Increasing resistance of the Liverpool Epidemic Strain (LES) of @entity796 (Psa) to antibiotics in XXXX ( @entity1577 )--a cause for concern?

@entity1 @entity796 @entity1577 @entity580
BACKGROUND: Transmissible @entity796 (Psa) strains such as the Liverpool Epidemic Strain (LES) are now widespread throughout UK @entity1577 clinics: their susceptibility to antibiotics is therefore important. To study this, we compared antibiogram patterns of Psa strains in our @entity1577 clinic over 5 years, looking at differences in resistance patterns between strains and changes to these over time. METHODS: The antibiograms of sputum samples between 2004 and 2008 from @entity1 attending our centre were included. We compared Psa isolate antibiotic resistance (to six anti-pseudomonal antibiotics) patterns for @entity1 infected with LES with those infected with other Psa strains, both in the total population in 2004 (125 @entity1 ) and 2008 (166 @entity1 ) and also longitudinally from annual review samples 2004 to 2008 in matched and unmatched @entity1 groups. RESULTS: LES exhibited significantly more resistant isolates in 2004 (p<0.0001). There was an increase in antibiotic resistance in both LES and other Psa strains over time (p<0.001). Cox proportional hazards analysis of both unmatched (n=125) and matched (n=56) @entity1 in 2004 revealed that LES infected @entity1 were more likely to develop antibiotic resistant isolates over time (hazard ratio 8.1, p<0.001). Fewer LES isolates were classed as fully sensitive in both matched and unmatched groups at the end of study period (p<0.001). CONCLUSION: This study shows a worrying trend in antibiotic resistance in the Psa isolates amongst @entity1 chronically infected with LES. This highlights the need to prevent @entity580 through segregation and also the need to develop new strategies to treat these organisms.
