scholarly journals Characterization of Imipenem Unsusceptible Pseudomonas Aeruginosa Isolates from Inpatients without Carbapenem Treatment

2013 ◽  
Vol 2 (1) ◽  
pp. 1-5
Author(s):  
Yi-hai Gu ◽  
Xiao Zhu ◽  
Jing-yun Li ◽  
Jun Zhang ◽  
Qing-yuan Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Wide Spectrum ◽  
Mechanism Analysis ◽  
Antimicrobial Susceptibility Test ◽  
Resistance Development ◽  
Carbapenem Resistant ◽  
Drug Classes ◽  
Imipenem Resistance

Abstract Objective To identify the risk factors for imipenem resistance development and transmission of clinical Pseudomonas aeruginosa isolates. Methods Thirty-seven imipenem unsusceptible Pseudomonas aeruginosa isolates collected from patients in absence of carbapenem treatment were characterized by antimicrobial susceptibility test, pulsed field gel electrophoresis (PFGE) and carbapenem resistant mechanism analysis. Results Before the collection of imipenem unsusceptible Pseudomonas aeruginosa isolates, the average time of patients treated with more than one antimicrobial (20.0 ± 9.5 days, n = 16) was significantly longer than those treated with only one antimicrobial (12.6 ± 4.4 days, n = 21; t-test, Welch, t = -2.9004, P < 0.01). And 32 isolates showed resistance to more than 3 classes of antimicrobials. Six PFGE clusters were identified and 26 isolates were grouped into one dominant cluster (C2). An ISpa1328 sequence insertion in oprD was detected in 33 isolates and the function of efflux was observed in all 37 isolates in the presence of a wide spectrum efflux inhibitor. Conclusions Our data demonstrated that exposure to non-carbapenem drug classes, especially fluoroquinolones and β-lactams, may be important risk factors for the spread of carbapenem resistant Pseudomonas aeruginosa.

scholarly journals Effects of Carbapenem Exposure on the Risk for Digestive Tract Carriage of Intensive Care Unit-Endemic Carbapenem-Resistant Pseudomonas aeruginosa Strains in Critically Ill Patients

2007 ◽  
Vol 51 (6) ◽  
pp. 1967-1971 ◽  
Author(s):  
C. Peña ◽  
A. Guzmán ◽  
C. Suarez ◽  
M. A. Dominguez ◽  
F. Tubau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Digestive Tract ◽  
Bacterial Resistance ◽  
Clonal Diversity ◽  
Carbapenem Resistant ◽  
Resistance Patterns ◽  
Cross Transmission ◽  
Imipenem Resistance

ABSTRACT To determine the epidemiology and risk factors for carbapenem-resistant Pseudomonas aeruginosa (CR-PA) digestive tract colonization, weekly rectal and pharyngeal swabs were obtained in two serial incidence surveys (266 patients). Forty-two (16%) patients were CR-PA colonized (12 [29%] on admission and 30 [71%] in intensive care units). Pulsed-field gel electrophoresis showed extensive clonal diversity, although one specific clone (type B) was isolated from 11 patients. The presence of similar genotypes of CR-PA colonizing 30% of the CR-PA-colonized patients suggests the occurrence of cross-colonization; in addition, 10 pairs of carbapenem-susceptible P. aeruginosa (CS-PA) and subsequent CR-PA strains isolated from the same patients were found to be clonally identical and were considered to have been endogenously acquired (33%). All endogenously acquired CR-PA strains were isolated after exposure to a carbapenem, and 80% showed a phenotype of imipenem resistance (IR pattern) alone, while 67% of the CR-PA strains acquired by cross-transmission exhibited a multiresistant (MR) phenotype, with previous carbapenem exposure in 44%. Logistic regression analysis identified severity of acute illness (odds ratio [OR], 1.0; 95% confidence interval [CI], 1.0 to 1.1), prior carbapenem use (OR, 7.8; 95% CI, 1.7 to 35.3), and prior use of fluoroquinolones (OR, 11.0; 95% CI, 1.7 to 67.9) as independent risk factors for CR-PA digestive tract colonization. Overall, the local epidemiology of CR-PA digestive tract colonization was characterized by polyclonal endemicity with phenotype patterns of IR and MR divided evenly between patients. Restricting the use of particular agents, such as carbapenems and fluoroquinolones, should be considered advisable to minimize the problem of this antibiotic resistance. However, the possible risk for development of collateral unexpected bacterial resistance patterns should be accurately monitored.

