Introduction: The spread of multidrug-resistant
Pseudomonas aeruginosa in Brazilian
hospitals has greatly impacted upon the
morbidity and
mortality of individuals in
intensive care units . Given the lack of information regarding the dynamics of
multidrug resistance in northern
Brazil , we analyzed the clinical and microbiological features of
nosocomial infections caused by P. aeruginosa.
Methods: Between January 2010 and March 2012, we conducted a retrospective
cohort study of P. aeruginosa isolates from 54
patients who were hospitalized in
intensive care units . The clinical and epidemiologic variables were analyzed, including the
patients '
demographic data and comorbidities, and the lengths of the
intensive care unit stays, the
classification of the
infections as nosocomial, the use of invasive
procedures , antimicrobial
therapy , and the
patients ' outcomes. We undertook susceptibility tests, molecular
detection of the metallo-?-lactamase
genes , and genotypic analyses of the isolates using the repetitive
element -
polymerase chain reaction .
Results: Multidrug resistance occurred most frequently among isolates from
adults who had been hospitalized for an average of 87.1 days. The use of
mechanical ventilation and
urinary catheters were
risk factors for
infection . The four isolates that harbored the blaSPM-1-like
gene showed >95% genetic similarity.
Conclusions: This study's findings show that P. aeruginosa has a high
death rate , and that inadequate
treatment and invasive
procedures are
risk factors for
infection . This is the first
report describing the
detection of the blaSPM-1-like
gene in northern
Brazil . These results highlight the need for better
monitoring and a greater
understanding of
nosocomial infections and their
public health impacts (AU)