scholarly journals Intrahospital spread of carbapenem-resistant Pseudomonas aeruginosa in a University Hospital in Florianópolis, Santa Catarina, Brazil

2010 ◽  
Vol 43 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Mara Cristina Scheffer ◽  
Maria Luiza Bazzo ◽  
Mario Steindel ◽  
Ana Lucia Darini ◽  
Eduardo Clímaco ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Polymyxin B ◽  
University Hospital ◽  
Nucleotide Sequence Analysis ◽  
Epidemiological Typing ◽  
Carbapenem Resistant ◽  
Cross Transmission ◽  
Agar Dilution ◽  
High Level ◽  
The City

INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been isolated with increasing frequency in Brazilian hospitals. Since June 2003, its detection in a teaching hospital in the city of Florianópolis, Brazil, has increased. This study aimed to investigate the minimal inhibitory concentration (MIC), presence of Metallo-β-lactamase (MβL) and a possible clonal relationship among the isolates. METHODS: The study included 29 CRPA and seven isolates with reduced susceptibility. The MIC was determined by agar-dilution. Detection of MβL was performed by Double Disk Sinergism (DDS) and Combined Disk (CD). The MβL gene was verified by PCR and nucleotide sequence analysis. Epidemiological typing was performed by pulsed-field gel electrophoresis. RESULTS: Among the 29 carbapenem-resistant isolates, polymyxin B presented 100% susceptibility and piperacillin/tazobactam 96.7%. Seventeen (62%) strains were verified as clonal (A clone) and among these, six isolates indicated phenotypically positive tests for MβL and harbored the blaSPM-1 gene. The first CRPA isolates were unrelated to clone A, harbored blaIMP-16 and were phenotypically positive only by CD. CONCLUSIONS: The spread of a high-level of resistance clone suggests cross transmission as an important dissemination mechanism and has contributed to the increased rate of resistance to carbapenems. This study emphasizes the need for continuous surveillance and improved strategies.

scholarly journals High genetic diversity among Pseudomonas aeruginosa and Acinetobacter spp. isolated in a public hospital in Brazil

2013 ◽  
Vol 49 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Vera Lúcia Dias Siqueira ◽  
Rosilene Fressatti Cardoso ◽  
Rubia Andreia Falleiros de Pádua ◽  
Katiany Rizzieri Caleffi-Ferracioli ◽  
Cesar Helbel ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Pseudomonas Aeruginosa ◽  
Polymyxin B ◽  
University Hospital ◽  
High Genetic Diversity ◽  
Carbapenem Resistant ◽  
Antimicrobial Resistance Profile ◽  
Cross Transmission ◽  
Acinetobacter Spp ◽  
Small Clusters

In Brazil and other regions of the world, Pseudomonas aeruginosa and Acinetobacter spp. have emerged as important agents of nosocomial infection and are commonly involved in outbreaks. The main objective of the present study was to evaluate the genetic relationship among P. aeruginosa and Acinetobacter spp. isolated from patients in a public university hospital in northwestern Paraná, Brazil, and report their antimicrobial resistance profile. A total of 75 P. aeruginosa and 94 Acinetobacter spp. isolates were phenotypically identified and tested for antibiotic susceptibility using automated methodology. Polymyxin B was tested by disk diffusion for P. aeruginosa. Metallo-β-lactamase (MBL) was detected using a disk approximation test. Genotyping was performed using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR). Approximately 55% of the P. aeruginosa isolates and 92% of the Acinetobacter spp. isolates were multiresistant, but none were MBL-producers. ERIC-PCR revealed the presence of small clusters of carbapenem-resistant Acinetobacter spp., most likely OXA-type carbapenemase producers. Furthermore, high genetic diversity in P. aeruginosa and Acinetobacter spp. clinical isolates was observed, suggesting that cross-transmission is not very frequent in the studied hospital.

scholarly journals Characteristics of Carbapenem-Resistant Pseudomonas aeruginosa Strains in Patients with Ventilator-Associated Pneumonia in Intensive Care Units

Medicina ◽  
2012 ◽  
Vol 47 (12) ◽  
pp. 95
Author(s):  
Astra Vitkauskienė ◽  
Erika Skrodenienė ◽  
Asta Dambrauskienė ◽  
Giedrė Bakšytė ◽  
Andrius Macas ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Test Results ◽  
Disk Diffusion Test ◽  
Carbapenem Resistant ◽  
Resistant Strains ◽  
High Level ◽  
O 11