scholarly journals Acquisition of multidrug resistance transposon Tn6061 and IS6100-mediated large chromosomal inversions in Pseudomonas aeruginosa clinical isolates

Microbiology ◽  
2010 ◽  
Vol 156 (5) ◽  
pp. 1448-1458 ◽  
Author(s):  
Sébastien Coyne ◽  
Patrice Courvalin ◽  
Marc Galimand
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Opportunistic Pathogen ◽  
Clinical Isolates ◽  
Chromosomal Inversions ◽  
Gene Acquisition ◽  
Drug Classes ◽  
Horizontal Acquisition

Pseudomonas aeruginosa is a major human opportunistic pathogen, especially for patients in intensive care units or with cystic fibrosis. Multidrug resistance is a common feature of this species. In a previous study we detected the ant(4′)-IIb gene in six multiresistant clinical isolates of P. aeruginosa, and determination of the environment of the gene led to characterization of Tn6061. This 26 586 bp element, a member of the Tn3 family of transposons, carried 10 genes conferring resistance to six drug classes. The ant(4′)-IIb sequence was flanked by directly repeated copies of ISCR6 in all but one of the strains studied, consistent with ISCR6-mediated gene acquisition. Tn6061 was chromosomally located in six strains and plasmid-borne in the remaining isolate, suggesting horizontal acquisition. Duplication-insertion of IS6100, that ended Tn6061, was responsible for large chromosomal inversions. Acquisition of Tn6061 and chromosomal inversions are further examples of intricate mechanisms that contribute to the genome plasticity of P. aeruginosa.

scholarly journals Risk Factors for Carbapenem-Resistant Pseudomonas aeruginosa, Zhejiang Province, China

2019 ◽  
Vol 25 (10) ◽  
pp. 1861-1867 ◽  
Author(s):  
Yan-Yan Hu ◽  
Jun-Min Cao ◽  
Qing Yang ◽  
Shi Chen ◽  
Huo-Yang Lv ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Zhejiang Province ◽  
Carbapenem Resistant

Imipenem Resistance Among Pseudomonas aeruginosa Isolates Risk Factors for Infection and Impact of Resistance on Clinical and Economic Outcomes

2006 ◽  
Vol 27 (9) ◽  
pp. 893-900 ◽  
Author(s):  
Ebbing Lautenbach ◽  
Mark G. Weiner ◽  
Irving Nachamkin ◽  
Warren B. Bilker ◽  
Angela Sheridan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Medical Center ◽  
Tertiary Care ◽  
Economic Outcomes ◽  
Control Group ◽  
Case Group ◽  
Tertiary Care Medical Center ◽  
Imipenem Resistance ◽  
The Impact

Objectives.To identify risk factors for infection with imipenem-resistant Pseudomonas aeruginosa and determine the impact of imipenem resistance on clinical and economic outcomes among patients infected with P. aeruginosa.Designs.An ecologic study, a case-control study, and a retrospective cohort study.Setting.A 625-bed tertiary care medical center.Patients.All patients who had an inpatient clinical culture positive for P. aeruginosa between January 1, 1999, and December 31, 2000.Results.From 1991 through 2000, the annual prevalence of imipenem resistance among P. aeruginosa isolates increased significantly (P<.001 by the χ2 test for trend). Among 879 patients infected with P. aeruginosa during 1999-2000, a total of 142 had imipenem-resistant P. aeruginosa infection (the case group), whereas 737 had imipenem-susceptible P. aeruginosa infection (the control group). The only independent risk factor for imipenem-resistant P. aeruginosa infection was prior fluoroquinolone use (adjusted odds ratio, 2.52 [95% confidence interval {CI}, 1.61-3.92]; P<.001). Compared with patients infected with imipenem-susceptible P. aeruginosa, patients infected with imipenem-resistant P. aeruginosa had longer subsequent hospitalization durations (15.5 days vs 9 days; P = .02) and greater hospital costs ($81,330 vs $48,381; P<.001). The mortality rate among patients infected with imipenem-resistant P. aeruginosa was 31.1%, compared with 16.7% for patients infected with imipenem-susceptible P. aeruginosa (relative risk, 1.86 [95% CI, 1.38-2.51]; P<.001). In multivariable analyses, there remained an independent association between infection with imipenem-resistant P. aeruginosa and mortality.Conclusions.The prevalence of imipenem resistance among P. aeruginosa strains has increased markedly in recent years and has had a significant impact on both clinical and economic outcomes. Our results suggest that curtailing use of other antibiotics (particularly fluoroquinolones) may be important in attempts to curb further emergence of imipenem resistance.

