Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing
This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) <i>Pseudomonas aeruginosa</i> isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic ch...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-04-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/9/4/153 |
| _version_ | 1827719533879623680 |
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| author | Márió Gajdács |
| author_facet | Márió Gajdács |
| author_sort | Márió Gajdács |
| collection | DOAJ |
| description | This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) <i>Pseudomonas aeruginosa</i> isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic characterization of the possible resistance mechanisms in these isolates. Isolates and data were collected regarding <i>P. aeruginosa</i> UTIs corresponding to the period between 2008 and 2017. Susceptibility testing was performed using the Kirby–Bauer disk diffusion method; minimum inhibitory concentrations (MICs) of the isolates were determined using E-tests. The phenotypic detection of ampicillin C-type (AmpC) β-lactamases, efflux pump overexpression and carbapenemase production was also performed. <i>P. aeruginosa</i> represented <i>n</i> = 575 (2.72% ± 0.64%) from outpatient, and <i>n</i> = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, <i>n</i> = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, <i>n</i> = (64.34%) were also resistant to ciprofloxacin; <i>n</i> = (60.17%) to gentamicin/tobramycin; <i>n</i> = (58.51%) to levofloxacin; and <i>n</i> = (27.57%) to amikacin. From among the carbapenem-resistant isolates, <i>n</i> = 56 (15.59%) isolates were multidrug-resistant, while <i>n</i> = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (<i>n</i> = 57), overexpression of AmpC was observed in <i>n</i> = 7 cases (12.28%); carbapenemase production in <i>n</i> = 4 (7.02%); while overexpression of efflux pumps was present in <i>n</i> = 31 (54.39%) isolates. To spare last-resort agents, e.g., colistin, the use of broad-spectrum cephalosporins or safe, alternative agents should be considered in these infections. |
| first_indexed | 2024-03-10T20:45:30Z |
| format | Article |
| id | doaj.art-fab9487c1127487ba6a8557bc15ffde4 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T20:45:30Z |
| publishDate | 2020-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-fab9487c1127487ba6a8557bc15ffde42023-11-19T20:22:50ZengMDPI AGAntibiotics2079-63822020-04-019415310.3390/antibiotics9040153Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin SparingMárió Gajdács0Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, HungaryThis paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) <i>Pseudomonas aeruginosa</i> isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic characterization of the possible resistance mechanisms in these isolates. Isolates and data were collected regarding <i>P. aeruginosa</i> UTIs corresponding to the period between 2008 and 2017. Susceptibility testing was performed using the Kirby–Bauer disk diffusion method; minimum inhibitory concentrations (MICs) of the isolates were determined using E-tests. The phenotypic detection of ampicillin C-type (AmpC) β-lactamases, efflux pump overexpression and carbapenemase production was also performed. <i>P. aeruginosa</i> represented <i>n</i> = 575 (2.72% ± 0.64%) from outpatient, and <i>n</i> = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, <i>n</i> = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, <i>n</i> = (64.34%) were also resistant to ciprofloxacin; <i>n</i> = (60.17%) to gentamicin/tobramycin; <i>n</i> = (58.51%) to levofloxacin; and <i>n</i> = (27.57%) to amikacin. From among the carbapenem-resistant isolates, <i>n</i> = 56 (15.59%) isolates were multidrug-resistant, while <i>n</i> = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (<i>n</i> = 57), overexpression of AmpC was observed in <i>n</i> = 7 cases (12.28%); carbapenemase production in <i>n</i> = 4 (7.02%); while overexpression of efflux pumps was present in <i>n</i> = 31 (54.39%) isolates. To spare last-resort agents, e.g., colistin, the use of broad-spectrum cephalosporins or safe, alternative agents should be considered in these infections.https://www.mdpi.com/2079-6382/9/4/153<i>Pseudomonas aeruginosa</i>urinary tract infectioncarbapenemcephalosporinresistanceuncommon phenotype |
| spellingShingle | Márió Gajdács Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing Antibiotics <i>Pseudomonas aeruginosa</i> urinary tract infection carbapenem cephalosporin resistance uncommon phenotype |
| title | Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing |
| title_full | Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing |
| title_fullStr | Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing |
| title_full_unstemmed | Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing |
| title_short | Carbapenem-Resistant but Cephalosporin-Susceptible <i>Pseudomonas aeruginosa</i> in Urinary Tract Infections: Opportunity for Colistin Sparing |
| title_sort | carbapenem resistant but cephalosporin susceptible i pseudomonas aeruginosa i in urinary tract infections opportunity for colistin sparing |
| topic | <i>Pseudomonas aeruginosa</i> urinary tract infection carbapenem cephalosporin resistance uncommon phenotype |
| url | https://www.mdpi.com/2079-6382/9/4/153 |
| work_keys_str_mv | AT mariogajdacs carbapenemresistantbutcephalosporinsusceptibleipseudomonasaeruginosaiinurinarytractinfectionsopportunityforcolistinsparing |