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P seudomonas aeruginosa antibiotic resistance in A ustralian cystic fibrosis centres
Author(s) -
Smith Daniel J.,
Ramsay Kay A.,
Yerkovich Stephanie T.,
Reid David W.,
Wainwright Claire E.,
Grimwood Keith,
Bell Scott C.,
Kidd Timothy J.
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12714
Subject(s) - azithromycin , medicine , cystic fibrosis , pseudomonas aeruginosa , antibiotics , antibiotic resistance , pediatrics , microbiology and biotechnology , bacteria , genetics , biology
Background and objective In cystic fibrosis ( CF ), chronic P seudomonas aeruginosa infection is associated with increased morbidity, antibiotic treatments and mortality. By linking Australian CF registry data with a national microbiological data set, we examined the association between where treatment was delivered, its intensity and P . aeruginosa antibiotic resistance. Methods Sputa were collected from paediatric and adult CF patients attending 18 A ustralian CF centres. P . aeruginosa antibiotic susceptibilities determined by local laboratories were correlated with clinical characteristics, treatment intensity and infection with strains commonly shared among A ustralian CF patients. Between‐centre differences in treatment and antibiotic resistance were also compared. Results Large variations in antibiotic usage, maintenance treatment practices and multi‐antibiotic resistant P . aeruginosa ( MARPA ) prevalence exist between Australian CF centres, although the overall proportions of MARPA isolates were similar in paediatric and adult centres (31% vs 35%, P = 0.29). Among paediatric centres, MARPA correlated with intravenous antibiotic usage and the Australian state where treatment was delivered, while azithromycin, reduced lung function and treating state predicted intravenous antibiotic usage. In adult centres, body mass index ( BMI ) and treating state were associated with MARPA , while intravenous antibiotic use was predicted by gender, BMI , dornase‐alpha, azithromycin, lung function and treating state. In adults, P . aerug inosa strains AUST ‐01 and AUST ‐02 independently predicted intravenous antibiotic usage.Conclusion Increased treatment intensity in paediatric centres and the Australian state where treatment was received are both associated with greater risk of MARPA , but not worse clinical outcomes.