Outbreaks, persistence, and high mortality rates of multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

introduction: authors have reported increased incidence of multiresistant pseudomonas aeruginosa (mr-pa) infections worldwide over the last decade. researchers have proposed multifaceted approaches to control mr-pa infections, but none have been reported in the acquired immunodeficiency syndrome (aids) setting. objective and methods: herein we report the impact of a multifaceted intervention for controlling mr-pa over five years in a hospital with aids-predominant admissions and describe the clinical characteristics of mr-pa infection in our patient population. the clinical outcomes of infected patients and molecular characteristics of the isolated strains were used as tools for controlling mr-pa infection rates. results: significant temporary decrease of new infections was achieved after intervention, although a high level of diagnostic suspicion of nosocomial infection was maintained. we obtained 35 p. aeruginosa isolates with multiresistant profiles from 13 infected and 3 colonized patients and 2 environmental samples. most of the patients (94%) were immunocompromised with aids (n = 10) or htlv-1 infections (n = 5). of the followed patients, 67% had persistent and/or recurrent infections, and 92% died. we observed differences in the antibiotic-resistance pattern of mr-pa infection/colonization during two outbreaks, although the genetic profiles of the tested strains were identical. conclusions: therefore, we concluded that early multidisciplinary interventions are essential for reducing the burden caused by this microorganism in patients with aids. prolonged or suppressive antibiotic-based therapy should be considered for mr-pa infections in patients with aids because of the persistence characteristic of mr-pa in these patients.