scholarly journals Carbapenem-Resistant Pseudomonas aeruginosa Bacteremia: Risk Factors for Mortality and Microbiologic Treatment Failure

2016 ◽  
Vol 61 (1) ◽  
Author(s):  
Deanna J. Buehrle ◽  
Ryan K. Shields ◽  
Lloyd G. Clarke ◽  
Brian A. Potoski ◽  
Cornelius J. Clancy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Treatment Failure ◽  
Antimicrobial Therapy ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Active Therapy ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Multiple Drug Resistant

ABSTRACT We reviewed 37 patients treated for bacteremia due to carbapenem-resistant (CR) Pseudomonas aeruginosa. Although 65% of isolates were multiple-drug resistant, therapeutic options were available, as all were susceptible to ≥1 antibiotic. A total of 92% of patients received active antimicrobial therapy, but only 57% received early active therapy (within 48 h). Fourteen-day mortality was 19%. Microbiologic failure occurred in 29%. The Pitt bacteremia score (P = 0.046) and delayed active therapy (P = 0.027) were predictive of death and microbiologic failure, respectively.

scholarly journals Characterization of N4-like Pseudomonas Phage vB_Pae-PA14 Isolated from Seawater Sampled in Thailand

2021 ◽  
Author(s):  
Akkaraphol Srichaisupakit ◽  
Peechanika Chopjitt ◽  
Anusak Kerdsin
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Phylogenetic Analysis ◽  
Burst Size ◽  
Biological Entity ◽  
Whole Genome ◽  
Lytic Bacteriophage ◽  
Carbapenem Resistant ◽  
Infected Cells ◽  
Range Test

Bacteriophage, a predator virus of bacteria, is an abundant biological entity in the biosphere. With ultimate applications in medicine and biotechnology, new phages are extensively being isolated and characterized. The objective of the present study was to characterize lytic bacteriophage vB_Pae-PA14 infecting Pseudomonas aeruginosa ATCC 27853 that was isolated from seawater in Thailand. vB_Pae-PA14 was subjected to whole genome phylogenetic analysis, host range test, biofilm test and characterization. Results showed that the phage belonged to a group of N4-like viruses, could infect P. aeruginosa isolates including carbapenem-resistant P. aeruginosa. The burst size of vB_Pae-PA14 was 86 plaque-forming unit/infected cells. Also, the phage showed a greater ability to control planktonic P. aeruginosa cells than the biofilm cells. Phage could withstand physical stresses especially the high salt concentration. In brief, lytic bacteriophage vB_Pae-PA14 infecting P. aeruginosa was isolated and characterized, which might be useful in further bacteriophage lytic applications.

scholarly journals Molecular characterization of NDM-1-producing Pseudomonas aeruginosa isolates from hospitalized patients in Iran

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mojtaba Shahin ◽  
Ali Ahmadi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance Genes ◽  
Healthcare Setting ◽  
Main Cluster ◽  
Carbapenem Resistant ◽  
Pcr Method ◽  
Synergy Test ◽  
Relationship Of ◽  
Encoding Genes

Abstract Background The emergence of carbapenem-resistant Pseudomonas aeruginosa is one of the most important challenges in a healthcare setting. The aim of this study is double-locus sequence typing (DLST) typing of blaNDM-1 positive P. aeruginosa isolates. Methods Twenty-nine blaNDM-1 positive isolates were collected during three years of study from different cities in Iran. Modified hodge test (MHT), double-disk synergy test (DDST) and double-disk potentiation test (DDPT) was performed for detection of carbapenemase and metallo-beta-lactamase (MBL) producing blaNDM-1 positive P. aeruginosa isolates. The antibiotic resistance genes were considered by PCR method. Clonal relationship of blaNDM-1 positive was also characterized using DLST method. Results Antibiotic susceptibility pattern showed that all isolates were resistant to imipenem and ertapenem. DDST and DDPT revealed that 15/29 (51.8%) and 26 (89.7%) of blaNDM-1 positive isolates were MBL producing isolates, respectively. The presence of blaOXA-10,blaVIM-2, blaIMP-1 and blaSPM genes were detected in 86.2%, 41.4%, 34.5% and 3.5% isolates, respectively. DLST typing results revealed the main cluster were DLST 25-11 with 13 infected or colonized patients. Conclusions The presence of blaNDM-1 gene with other MBLs encoding genes in P. aeruginosa is a potential challenge in the treatment of microorganism infections. DLST showed partial diversity among 29 blaNDM-1 positive isolates.

