Increased prevalence and clonal dissemination of multidrug-resistant Pseudomonas aeruginosa with the blaIMP-1 gene cassette in Hiroshima

Kouda, Syuntaro; Ohara, Masaru; Onodera, Makoto; Fujiue, Yoshihiro; Sasaki, Megumi; Kohara, Tadahiro; Kashiyama, Seiya; Hayashida, Shizue; Harino, Toshie; Tsuji, Takahiro; Itaha, Hideyuki; Gotoh, Naomasa; Matsubara, Akio; Usui, Tsuguru; Sugai, Motoyuki

doi:10.1093/jac/dkp142

Cited by 89 publications

(72 citation statements)

References 24 publications

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“…Thus, imipenem resistance in the present study is probably due to several interplay mechanisms including AmpC overproduction, efflux pumps, and loss of OprD rather than due to the production of specific MBLs, although a novel MBLs may be involved (Shehabi et al, 2011). In agreement to the present study, P. aeruginosa isolates were reported negative to bla VIM1a,b and bla IMP1,2 genes, however isolates were found positive to class 1 integrons (Kouda et al, 2009). Contrary to the absence of integron mediated MBLs in the present study, class 1 integron containing MBL-mediated resistance was reported elsewhere (Tawfik et al, 2012).…”

Section: Discussionsupporting

confidence: 91%

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Zowalaty

Gyetvai

2016

Polish Journal of Microbiology

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A b s t r a c tPseudomonas aeruginosa is a leading human pathogen that causes serious infections at various tissues and organs leading to life threatening health problems and possible deadly outcomes. Resistance patterns vary widely whether it is from hospitals or community acquired infections. Reporting resistance profiles to a certain antibiotics provide valuable information in a given setting, but may be extrapolated outside the sampling location. In the present study, P. aeruginosa isolates were screened to determine their susceptibilities against antipseudomonal antimicrobial agents and possible existing mechanisms of resistance were determined. Eighty-six isolates of P. aeruginosa were recovered. Isolates representing different resistance profiles were screened for the existence of three different resistance mechanisms including drug inactivation due to metallo-β-lactamases, drug impermeability by outer membrane proteins and drug efflux. All tested isolates showed uniform susceptibility (100%, n = 86/86) to piperacillin, meropenem, amikacin, and polymyxin B. A single isolate was found to be imipenem resistant (99%, n = 85/86). The possible mechanisms of resistance of P. aeruginosa to imipenem involve active drug efflux pumps, outer membrane impermeability as well as drug inactivating enzymes. These findings demonstrate the fundamental importance of the in vitro susceptibility testing of antibiotics prior to antipseudomonal therapy and highlight the need for a continuous antimicrobial resistance surveillance programs to monitor the changing resistance patterns so that clinicians and health care officials are updated as to the most effective therapeutic agents to combat the serious outcomes of P. aeruginosa infections. This copy is for personal use only -distribution prohibited.El Zowalaty M.E. and Gyetvai B.1 24 anti biotics (El Zowalaty et al., 2015). The literature is rich in surveillance studies from all over the world reporting varying resistance rates among P. aeruginosa against different antimicrobial agent. Recently, studies have focused on the decreased susceptibility of P. aeru ginosa to currently used antipseudomonal agents, including β-lactams, aminoglycosides, and fluoroquinolones (Al-Tawfiq, 2007) since resistance of P. aeru ginosa to carbapenems, piperacillin, and other highly active antibiotics has emerged and is increasing which makes treatment of P. aeruginosa infections troublesome (Strateva et al., 2007).Recently, resistance rates of P. aeruginosa clinical isolates recovered from patients admitted to Zagazig University hospitals in Egypt against different classes of antimicrobial agents were reported (El Zowalaty, 2012). The current study further examined the susceptibilities and possible resistance mechanisms of P. aeruginosa isolates collected from hospitalized patients against selected antipseudomonal agents that are available in the Egyptian pharmaceutical market and are frequently prescribed to patients. Experimental Materials and MethodsStudy site. The specimens were collected from ...

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Section: Discussionsupporting

confidence: 91%

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Zowalaty

Gyetvai

2016

Polish Journal of Microbiology

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“…Our results showed that P. aeruginosa clinical isolates resistant to carbapenems were more resistant to piperacillin, piperacillin/tazobactam, ceftazidime, cefoperazone/sulbactam, ciprofloxacin and aminoglycosides. The data of Lagatolla et al [26], similar to those in other studies [27,28], demonstrate that most of the blaVIM positive isolates of P. aeruginosa exhibited a multidrug-resistant phenotype, including imipenem, meropenem, ceftazidime, piperacillin, aztreonam, amikacin, gentamicin, tobramycin and ciprofloxacin, except polymixin B. Antibiotic resistance alone cannot explain the virulence of bacteria.…”

