Carbapenems resistance in Pseudomonas aeruginosa during a 10-year period at Rawson Hospital

Authors

  • Luisa A. Orecchini Unidad de Microbiología, Hospital Rawson, Córdoba.
  • Teresa López Unidad de Microbiología, Hospital Rawson, Córdoba.
  • Ana Littvik Unidad de Microbiología, Hospital Rawson, Córdoba.

DOI:

https://doi.org/10.31053/1853.0605.v67.n4.22565

Keywords:

carbapenems, pseudomonas aeruginosa

Abstract

Backgrounds: Pae is a non-fermenting, Gram-negative bacillus that is associated with nosocomial infections and can easily be transmitted through the hands of health staff from patient to patient. Pae has a wide variety of natural resistance mechanisms and a great capacity to acquire new resistance mechanisms or to increase the expression of their natural resistance. Carbapenems resistance may be offered by impermeability mechanisms, increase in the efflux or enzymatic pump (production of carbapenemases).

Purpose: To determine prevailing carbapenems resistance mechanisms in Pae and their evolution.

Materials and methods: 372 Pae strains were collected during a ten-year period. The strains were identified through biochemical tests and performed a sensitivity test through diffusion and microbiological method.

Results: carbapenems resistance mechanisms for efflux in the year 2000 were, 50%; 2001 16.6%, 2002 6.3%, 2003 23.9%, 2004 18%, 2005 8.8%, 2006 17.8%, 2007 31.8%, 2008 2.5%, 2009 5.2%. As regards impermeability: 2000 33%, 2001 21.4%, 2002 8.5%, 2003 30.4%, 2004 14.7%, 2005 28.8%, 2006 23.5%, 2007 13.6%, 2008 2.5%, 2009 5.2%. The microbiological test was negative for all studied strains.

Conclusion: carbapenems resistance during this period was offered by impermeability and an increase in the expression of the efflux mechanism, not by enzymatic mechanism in our hospital. This is a very important issue from an epidemiological point of view because of the rapid horizontal transmission of the strains with this resistance mechanism.

Downloads

Download data is not yet available.

References

Paterson D. The Epidemiological Profile of Infections with Multidrug-Resistant Pseudomonas aeruginosa and Acinetobacter Species. Clinical Infectious Diseases 2006; 43:S43–8.

Bertrand X., Bailly P., Blasco G., Balvay P., Boillot A., Talon D. Large Outbreak in a Surgical Intensive Care Unit of Colonization or Infection with Pseudomonas aeruginosa that Overexpressed an Active Efflux Pump. Clinical Infectious Diseases 2000; 31:e9–14.

Livermore D. Multiple Mechanisms of Antimicrobial Resistance in Pseudomonas aeruginosa: Our Worst Nightmare?. Clinical Infectious Diseases 2002; 34:634–40.

Laupland K., Parkins M., Church D., Gregson D., Louie T., Conly J., Elsayed S., Pitout J. Population-Based Epidemiological Study of Infections Caused by Carbapenem-Resistant Pseudomonas aeruginosa in the Calgary Health Region: Importance of Metallo-b-Lactamase (MBL)–Producing Strains. The Journal of Infectious Diseases 2005; 192:1606–12.

Bonomo R., Szabo D. Mechanisms of Multidrug Resistance in Acinetobacter Species and Pseudomonas aeruginosa. Clinical Infectious Diseases 2006; 43:S49

Wolter D., Acquazzino D., Goering R., Sammut P., Khalaf N., Hanson N. Emergence of Carbapenem Resistance in Pseudomonas aeruginosa Isolates from a Patient with Cystic Fibrosis in the Absence of Carbapenem Therapy. Clinical Infectious Diseases 2008; 46:e137–41.

Lister P., Wolter D. Levofloxacin-Imipenem Combination Prevents the Emergence of Resistance among Clinical Isolates of Pseudomonas aeruginosa Clinical Infectious Diseases 2005; 40:S105–14.

Rice L. Challenges in Identifying New Antimicrobial Agents Effective for Treating Infections with Acinetobacter baumannii and Pseudomonas aeruginosa. Clinical Infectious Diseases 2006; 43:S100–5.

