Surveillance of cystic fibrosis patients with multi-drug resistant Gram-negative rods.

Objectives: Although several nosocomial outbreaks with multi-drug resistant Gram-negative bacteria (MRGN) are documented, only few are known about the endemic situation of theses pathogens. Especially cystic fibrosis (CF) patients are known to be at risk for MRGN acquisition. We present surveillance data of endemic MRGN in CF patients from a German university hospital during a 3-year period.

Methods: CF inpatients from 2002 to 2004 were included. A MRGN was defined as a Gram-negative rod of which less than two groups of antibiotics had been tested susceptible. MRGN patients who were admitted more than once were counted each time as a new MRGN case.

Results: Three hundred and thirty-nine inpatient cases (109 different patients) with MRGN were enrolled. Two hundred and sixty-seven cases were known to be MRGN positive at the time point of admission, 167 cases were affected by pan-resistant pathogens. P. aeruginosa was the MRGN species detected most frequently. MRGN was detected after 48h of hospital stay in 9 patients.

Conclusions: MRGN surveillance is recommended by several experts but unfortunately only few data has been published. To our knowledge this is the first description of the complete endemic MRGN situation in CF patients. MRGN surveillance is necessary and will be continued in our facility.