Section: Discussionsupporting

confidence: 63%

Biofilm formation and serum susceptibility in Pseudomonas aeruginosa

et al. 2014

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AbstractPseudomonas aeruginosa (P. aeruginosa) is one of the most important opportunistic pathogens. The pathogenicity of P. aeruginosa has been associated with multiple bacterial virulence factors. The aim of this study was to evaluate the association between P. aeruginosa strains obtained from various clinical samples and resistance to antibiotics and pathogenicity factors, such as resistance to serum bactericidal activity and biofilm formation. This study included 121 P. aeruginosa strains isolated from clinical samples; 65 of the isolated P. aeruginosa strains were carbapenem-resistant, and 56 were carbapenem-sensitive. Carbapenem-resistant P. aeruginosa strains were more often resistant to the majority of tested antibiotics, compared to carbapenem-sensitive strains. We did not find any statistically significant difference between resistance to carbapenems and serum resistance and ability of tested P. aeruginosa strains to produce biofilms. Carbapenem-resistant P. aeruginosa strains were recovered from the urinary tract significantly more often (75.0%) than carbapenem-sensitive P. aeruginosa strains (25.0%). Carbapenem-sensitive P. aeruginosa strains were recovered significantly more often from the respiratory tract than carbapenem-resistant strains, 60.0% and 40.0%, respectively. All the P. aeruginosa strains recovered from blood were serum-resistant. P. aeruginosa strains recovered from the respiratory tract and wounds were significantly frequently serum sensitive, 95.6% and 56.6%, respectively. We did not find any differences in biofilm production among the P. aeruginosa strains recovered from different sources.

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“…ST235 was the founder ST of the clonal complex CC235 (previously described as CC11/BG11). CC235 has been long known as responsible for outbreaks throughout Europe, Asia, and South America (8,11,15,17,18,20,27) while armed with various ESBLs (such as PER-1, GES-1, and BEL-1) as well as MBLs (such as VIM-1, VIM-4, and IMP-1) (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

Most Multidrug-Resistant Pseudomonas aeruginosa Isolates from Hospitals in Eastern France Belong to a Few Clonal Types

et al. 2011

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This study aimed to determine the genetic diversity of clinical multidrug-resistant Pseudomonas aeruginosa. We used pulsed-field gel electrophoresis and multilocus sequence typing to analyze 187 strains isolated in different French hospitals. To illustrate the diversity of resistance mechanisms to antibiotics in a given clone, we identified ␤-lactamases with an extended spectrum by using phenotypic and genotypic methods. Typing results showed that the majority of our multidrug-resistant isolates belong to a few clonal types (ST235, ST111, and ST175) that are already spreading worldwide. These successful international clones sporadically produced extended-spectrum ␤-lactamase-encoding genes but mostly became extensively resistant to ␤-lactams after derepression of intrinsic resistance mechanisms (i.e., AmpC cephalosporinase). Our results indicate that cross-transmission plays a major role in the spread of multidrug-resistant P. aeruginosa in hospital settings.Pseudomonas aeruginosa is the third most important nosocomial pathogen in French hospitals, responsible for 10% of hospital-acquired infections (13). Additionally, the growing threat of antimicrobial resistance in P. aeruginosa is driven by its extraordinary capacity for developing resistance to almost any antibiotic by selection of mutations in chromosomal genes in conjunction with spread of horizontally acquired resistance (21, 30). Multidrug resistance in P. aeruginosa makes treatment of infections both difficult and expensive and can increase morbidity and mortality (16).There appears to be a consensus that the P. aeruginosa population structure is nonclonal epidemic, that clinical isolates are indistinguishable from environmental isolates, and that there are no specific clones with a specific habitat or disease (25). However, some important controversial issues remain. First, since the 1980s, several studies have reported the emergence, spread, and persistence of multidrug-resistant clones in hospitals, evidencing a lack of genetic diversity (25). Second, cystic fibrosis (CF) clones have been reported worldwide, suggestive of an emergence of specific clones spreading within the CF population (25,29).The objective of this study was to assess the genetic diversity, by using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), of a large panel of multidrugresistant (MDR) P. aeruginosa isolates from patients hospitalized in different French hospitals. MATERIALS AND METHODSSettings. Five university hospitals (Besançon, Dijon, Nancy, Reims, and Strasbourg) of five administrative regions in eastern France took part in this survey over a 32-month period (from October 2007 to May 2010). These regions account for 8.5 million inhabitants, corresponding to 14% of the French population.Bacterial strains. All P. aeruginosa clinical and screening (if performed) isolates, except CF isolates, were collected and tested for antimicrobial resistance. The susceptibilities to ticarcillin, tazobactam/piperacillin, ceftazidime, cefepime, aztreonam, me...

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Increased prevalence and clonal dissemination of multidrug-resistant Pseudomonas aeruginosa with the blaIMP-1 gene cassette in Hiroshima

Abstract: This study shows a dramatic increase in MBL genes, primarily bla(IMP-1), in MDR P. aeruginosa isolates in Hiroshima during these 3 years. In addition, MDR P. aeruginosa with the newly discovered In113-derived bla(IMP-1) gene cassette array appears to be clonally expanding.

Cited by 89 publications

References 24 publications

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Effectiveness of Antipseudomonal Antibiotics and Mechanisms of Multidrug Resistance in Pseudomonas aeruginosa

Biofilm formation and serum susceptibility in Pseudomonas aeruginosa

Most Multidrug-Resistant Pseudomonas aeruginosa Isolates from Hospitals in Eastern France Belong to a Few Clonal Types

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