The aim of this study was to determine the characteristics of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) strains and 5-year changes in resistance in a tertiary university hospital. Material and Methods. The study included 90 and 101 randomly selected P. aeruginosa strains serotyped in 2003 and 2008, respectively. The standardized disk diffusion test and E-test were used to determine resistance to antibiotics. P. aeruginosa strains were considered to have high-level resistance if a minimum inhibitory concentration (MIC) for imipenem or meropenem was >32 μg/mL. To identify serogroups, sera containing specific antibodies against O group antigens of P. aeruginosa were used. P. aeruginosa isolates resistant to imipenem or/and meropenem were screened for metallo-β-lactamase (MBL) production by using the MBL E-test. Results. Comparison of the changes in resistance of P. aeruginosa strains to carbapenems within the 5-year period revealed that the level of resistance to imipenem increased. In 2003, 53.3% of P. aeruginosa strains were found to be highly resistant to imipenem, while in 2008, this percentage increased to 87.8% (P=0.01). The prevalence of MBL-producing strains increased from 15.8% in 2003 to 61.9% in 2008 (P<0.001). In 2003 and 2008, carbapenem-resistant P. aeruginosa strains were more often resistant to ciprofloxacin and gentamicin than carbapenem-sensitive strains. In 2008, carbapenem- resistant strains additionally were more often resistant to ceftazidime, cefepime, aztreonam, piperacillin, and amikacin than carbapenem-sensitive strains. MBL-producing P. aeruginosa strains belonged more often to the O:11 serogroup than MBL-non-producing strains (51.7% vs. 34.3%, P<0.05). A greater percentage of non-MBL-producing strains had low MICs against ciprofloxacin and amikacin as compared with MBL-producing strains. Conclusions. The results of our study emphasize the need to restrict the spread of O:11 serogroup P. aeruginosa strains and usage of carbapenems to treat infections with P. aeruginosa in the intensive care units of our hospital

scholarly journals Carbapenem-Resistant Pseudomonas aeruginosa in Malaysia Producing IMP-7 β-Lactamase

2002 ◽  
Vol 46 (10) ◽  
pp. 3286-3287 ◽  
Author(s):  
Siaw Eng Ho ◽  
Geetha Subramaniam ◽  
Selvi Palasubramaniam ◽  
Parasakthi Navaratnam
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Dna Sequencing ◽  
Isoelectric Focusing ◽  
Carbapenem Resistant ◽  
High Level ◽  
Level Resistance

ABSTRACT We have isolated and identified a carbapenem-resistant Pseudomonas aeruginosa strain from Malaysia that produces an IMP-7 metallo-β-lactamase. This isolate showed high-level resistance to meropenem and imipenem, the MICs of which were 256 and 128 μg/ml, respectively. Isoelectric focusing analyses revealed pI values of >9.0, 8.2, and 7.8, which indicated the possible presence of IMP and OXA. DNA sequencing confirmed the identity of the IMP-7 determinant.

scholarly journals Characterization of clinical isolates of Pseudomonas aeruginosa heterogeneously resistant to carbapenems

2007 ◽  
Vol 56 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Spyros Pournaras ◽  
Alexandros Ikonomidis ◽  
Antonios Markogiannakis ◽  
Nicholas Spanakis ◽  
Antonios N. Maniatis ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Population Analysis ◽  
Growth Curves ◽  
Clinical Isolates ◽  
Lag Phase ◽  
Carbapenem Resistant ◽  
One Step ◽  
Agar Dilution ◽  
Resistant Mutants ◽  
Selection Of

Fourteen apparently carbapenem-susceptible Pseudomonas aeruginosa clinical isolates that exhibited colonies within the inhibition zone around carbapenem discs were analysed. MICs of carbapenems were determined and the isolates were genotyped by PFGE. Population analysis, one-step selection of carbapenem-resistant mutants and growth curves of progenitors and carbapenem-resistant subpopulations were performed. Agar dilution MICs of imipenem and meropenem ranged from 0.5 to 4 mg l−1 and from 0.25 to 2 mg l−1, respectively. Population analysis confirmed subpopulations that grew in concentrations of up to 18 mg l−1 and 12 mg l−1 of imipenem and meropenem, respectively, at frequencies ranging from 6.9×10−5 to 1.1×10−7, suggesting that they might not be detected by standard agar dilution MIC testing. The minority subpopulations exhibited MICs for imipenem ranging from 10 to 20 mg l−1 and for meropenem from 4 to 14 mg l−1. The one-step 8 mg l−1 selection of imipenem-resistant mutants test showed growth in all isolates at frequencies ranging from 3.8×10−4 to 5.1×10−7. Growth curves revealed a prolonged lag phase and a short exponential phase for the heterogeneous subpopulations compared with their respective native subpopulations. These findings may be indicative that the use of carbapenems can lead to selection of P. aeruginosa resistant subpopulations that subsequently cause infections and result in treatment failure.

scholarly journals Caspofungin and Polymyxin B Reduce the Cell Viability and Total Biomass of Mixed Biofilms of Carbapenem-Resistant Pseudomonas aeruginosa and Candida spp.

