseudomonas infection is one of the most problematic pathogens of pneumonia, because it has natural resistance to many antibiotics, is able to quickly form acquired resistance, often causes severe pneumonia with a poor prognosis. Analysis of the literature data showed that today P. Aeruginosa demonstrates resistance to all anti-pest control antibiotics, with the exception of polymyxin. The levels of resistance of P. Aeruginosa are very considerably depending on the region of the survey and the profile of the hospital, which requires monitoring the sensitivity of microorganisms in each department of the hospital. The data on the degree of resistance to P. Aeruginosa antibiotics in Ukraine are limited, but available local studies on this issue also show a high level of resistance of this microorganism to the main anti-pest antibiotics. In patients with pneumonia and risk factors for the involvement of Pseudomonas infection, most authors recommend combination antibiotic therapy, which has a synergistic effect on P. Aeruginosa, which allows, in most cases, to overcome the resistance of this microorganism. According to the literature, such synergism has been proven for the combination: beta-lactams (ceftazidime, cefepime, antipseudomonas carbapenems) + aminoglycosides (amikacin) or fluoroquinolones (ciprofloxacin or levofloxacin). The use of these drugs in the maximum allowable dose allows a higher degree of probability to achieve the eradication of P. Aeruginosa in patients with pneumonia and to improve the prognosis for this disease.
References
Chuchalin AG, Sinopalnikov AI, Kozlov RS et al. Community-acquired pneumonia in adults: practical recommendations for diagnosis and treatment. Tutorial. Moscow, 2010, 106.
Non-hostile and nosocomial pneumonia in adults: etiology, pathogenesis, classification, diagnosis, antibiotic therapy. Order of the Ministry of Health of Ukraine dated March 19, 2007 № 128.
Strachunsky LS, Reshedko GK, Stetsyuk OI, Andreeva FS. Comparative activity of antipesticide antibiotics against nosocomial strains of Pseudomonas aeruginosa, isolated in the intensive care units and intensive care in Russia (research group ROSNET). Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2003; 1 (5): 35–46.
Hauser AR, Sritram P. Severe Pseudomonas aeruginosa infections. Tacking the conundrum of drug resistance. Postgrad Med. 2005; 117 (1): 41–48.
Van Eldre J. Multicentre surveillance of Pseudomonas aeruginosa subsebility patterns in nosocomial infections. J of Antimicrobial Chemotherapy. 2003; 51 (2): 347–352.
Egorovа ON. Infections due to Pseudomonas aeruginosa in intensive care units. Obshchaya reanimatsiya. 2010; 1 (5): 51–54.
Giamarellon H. Prescribing guidelines for severe Pseudomonas aeruginosa infections. J of Antimicrobial chemotherapy. 2002; 49 (2): 229–233. DOI: 10.1093/jac/49.2.229.
Rello J, Sa-Borges M, Correa H et al. Variations in etiology of ventilator-associated pneumonia across four treatment sites. Am J Respir Crit. Care Med. 1999; 160 (2): 608–613. DOI:10.1164/ajrccm.160.2.9812034.
American Thoracic Society; Infectious Diseases Society of America. Guidelines for management of adults with hospital-acquired, ventilator-associated and health-care associated pneumonia. Am J Respir Crit Care Med. 2005; 117 (4): 388–416. DOI: 10.1164/rccm.200405-644ST.
Rotstein C, Evans G, Bom A et al. Clinical practice guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia in adults. Can J Infect Dis Med Microbiol. 2008; 19 (1): 19–53.
Driscoll JA, Brody SL, Kollef MH. The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections. Drugs. 2007; 67 (3): 351–368. DOI: 10.2165/00003495-200767030-00003.
Woodhead M, Blasi F, Ewig S et al. Guidelines for the management of adult lower respiratory tract infections – full version. Clin Microbiol Infect. 2011; 17 Suppl 6: E1–59. DOI: 10.1111/j.1469-0691.2011.03672.x.
Chastre J, Fagon J. Ventilator-associated pneumonia. American J Respiratory Critical Care Medicine. 2002; 165 (7): 867–903. DOI: 10.1164/ajrccm.165.7.2105078.
