Beta-Lactam Resistance Mechanisms in Pseudomonas aeruginosa Strains Causing Bloodstream Infections: Comparative Results Between Brazilian and American Isolates

被引:19
作者
Fehlberg, Lorena C. C. [1 ]
Xavier, Danilo E.
Peraro, Paula P.
Marra, Alexandre R. [2 ]
Edmond, Michael B. [3 ]
Gales, Ana C.
机构
[1] Univ Fed Sao Paulo, Lab Alerta, Div Infect Dis, BR-04025010 Sao Paulo, Brazil
[2] Hosp Israelita Albert Einstein, Intens Care Unit, Sao Paulo, Brazil
[3] Virginia Commonwealth Univ, Dept Internal Med, Richmond, VA USA
基金
巴西圣保罗研究基金会;
关键词
MEXAB-OPRM; ACINETOBACTER-BAUMANNII; CARBAPENEM RESISTANCE; EFFLUX PUMP; SUSCEPTIBILITY; SURVEILLANCE; EXPRESSION; INTERPLAY; PREVALENT; GENES;
D O I
10.1089/mdr.2011.0174
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
This study evaluated the presence of distinct mechanisms of beta-lactam resistance in 122 Pseudomonas aeruginosa isolates, causing bloodstream infections at Hospital Sao Paulo (HSP, Brazil; 82 isolates) and Virginia Commonwealth University Medical Center (VCU, United States; 40 isolates). By Clinical Laboratory Standards Institute agar dilution, Brazilian P. aeruginosa isolates showed higher resistance rates to most antimicrobials tested than those collected from the United States, except for ciprofloxacin. Carbapenem hydrolysis was detected in seven P. aeruginosa from HSP, in which bla(SPM-1) (n = 5), bla(IMP-1) (n = 1), and bla(IMP-16) (n = 1) were detected by polymerase chain reaction (PCR) followed by DNA sequencing. The production of GES-5 was observed in 1.25% of HSP isolates. No extended-spectrum beta-lactamase-encoding genes were detected in the VCU isolates. Expression of efflux systems genes (mexB, mexD, mexF, and mexY) was evaluated by quantitative reverse transcriptase-PCR. In HSP isolates MexXY-OprM (41.4%) efflux system was more frequently overexpressed, in contrast to what was observed in the VCU isolates, where both MexXY-OprM (25.0%) and MexAB-OprM (25.0%) were equally overexpressed. The oprD downregulation was similar among isolates collected from the HSP (92.7%) and VCU (95.0%). On the other hand, ampC overexpression was observed only among HSP isolates (31.7%). The distinct antimicrobial susceptibility profile and mechanisms of beta-lactam resistance found among P. aeruginosa isolated from teaching hospitals located in Brazil and the United States exemplify the importance of local epidemiology in determining antimicrobial resistance rates.
引用
收藏
页码:402 / 407
页数:6
相关论文
共 30 条
[1]  
Andrade SS, 2008, BRAZ J INFECT DIS, V12, P3
[2]   Overexpression of AmpC and Efflux Pumps in Pseudomonas aeruginosa Isolates from Bloodstream Infections: Prevalence and Impact on Resistance in a Spanish Multicenter Study [J].
Cabot, Gabriel ;
Ocampo-Sosa, Alain A. ;
Tubau, Fe ;
Macia, Maria D. ;
Rodriguez, Cristina ;
Moya, Bartolome ;
Zamorano, Laura ;
Suarez, Cristina ;
Pena, Carmen ;
Martinez-Martinez, Luis ;
Oliver, Antonio .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2011, 55 (05) :1906-1911
[3]  
Clinical and Laboratory Standards Institute, 2010, M100S20 CLIN STAND I
[4]   Characterization of Pseudomonas aeruginosa isolates:: Occurrence rates, antimicrobial susceptibility patterns, and molecular typing in the global SENTRY Antimicrobial Surveillance Program, 1997-1999 [J].
Gales, AC ;
Jones, RN ;
Turnidge, J ;
Rennie, R ;
Ramphal, R .
CLINICAL INFECTIOUS DISEASES, 2001, 32 :S146-S155
[5]  
Hocquet D, 2007, ANTIMICROB AGENTS CH, V51, P1582, DOI 10.1128/AAC.01334-06
[6]   Efflux Pump Contribution to Multidrug Resistance in Clinical Isolates of Pseudomonas aeruginosa [J].
Kiser, Tyree H. ;
Obritsch, Marilee D. ;
Jung, Rose ;
MacLaren, Robert ;
Fish, Douglas N. .
PHARMACOTHERAPY, 2010, 30 (07) :632-638
[7]   Inadequate antimicrobial treatment of infections - A risk factor for hospital mortality among critically ill patients [J].
Kollef, MH ;
Sherman, G ;
Ward, S ;
Fraser, VJ .
CHEST, 1999, 115 (02) :462-474
[8]   Antibacterial-Resistant Pseudomonas aeruginosa: Clinical Impact and Complex Regulation of Chromosomally Encoded Resistance Mechanisms [J].
Lister, Philip D. ;
Wolter, Daniel J. ;
Hanson, Nancy D. .
CLINICAL MICROBIOLOGY REVIEWS, 2009, 22 (04) :582-+
[9]   Substrate specificities of MexAB-OprM, MexCD-OprJ, and MexXY-OprM efflux pumps in Pseudomonas aeruginosa [J].
Masuda, N ;
Sakagawa, E ;
Ohya, S ;
Gotoh, N ;
Tsujimoto, H ;
Nishino, T .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2000, 44 (12) :3322-3327
[10]   Rapid detection and identification of metallo-β-lactamase-encoding genes by multiplex real-time PCR assay and melt curve analysis [J].
Mendes, Rodrigo E. ;
Kiyota, Katia A. ;
Monteiro, Jussimara ;
Castanheira, Mariana ;
Andrade, Soraya S. ;
Gales, Ana C. ;
Pignatari, Antonio C. C. ;
Tufik, Sergio .
JOURNAL OF CLINICAL MICROBIOLOGY, 2007, 45 (02) :544-547