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Background. Irrational use of antimicrobials (ATMs) triggers microbial resistance (AMR) which has severe consequences for human health. ATM consumption varies among countries and within each territory. These data should be known, in order to perform local policies towards AMR reduction. This work aimed to expose the association of the level of consumption of carbapenems and fluoroquinolones with their resistance rates in Pseudomonas aeruginosa in Argentina. Method. Consumption of antimicrobials was expressed by defined daily dose (DDD)/1000 inhabitants for each ATM during one year period, discriminating by each country region. Resistance of P. aeruginosa to carbapenems/fluoroquinolones groups was recorded. Consumption/resistance ratio “R” was calculated for each region of the country, comparing results with other countries. Results. P. aeruginosa resistance rate to fluoroquinolone (F) was 26.4% in blood samples and 29.7% in urine samples, whereas resistance rates to carbapenems (C) were 19.9 and 17.7% in blood and urine, respectively. Correlation between consumption and resistance was demonstrated for both antimicrobials (C : R = 0.58; p = 0.003 and F : R = 0.77; p = 0.0001 ). Great fluctuations of resistance levels were seen among regions within the country, always correlating resistance with areas in which a higher level of ATM consumption was detected. Conclusion. P. aeruginosa resistance to fluoroquinolone/carbapenems in Argentina directly correlated with antimicrobial consumption levels. A great heterogeneity in resistance profile was observed among areas where ATMs were widely used. Global data at the national level might mask local realities that require specific health policies in order to control the irrational use of ATMs.

The appropriate treatment of ventilator-associated pneumonia (VAP) must be based on accurate diagnosis, which can be done by microbiological examination of the samples obtained from the respiratory tract by nonbronchoscopic bronchoalveolar lavages (NB-BAL). This study was designed to determine the effectiveness of NB-BAL in diagnosing VAP in newborns. Two hundred and seven NB-BAL samples were obtained from 145 intubated neonates for microbiologic and cytologic evaluation of the distal air-way. The NB-BAL samples were processed for microscopic quantification of the polymorphonuclear cells (PMN) containing intracellular bacteria (ICB) and quantitative culture (positive threshold, 10(5) cfu/ml). VAP was defined as a new, progressive, or persistent (>24 hrs) infiltrate on the chest radiograph, with two or more of the following criteria: a) macroscopically purulent tracheal secretions, b) fever or hypothermia, c) leukocytosis or leukopenia, and d) worsening of respiratory status with a Pa O-2/F IO2 ratio of

Background and Objectives: Cystic fibrosis (CF) is an autosomal recessive genetic disease. Infections in these patients gene.are mostly caused by three bacteria: Staphylococcus aureus, Haemophilus influenza and particularly Pseudomonas aeruginosa. Carbapenems including antibiotics are used to combat infections with Pseudomonas aeruginosa. In recent years, carbapenems resistant strains of P. aeruginosa isolated from clinical specimens are being reported. Decrease in drug penetration and production of metalobeta lactamase (MBLS) have been proposed as mechanisms of resistance. Materials and Methods: In this descriptive study, the population under investigation was 27 patients suffering from CF in Alzahra hospital of Isfahan. Clinical specimens were taken by deep swabbing from throat and data from every patient was recorded in a questionnaire. The specimens were cultured and isolated organisms were identified as P. aeruginosa using standard tests. Kirby-Bauer disk diffusion method was used to determine the bacterial drug resistance pattern. Strains of P. aeruginosa were checked for production of MBLS using disk impregnated with IPM-EDTA and PCR targeting of bla. Results: Among the 27 patients, 7 (26%) had P. aeruginosa infection. In total, 11 P. gene. aeruginosa isolates were taken. All isolates were susceptible to imipenem, ticarcillin, ciprofloxacin and piperacillin. The lowest scale of susceptibility belonged VIM to eftazidime (72.2%) followed by tobramycin (45.4%). None of the strains were positive for the bla Conclusion: Isolates of P. aeruginosa from CF patients in Isfahan were susceptible to antibiotics during the study period.