Pan-drug-resistant Pseudomonas aeruginosa causing nosocomial infection at a university hospital in Taiwan.

This study evaluated the clinical and microbiological characteristics of 16 patients who were colonised or infected with 26 isolates of pan-drug-resistant Pseudomonas aeruginosa (PDRPA; intermediately-resistant or resistant to all cephalosporins, piperacillin-tazobactam, aztreonam, carbapenems, ciprofloxacin and aminoglycosides) in a university hospital during 1999-2002. All the isolates had colistin MICs < or = 4 mg/L, 19 (73%) isolates had bla(VIM-3), and 25 (96%) isolates had class I integrons (intI). Time-kill studies for two PDRPA blood isolates demonstrated synergism for cefepime-amikacin after 24 h. Pulsed-field gel electrophoresis analysis of the isolates revealed a polyclonal nature (12 pulsotypes), although clonal dissemination of PDRPA isolates among these patients was also present.