scholarly journals A systematic review and expert’s analysis of risk factors of infections in adults due to carbapenem-resistant Pseudomonas aeruginosa or Acinetobacter baumannii in Spain

2021 ◽  
Author(s):  
Ricard Ferrer ◽  
Alex Soriano ◽  
Rafael Cantón ◽  
José Luis Del Pozo ◽  
Carol García-Vidal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pseudomonas Aeruginosa ◽  
Literature Review ◽  
Acinetobacter Baumannii ◽  
Systematic Literature Review ◽  
Factors Associated ◽  
Carbapenem Resistant ◽  
Factor Evaluation ◽  
Associated Risk Factors

Objective. The aim of the study is to identify risk factors associated to infections caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) in adult patients through a systematic literature review, classify them according to their importance and provide recommendations by experts in the Spanish context. Material and methods. We developed a systematic literature review to identify risk factors associated to CRPA or CRAB infections and they were evaluated and discussed by a multidisciplinary panel of experts. Results. There were included 29 studies for P. aeruginosa and 23 for A. baumannii out of 593 identified through systematic literature review. We identified 38 risk factors for P. aeruginosa and 36 for A. baumannii. After risk factor evaluation by the panel of experts, results for CRPA were: 11 important, 10 slightly important and 15 unimportant risk factors; and for CRAB were: 9 important, 5 slightly important and 19 unimportant risk factors. For both pathogens, previous use of antibiotics and hospitalization were important risk factors. Conclusion. We could identify the main risk factors associated to CRPA and CRAB through literature review. There is a need for developing additional studies with higher levels of evidence to identify sooner and better infected patients through associated risk factors.

scholarly journals Activity of imipenem/relebactam against Pseudomonas aeruginosa producing ESBLs and carbapenemases

2020 ◽  
Author(s):  
Shazad Mushtaq ◽  
Danièle Meunier ◽  
Anna Vickers ◽  
Neil Woodford ◽  
David M Livermore
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Latin America ◽  
Middle East ◽  
Eastern Europe ◽  
Class A ◽  
Carbapenem Resistant ◽  
Class B ◽  
Agar Dilution ◽  
Imipenem Resistance ◽  
Esbl Producers

Abstract Background ESBL- and carbapenemase-producing Pseudomonas aeruginosa are prevalent in, for example, the Middle East, Eastern Europe and Latin America, though rarer elsewhere. Because P. aeruginosa readily mutate to become carbapenem resistant via loss of OprD, isolates producing ESBLs are often as broadly resistant as those producing carbapenemases. We hypothesized that: (i) relebactam might overcome class A carbapenemases directly in P. aeruginosa; and (ii) relebactam’s inhibition of AmpC, which gives a generalized potentiation of imipenem against the species, might restore imipenem susceptibility in OprD-deficient ESBL producers. Methods MICs were determined using CLSI agar dilution for P. aeruginosa isolates producing ESBLs, principally VEB types, and for those producing GES-5, KPC and other carbapenemases. Results Relebactam potentiated imipenem by around 4–8-fold for most P. aeruginosa isolates producing VEB and other ESBLs; however, MICs were typically only reduced to 4–16 mg/L, thus mostly remaining above EUCAST’s susceptible range and only partly overlapping CLSI’s intermediate range. Strong (approx. 64-fold) potentiation was seen for isolates producing KPC carbapenemases, but only 2-fold synergy for those with GES-5. Predictably, potentiation was not seen for isolates with class B or D carbapenemase activity. Conclusions Relebactam did potentiate imipenem against ESBL-producing P. aeruginosa, which are mostly imipenem resistant via OprD loss, but this potentiation was generally insufficient to reduce imipenem MICs to the clinical range. Imipenem resistance owing to KPC carbapenemases was reversed by relebactam in P. aeruginosa, just as for Enterobacterales.

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