Regional features of Pseudomonas aeruginosa (PA) antibiotic (AB) resistance (R) in patients (pts) with bronchiectasis (Bx)

Abstract

PA is the one pathogen which recommended to be eradicated in pts with Bx. The study aimed to investigate the phenotype of PA R to AB are using in Ukraine for its eradication. 99 pts with stable Bx confirmed by HRCT were examined. Isolation and identification of pathogens were conducted by bacteriological method, sensitivity to AB was determined by disco-diffusion method according to EUCAST (ticarcillin-clavulanat(TC), piperacillin-tazobactam(PT), aztreonam(Az), ceftazidime(Cd), cefepime(Cp), imipenem(Ip), meropenem(Mp), ciprofloxacin(Cf), levofloxacin(Lf), gentamicin(Gm), amikacin(Ac), tobramycin(Tm)). Among 99 pts, in 58 pts 76 pathogens were detected. PA was detected in 19 cases (25%). The median age was 55(37-67) years, 31.6%‑men. 31.6% were resistant to Cd and Im; 21%‑to Az, Cp, Lf; 15.8%‑to Mp, Cf, Gm, Ac, Tm; 10.5% to TC and 5.3% to PT. Among 8 isolates of non-mucoid PA, 2 were sensitive to all tested drugs (25%), one was resistant only to Ip (12.5%). The remaining 5 isolates were polyresistant (62.5%), and one of them was resistant to all tested drugs. Among the 11 isolates of mucoid PA, 6 isolates were sensitive to all tested drugs (54.5%), 2 were resistant only to Lf (18.2%), and 3 isolates were polyresistant (27.3%). Among non-mucoid isolates of PA, the phenomenon of polyresistance was more common, however, this difference was not significant (p=0.13). In conclusion, PA is highly resistant to Cd, Im, Az, Cp, Lf, Mp, Cf, Gm, Ac, and Tm in pts with Bx in Ukraine. A feature is a tendency towards greater multidrug R among non-mucoid strains than among mucoid, which should be taken into account when prescribing eradication AB therapy.