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Ability of an Antibiogram to Predict Pseudomonas aeruginosa Susceptibility to Targeted Antimicrobials Based on Hospital Day of Isolation

Published online by Cambridge University Press:  02 January 2015

Deverick J. Anderson ,
Becky Miller ,
Ruchit Marfatia  and
Richard Drew
Deverick J. Anderson*
Affiliation:
Duke University School of Medicine, Durham, North Carolina
Becky Miller
Affiliation:
North Shore University Health System, Evanston, Illinois
Ruchit Marfatia
Affiliation:
Campbell University College of Pharmacy and Health Science, Buies Creek, North Carolina
Richard Drew
Affiliation:
Duke University School of Medicine, Durham, North Carolina Campbell University College of Pharmacy and Health Science, Buies Creek, North Carolina
*
Box 102359, Duke University Medical Center, Durham, NC 27710 ([email protected])
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Abstract

Objective.

To determine the utility of an antibiogram in predicting the susceptibility of Pseudomonas aeruginosa isolates to targeted antimicrobial agents based on the day of hospitalization the specimen was collected.

Design.

Single-center retrospective cohort study.

Setting.

A 750-bed tertiary care medical center.

Patients and Methods.

Isolates from consecutive patients with at least 1 clinical culture positive for P. aeruginosa from January 1, 2000, to June 30, 2007, were included. A study antibiogram was created by determining the overall percentages of P. aeruginosa isolates susceptible to amikacin, ceftazidime, ciprofloxacin, gentamicin, imipenem-cilastin, piperacillin-tazobactam, and tobramycin during the study period. Individual logistic regression models were created to determine the day of infection after which the study antibiogram no longer predicted susceptibility to each antibiotic.

Results.

A total of 3,393 isolates were included. The antibiogram became unreliable as a predictor of susceptibility to ceftazidime, imipenem-cilastin, piperacillin-tazobactam, and tobramycin after day 10 and ciprofloxacin after day 15 but longer for gentamicin (day 21) and amikacin (day 28). Time to unreliability of the antibiogram varied for antibiotics based on location of isolation. For example, the time to unreliability of the antibiogram for ceftazidime was 5 days (95% confidence interval [CI], <1–8) in the intensive care unit (ICU) and 12 days (95% CI, 7–21) in non-ICU hospital wards (P = .003).

Conclusions.

The ability of the antibiogram to predict susceptibility of P. aeruginosa decreases as duration of hospitalization increases.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 6 , June 2012 , pp. 589 - 593
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

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