Morrow BJ, Pillar CM, Deane J et al. Activites of carbapenem and comparator agents against contemporary US Pseudomonas aeruginosa isolates from the CAPITAL surveillance program. Diagn Microbial Infect Dis. 2013; 75 (4): 412–416. DOI: 10.1016/j.diagmicrobio.2012.12.012.
Berttrand X, Thouverer M, Talon D. et al. Endemicity, molecular diversity and colonization routes of Pseudomonas aeruginosa in intensive care units. Intensive Care Med. 2001; 27 (8): 1263–1268.
Avdeev SN. Nosocomial pneumonia in adults. National recommendations.Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2009; 11 (2): 38–100.
Aloush V, Navon-Venezia S, SeigmanIgra Y et al. Multidrug-resistant Pseudomonas aeruginosa: risk factors and clinical impact. Antimicrobial Agents Chemotherapy. 2006; 50 (1): 43–48. DOI: 10.1128/AAC.50.1.43-48.2006.
Strachunsky LS, Belousov YuB, Kozlov SN. A practical guide to anti-infective chemotherapy. Smolensk, MAKMAH, 2007, 464 p.
Rudnov VA. Antibiotic treatment of nosocomial infections caused by Pseudomonas aeruginosa. Russkiy Meditsinskiy Zhurnal. 2005; 13. (7): 28–35.
Jones RN, Sander HS, ML. Beach Contemporary in vitro spectrum of activity summary for antimicrobial agеnts tested against 18569 strains non-fermentative Gram-negative bacillе isolated in the SENTRY Antimicrobial Surveillance Program (1997–2001). Int J Antimicrob Agents. 2003; 22: 6–55.
Stratchounski L, Reshedko G, Stetsiouk O et al. Results of Russian country-wide surveillance of antimicrobial resistance of nosocomial gramnegative bacteria from 28 intensive care units (ICUs). In: 41st Interscience Conference on Antimicrobial Agents and Chemotherapy; 2001 Dec 16–19, Chicago, USA, 113.
Gorbunov VA, Titov LP, Erlakova TS. Multicenter study of the antibiotic resistance of nosocomial strains of Pseudomonas aeruginosa in the Republic of Belarus. Zdravookhraneniye. 2007; 1: 28–31.
Skleyenova YY, Azizov IS, Shek YA et al.. Pseudomonas aeruginosa in the RF: the story of one of the most successful nosocomial pathogens. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2018; 20 (3): 164–171.
Reshedko GK, Ryabkova EL, Farashchuk AN, Strachunsky LS. Non-fermentative gram-negative pathogens of nosocomial infections in the ICU of Russia: problems of antibiotic resistance. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2006; 3 (8): 243–259.
Eidelstein MB, Sukhorukov MV, Skleenko EY et al. Antibiotic resistance of nosocomial strains of Pseudomonas aeruginosa in hospitals in Russia: the results of a multicenter epidemiological study «MARAFON» 2013–2014. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2017; 1 (9): 37–41.
Goossens H. MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) results from Europe: comparison of antibiotic susceptibilities between countries and centre types. MYSTIC Study Group (European centres only). J Antimicrob Chemother. 2000; 46 (2): 39–52.
Luyt CE, AubryА, Lu Q et al. Imepenem, Meropenem or Doripenem to treat patients with Pseudomonas aeruginosa ventilator-associated pneumonia. Antimicrob. Agents Chemoterapy. 2014; 58 (3): 1372–1380. DOI: 10.1128/AAC.02109-13.
Mangurenko OI, Fedchuk EA, Levchuk PV, Gritsay VF. Local monitoring of antibiotic resistance. Aktualʹni pytannya farmakolohiyi i medychnoyi nauky ta praktyky. 2011; Issue XXIV (1): 126–128.
Kharchenko LA. Pseudomonas aeruginosa: modern realities of antibacterial therapy. Meditsina neotlozhnykh sostoyaniy. 2015; 64 (1): 164–168.
Dundar D, Otkun М. In-vitro efficacy of synergistic antibiotic combination in multidrug resistance Pseudomonas aeruginosa strains. Yonsei Med J. 2010; 51 (1): 111–116. DOI: 10.3349/ ymj.2010.51.1.111.
