Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance in Pseudomonas Aeruginosa.

Q3 Immunology and Microbiology Open Microbiology Journal Pub Date : 2017-05-31 eCollection Date: 2017-01-01 DOI:10.2174/1874285801711010092

Kosuke Kosai, Norihito Kaku, Naoki Uno, Tomomi Saijo, Yoshitomo Morinaga, Yoshifumi Imamura, Hiroo Hasegawa, Taiga Miyazaki, Koichi Izumikawa, Hiroshi Mukae, Katsunori Yanagihara

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Abstract

Background: Carbapenems, fluoroquinolones (FQs), and aminoglycosides (AGs) are key drugs for treating Pseudomonas aeruginosa infections, and accumulation of drug resistances make antibiotic therapy difficult.

Methods: We evaluated 169 patients with imipenem (IPM)-resistant P. aeruginosa and compared patient background and microbiological characteristics between groups with or without FQ resistance. Similar analyses were performed for AG.

Results: Of the 169 IPM-resistant strains, 39.1% showed resistance to FQs and 7.1% to AGs. The frequency of exposure to FQs within 90 days previously was higher in the group with FQ resistance (45.5%) than in the group without FQ resistance (13.6%). Similarly, 33.3% of patients in the group with AG resistance had been previously administered AGs, higher than the 7.6% of patients without AG resistance. Frequencies of metallo-β-lactamase (MBL) production were higher in the group with FQ or AG resistance (16.7% or 33.3%) than in the group without FQ or AG resistance (2.9% or 6.4%). Multivariate analyses showed exposures to FQs or AGs were related to the respective resistances. MBL production was a common factor for resistance to FQs or AGs, in addition to IPM-resistant P. aeruginosa.

Conclusion: As well as promoting appropriate use of antibiotics, MBL production should be detected as a target of intervention for infection control.

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铜绿假单胞菌除碳青霉烯类耐药外对氟喹诺酮类或氨基糖苷类耐药的危险因素

背景:碳青霉烯类、氟喹诺酮类(FQs)和氨基糖苷类(AGs)是治疗铜绿假单胞菌感染的关键药物，耐药积累给抗生素治疗带来困难。方法:我们评估了169例亚胺培南(IPM)耐药铜绿假单胞菌，并比较了有无FQ耐药组的患者背景和微生物学特征。对AG进行了类似的分析。结果:169株ipm耐药菌株中，FQs耐药率为39.1%，AGs耐药率为7.1%。FQ耐药组90天内接触FQ的频率(45.5%)高于无FQ耐药组(13.6%)。同样，33.3%的AG耐药组患者曾接受过AGs治疗，高于无AG耐药组患者的7.6%。金属β-内酰胺酶(MBL)产生频率在FQ或AG耐药组(16.7%或33.3%)高于不FQ或AG耐药组(2.9%或6.4%)。多变量分析显示，暴露于FQs或AGs与各自的抗性有关。除了抗ipm的铜绿假单胞菌外，MBL的产生是对FQs或AGs耐药的常见因素。结论:在促进合理使用抗生素的同时，应检测MBL的产生，并将其作为感染控制干预的目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Microbiology Journal Immunology and Microbiology-Immunology and Microbiology (all)

CiteScore

1.80

自引率

0.00%

发文量

期刊介绍： The Open Microbiology Journal is a peer-reviewed open access journal which publishes research articles, reviews/mini-reviews, case studies, guest edited thematic issues and short communications/letters covering theoretical and practical aspects of Microbial systematics, evolutionary microbiology, immunology, virology, parasitology , bacteriology, mycology, phycology, protozoology, microbial ecology, molecular biology, microbial physiology, biochemistry, microbial pathogenesis, host-microbe interaction, systems microbiology, synthetic microbiology, bioinformatics. The Open Microbiology Journal , a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and freely available to researchers worldwide.