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Kamal S, Varshney K, Uayan DJ, Tenorio BG, Pillay P, Sava ST. Risk Factors and Clinical Characteristics of Pandrug-Resistant Pseudomonas aeruginosa. Cureus 2024; 16:e58114. [PMID: 38738125 PMCID: PMC11088816 DOI: 10.7759/cureus.58114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
The emergence of increasingly resistant strains of Pseudomonas aeruginosa is a great public health concern. Understanding the risk factors and clinical characteristics of patients with pandrug-resistant P. aeruginosa (PDR-PA) can help inform clinicians in creating guidelines for both prevention and management. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this scoping review retrieved existing literature on PDR-PA by searching PubMed, SCOPUS, Embase, Web of Science, and CINAHL databases. From the 21 studies that satisfied the inclusion criteria,1,059 P. aeruginosa samples were identified, and 161, or 15.2% of the isolates were found to have pandrug resistance. Furthermore, our review suggests that PDR-PA was largely hospital-acquired, and patients suffering from burn injuries and chronic lung diseases had a higher risk of colonization than other hospitalized individuals. In five out of the 21 studies, administration of the antibiotic colistin emerged to be the preferred therapeutic strategy. With regards to concurrent infections, Acinetobacter and Klebsiella species were found to occur most frequently with PDR-PA, suggesting mutualistic interactions that enable further antimicrobial resistance. In conclusion, this review showed the prevalence of PDR-PA and outlined the demographic and clinical profile of affected patients. Further research is needed to investigate the transmission and outcomes of PDR-PA infections and to find potential therapeutic strategies.
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Affiliation(s)
- Shahed Kamal
- Internal Medicine, Northern Hospital Epping, Melbourne, AUS
| | - Karan Varshney
- Public Health, School of Medicine, Deakin University, Waurn Ponds, AUS
| | - Danielle J Uayan
- Medicine, Ateneo School of Medicine and Public Health, Manila, PHL
| | - Bettina G Tenorio
- Medicine, Ateneo School of Medicine and Public Health, Philippines, Manila, PHL
| | - Preshon Pillay
- Faculty of Medicine and Dentistry, University of Alberta, Alberta, CAN
| | - Sergiu T Sava
- Medicine, School of Medicine, Deakin University, Geelong, AUS
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Clarke EA, Watson P, Freeston JE, Peckham DG, Jones AM, Horsley A. Assessing arthritis in the context of cystic fibrosis. Pediatr Pulmonol 2019; 54:770-777. [PMID: 30838784 DOI: 10.1002/ppul.24290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/17/2019] [Indexed: 12/11/2022]
Abstract
Inflammatory arthritis in the context of cystic fibrosis (CF) can represent a diagnostic and therapeutic challenge. Poor recognition and under-treatment of musculoskeletal conditions increases symptom burden, affects quality of life, and may lead to changes to an individual's ability to carry out activities of daily living and to exercise. A careful assessment and multidisciplinary approach is essential when considering a diagnosis of CF-associated arthritis (CFA), both in terms of identifying other treatable conditions, such as rheumatoid arthritis, and effectively addressing symptoms. In this collaboration between CF specialists and Rheumatologists, we consider joint symptoms in patients with CF, with a focus on CFA. We offer a differential diagnosis list and consider steps to assess and manage CF patients presenting with arthralgia including appropriate up-to-date rheumatological assessment.
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Affiliation(s)
- Elizabeth A Clarke
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester Foundation NHS Trust, Manchester, UK
| | - Pippa Watson
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Rheumatology Department, Wythenshawe Hospital, Manchester Foundation NHS Trust, Manchester, UK
| | - Jane E Freeston
- NIHR Leeds Biomedical Research Centre and Department of Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Daniel G Peckham
- Leeds Adult Cystic Fibrosis Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Andrew M Jones
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester Foundation NHS Trust, Manchester, UK
| | - Alex Horsley
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester Foundation NHS Trust, Manchester, UK
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Adelsten T, Rasmussen N, Katzenstein TL, Nielsen CT. Safe and effective tumour necrosis factor-α inhibitor (etanercept) treatment of chronic episodic arthritis in a patient with cystic fibrosis. Scand J Rheumatol 2016; 45:330-1. [DOI: 10.3109/03009742.2015.1122834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- T Adelsten
- Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - N Rasmussen
- Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - TL Katzenstein
- Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - CT Nielsen
- Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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