Characterization of AmpC ß-lactamase mutations of extensively drug-resistant Pseudomonas aeruginosa isolates that develop resistance to ceftolozane/tazobactam during therapy.
Enferm Infecc Microbiol Clin (Engl Ed)
; 38(10): 474-478, 2020 Dec.
Article
em En, Es
| MEDLINE
| ID: mdl-32143893
ABSTRACT
INTRODUCTION:
We characterized AmpC ß-lactamase mutations that resulted in ceftolozane/tazobactam resistance in extensively drug-resistant (XDR) Pseudomonas aeruginosa isolates recovered from patients treated with this agent from June 2016 to December 2018.METHODS:
Five pairs of ceftolozane/tazobactam susceptible/resistant P. aeruginosa XDR isolates were included among a total of 49 patients treated. Clonal relationship among isolates was first evaluated by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) was further performed. AmpC mutations were investigated by PCR amplification of the blaPDC gene followed by sequencing.RESULTS:
The ST175 high-risk clone was detected in four of the pairs of isolates and the ST1182 in the remaining one. All resistant isolates showed a mutation in AmpC T96I in two of the isolates, and E247K, G183V, and a deletion of 19 amino acids (G229-E247) in the other three. The G183V mutation had not been described before. The five isolates resistant to ceftolozane/tazobactam showed cross-resistance to ceftazidime/avibactam and lower MICs of imipenem and piperacillin/tazobactam than the susceptible isolates.CONCLUSIONS:
Ceftolozane/tazobactam resistance was associated in all of the cases with AmpC mutations, including a novel mutation (G183V) not previously described. There is a vital need for surveillance and characterization of emerging ceftolozane/tazobactam resistance, in order to preserve this valuable antipseudomonal agent.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Pseudomonas aeruginosa
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Proteínas de Bactérias
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Beta-Lactamases
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Cefalosporinas
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Farmacorresistência Bacteriana Múltipla
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Tazobactam
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Antibacterianos
Limite:
Humans
Idioma:
En
/
Es
Revista:
Enferm Infecc Microbiol Clin (Engl Ed)
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Espanha