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Susceptibility to carbapenems of Pseudomonas spp. isolated from patients with ventilator-associated pneumonia


Ventilator-associated pneumonia (VAP) is associated with the greatest mortality among nosocomial infections. Death rates associated with Pseudomonas spp. or with late-onset VAP seem higher. Antibacterial therapy is often complicated by resistance of nosocomial pathogens. This problem has been increasing in recent years.


The goal of the study was to assess susceptibility of Pseudomonas spp. to meropenem and imipenem in patients with VAP. In a 12-bed surgical ICU, at a 400-bed surgical complex of a district hospital, we studied prospectively all patients with VAP, clinical and bacteriological (quantitive endotracheal aspirate culture, Protected Specimen Brush), diagnosed from January 2002 to January 2004. We looked for the demography, APACHE II score, mortality, attributable VAP mortality, days on mechanical ventilation, and length of stay in the ICU. One hundred and forty strains of Pseudomonas spp. from patients with VAP were isolated. In 102 isolated strains, the gel diffusion technique was used to investigate susceptibility to meropenem and imipenem.


Susceptibility to meropenem and imipenem was registered in 55/102 (53.9%), while 35/102 (34.3%) showed susceptibility to meropenem and resistance to imipenem. Another 12/102 (11.8%) isolated strains were resistant to both carbapenems. Eighty-five of 140 strains were Pseudomonas aeruginosa. Susceptibility to carbapenems was tested in 64 strains: 36/64 (56.25%) were susceptible to both antibiotics; 16/64 (25%) were sensitive to meropenem and resistant or intermediary resistant to imipenem. Ten out of 85 (11.8%) were resistant to both antibiotics. Fifty-five out of 140 (39.3%) were Pseudomonas species, and in 37 susceptibility to meropenem and imipenem was investigated: 16/37 (43.24%) were sensitive to both antibiotics; 16/37 (43.24%) were susceptible to meropenem and resistant to imipenem; 5/37 (13.5%) isolated strains showed resistance to both investigated antibiotics.


Strains of Pseudomonas isolated from patients with VAP demonstrate a high level of resistance to imipenem. In the investigation period, Pseudomonas strains resistant to meropenem were isolated for the first time. Considering that carbapenems are drugs of choice for the treatment patients with VAP due to multiresistant strains, appearance of high resistance points to the necessity of their rational use.

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Zolotukhin, K., Abubakirova, A. & Popov, M. Susceptibility to carbapenems of Pseudomonas spp. isolated from patients with ventilator-associated pneumonia. Crit Care 10 (Suppl 1), P103 (2006).

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