2020 ◽  
Vol 11 ◽  
Author(s):  
Luciana Fernandes ◽  
Bruna Nakanishi Fortes ◽  
Nilton Lincopan ◽  
Kelly Ishida
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Inhibitory Activity ◽  
Inhibitory Concentration ◽  
Polymyxin B ◽  
Antibiofilm Activity ◽  
Total Biomass ◽  
Planktonic Cells ◽  
Carbapenem Resistant ◽  
Cell Counts ◽  
Viable Cells

Pseudomonas aeruginosa and Candida spp. are biofilm-forming pathogens commonly found colonizing medical devices, being mainly associated with pneumonia and bloodstream infections. The coinfection by these pathogens presents higher mortality rates when compared to those caused by a single microbial species. This study aimed to evaluate the antibiofilm activity of echinocandins and polymyxin B (PMB) against polymicrobial biofilms of carbapenem-resistant (CR) Pseudomonas aeruginosa and Candida spp. (C. albicans, C. parapsilosis, C. tropicalis, and C. glabrata). In addition, we tested the antimicrobial effect on their planktonic and monomicrobial biofilm counterparties. Interestingly, beyond inhibition of planktonic [minimum inhibitory concentration (MIC) = 0.5 μg/ml] and biofilm [minimum biofilm inhibitory concentration (MBIC)50 ≤ 2–8 μg/ml] growth of P. aeruginosa, PMB was also effective against planktonic cells of C. tropicalis (MIC = 2 μg/ml), and polymicrobial biofilms of CR P. aeruginosa with C. tropicalis (MBIC50 ≤ 2 μg/ml), C. parapsilosis (MBIC50 = 4–16 μg/ml), C. glabrata (MBIC50 = 8–16 μg/ml), or C. albicans (MBIC50 = 8–64 μg/ml). On the other hand, while micafungin (MFG) showed highest inhibitory activity against planktonic (MIC ≤ 0.008–0.5 μg/ml) and biofilm (MBIC50 ≤ 2–16 μg/ml) growth of Candida spp.; caspofungin (CAS) displays inhibitory activity against planktonic cells (MIC = 0.03–0.25 μg/ml) and monomicrobial biofilms (MBIC50 ≤ 2–64 μg/ml) of Candida spp., and notably on planktonic and monomicrobial biofilms of CR P. aeruginosa (MIC or MBIC50 ≥ 64 μg/ml). Particularly, for mixed biofilms, while CAS reduced significantly viable cell counts of CR P. aeruginosa and Candida spp. at ≥32 and ≥ 2 μg/ml, respectively; PMB was effective in reducing viable cells of CR P. aeruginosa at ≥2 μg/ml and Candida spp. at ≥8 μg/ml. Similar reduction of viable cells was observed for CAS (32–64 μg/ml) combined with PMB (2 μg/ml). These findings highlight the potential of PMB and CAS for the treatment of polymicrobial infections caused by Candida spp. and critical priority CR P. aeruginosa.

scholarly journals Prevalence and clinical outcomes of episodes of ventilator-associated pneumonia caused by SPM-1-producing and non-producing imipenem-resistant Pseudomonas aeruginosa

2011 ◽  
Vol 44 (5) ◽  
pp. 604-606 ◽  
Author(s):  
Guilherme Henrique Campos Furtado ◽  
Ana Cristina Gales ◽  
Luciana Baria Perdiz ◽  
Anderson Fernandes Santos ◽  
Eduardo Alexandrino Servolo de Medeiros
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Clinical Outcomes ◽  
Respiratory Infections ◽  
Carbapenem Resistance ◽  
Polymyxin B ◽  
Ventilator Associated Pneumonia ◽  
Antimicrobial Drugs ◽  
Major Mechanism ◽  
Carbapenem Resistant ◽  
Related Mortality

INTRODUCTION: Pseudomonas aeruginosa is a leading cause of ventilator-associated pneumonia (VAP) and exhibits high rates of resistance to several antimicrobial drugs. The carbapenens are usually the drugs of choice against this microorganism. However, the carbapenem resistance has increased among these strains worldwide. The presence of metallo-β-lactamases (MBL) has been pointed out as a major mechanism of resistance among these strains. No previous study addressed outcomes of respiratory infections caused by these strains. METHODS: Our group sought to analyze the epidemiology and clinical outcomes of patients with VAP caused by imipenem-resistant P. aeruginosa. A total of 29 clinical isolates of carbapenem-resistant Pseudomonas aeruginosa were screened for metallo-β-lactamase (MBL) genes. RESULTS: Demographic and clinical variables were similar between the SPM-1-producing and non-SPM-1-producing group. Five (17.2%) isolates were positive for blaSPM-1. No other MBL gene was found. All patients were treated with polymyxin B. The infection-related mortality was 40% and 54.2% for SPM-1-producing and -non-producing isolates, respectively. CONCLUSIONS: There were no differences in epidemiological and clinical outcomes between the two groups.

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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