ArticleBMC infectious diseases2014
An outbreak of extremely drug-resistant Pseudomonas aeruginosa in a tertiary care pediatric hospital in Italy.
Article in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Outbreak investigations after identifying carbapenem-resistant Pseudomonas aeruginosa: a systematic review.Antimicrobial resistance and infection control · 2023Pooled it
- Exploring the Synergistic Effects of Plant Extracts and Silver Nanoparticles Against Colistin-ResistantAdvanced biomedical research · 2025Article
- Review
- Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute.GMS hygiene and infection control · 2022Article
- Global Threat of Carbapenem-Resistant Gram-Negative Bacteria.Frontiers in cellular and infection microbiology · 2022Review
- Article
- Emergent Pneumonia in Children.Frontiers in pediatrics · 2021Review
- Successful Incidences of Controlling Multidrug-Resistant, Extensively Drug-Resistant, and Nosocomial InfectionInfection and drug resistance · 2020Article
- First Italian outbreak of VIM-producingWorld journal of clinical cases · 2019Article
- Successful control of resistance inInfection and drug resistance · 2018Article
- Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance inThe open microbiology journal · 2017Article
- Potentiation of Aminoglycoside Activity in Pseudomonas aeruginosa by Targeting the AmgRS Envelope Stress-Responsive Two-Component System.Antimicrobial agents and chemotherapy · 2016Article
- Characterization of clinical extensively drug-resistant Pseudomonas aeruginosa in the Hunan province of China.Annals of clinical microbiology and antimicrobials · 2016Article
- Diverse Genetic Background of Multidrug-Resistant Pseudomonas aeruginosa from Mainland China, and Emergence of an Extensively Drug-Resistant ST292 Clone in Kunming.Scientific reports · 2016Article
- Surveillance of bloodstream infections in pediatric cancer centers - what have we learned and how do we move on?GMS hygiene and infection control · 2016Review
- Pharmacokinetics and pharmacodynamics of continuous-infusion meropenem in pediatric hematopoietic stem cell transplant patients.Antimicrobial agents and chemotherapy · 2015Article
- Article
- Bacteriophage-based therapy in cystic fibrosis-associated Pseudomonas aeruginosa infections: rationale and current status.Drug design, development and therapy · 2015Review
- Animal models of polymicrobial pneumonia.Drug design, development and therapy · 2015Review
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtensively drug-resistant Pseudomonas aeruginosa (XDR-PA) isolates are susceptible to only one or two classes of antibiotics. In 2011-2012, we investigated an outbreak of XDR-PA affecting children with onco-hematological diseases.
methodsOutbreak investigation included ascertainment of cases, tracing of intestinal carriers and environmental surveillance. Contact precautions were adopted for patients with infection or colonization. Isolates were tested for antimicrobial susceptibility; phenotypic confirmation of carbapenemase production was performed, and carbapenemase genes were tested by multiplex polymerase-chain-reaction (PCR). Genotypes were determined by pulsed-field gel electrophoresis (PFGE).
resultsXDR-PA was isolated from 27 patients; 12 had bacteremia, 6 other infections and 9 were colonized. Severe neutropenia was significantly associated with bacteremia. Bloodstream-infection mortality rate was 67%. All isolates were resistant to carbapenems, cephalosporins and penicillins + β-lactamase inhibitors. Isolates were susceptible only to colistin in 22 patients, to colistin and amikacin in 4, and to ciprofloxacin and colistin in 1. PFGE results identified 6 subtypes of a single genotype, associated with clusters of cases, and 4 sporadic genotypes. Two sporadic isolates were metallo-β-lactamase producers, negative to PCR. All other isolates were metallo-β-lactamase producers due to the presence of a VIM carbapenemase. Incidence of XDR-PA infections decreased from 0.72 cases/1,000 inpatient-days in March 2011-March 2012, to 0.34/1,000 in April-December 2012, after implementation of active finding of intestinal carriers on all onco-hematological inpatients.
conclusionsControl measures targeting intestinal carriers are crucial in limiting in-hospital transmission of XDR-PA polyclonal strains, protecting more vulnerable patients, such as severely neutropenic children, from developing clinical infections.
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