Paterson D. Serious Infections in the Intensive Care Unit: Pseudomonas aeruginosa and Acinetobacter baumannii. Clinical Infectious Diseases 2006; 43:S41–2.

Yoichi Hirakata, Toshiyuki Yamaguchi,a Michiko Nakano, Koichi Izumikawa, Mariko Mine, Shiho Aoki, Akira Kondoh, Junichi Matsuda, Mitsukuni Hirayama, Katsunori Yanagihara, Yoshitsugu Miyazaki, Kazunori Tomono, Yasuaki Yamada, Shimeru Kamihira, and Shigeru Kohno. Clinical and Bacteriological Characteristics of IMP-Type Metallo-b-Lactamase–Producing Pseudomonas aeruginosa. Clinical Infectious Diseases 2003; 37:26–32.

Fritsche T., Sader H., Toleman M., Timothy R. Walsh T., Jones R. Emerging Metallo-b-Lactamase–Mediated Resistances: A Summary Report from the Worldwide SENTRY Antimicrobial Surveillance Program. Clinical Infectious Diseases 2005; 41:S276–8.

Queenan A., Bush K. Carbapenemases: the Versatile Lactamases. CLINICAL MICROBIOLOGY REVIEWS, July 2007, p. 440–458.

Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Disk Susceptibility Testsc Approved Standard. Tenth edition. 2009

WHONET. Programa de vigilancia de Resistencia de la OMS. John Stelling, MD, MPH. Collaborating Centre for Surveillance of Antimicrobial Resistance Brigham and Women’s Hospital, Boston.

Bauer, Kirby. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45: 493-496.

Marchiaro P., Mussi M., Ballerini V., Pasteran F., Viale A., Vila A., Limansky A. Sensitive EDTA-Based Microbiological Assays for Detection of Metallo-_-Lactamases in Nonfermentative Gram-Negative Bacteria. JOURNAL OF CLINICAL MICROBIOLOGY, Nov. 2005, p. 5648–5652.

Pasteran F., Faccone D., Petroni A., Rapoport M., Galas M., Vázquez M., Procopio A. Novel Variant (blaVIM-11) of the Metallo-_-Lactamase blaVIM Family in a GES-1 Extended-Spectrum-_-Lactamase-Producing Pseudomonas aeruginosa Clinical Isolate in Argentina. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Jan. 2005, p. 474–475.

Santella G., Cuirolo A., Almuzara M., Palombarani S., Sly G., Radice M., Gutkind G. Full Resistance and Decreased Susceptibility to Carbapenems in IMP-13-Producing Pseudomonas aeruginosa Isolates from an Outbreak. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Mar. 2010, p. 1381–1382.

Tam V., Chang K., Abdelraouf K., Brioso C., Ameka M., McCaskey L., Weston J., Caeiro J., Garey K. Prevalence, Resistance Mechanisms, and Susceptibility of Multidrug-Resistant Bloodstream Isolates of Pseudomonas aeruginosa. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Mar. 2010, p. 1160–1164

Rodríguez-Martínez J. M., Poirel L., Nordmann P. Molecular Epidemiology and Mechanisms of Carbapenem Resistance in Pseudomonas aeruginosa. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Nov. 2009, p. 4783–4788.

Castanheira M., Bell J., Turnidge J., Mathai D., Jones R. Carbapenem Resistance among Pseudomonas aeruginosa Strains from India: Evidence for Nationwide Endemicity of Multiple Metallo-_-Lactamase Clones (VIM-2, -5, -6, and -11 and the Newly Characterized VIM-18). ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Mar. 2009, p. 1225–1227.

Sung-Pin Tseng, Jui-Chang Tsai, Lee-Jene Teng and Po-Ren Hsueh. Dissemination of transposon Tn6001 in carbapenem-non-susceptible and extensively drug-resistant Pseudomonas aeruginosa in Taiwan. Journal of Antimicrobial Chemotherapy (2009) 64, 1170–1174.

Published

2010-12-07

How to Cite

1.
Orecchini LA, López T, Littvik A. Carbapenems resistance in Pseudomonas aeruginosa during a 10-year period at Rawson Hospital. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2010 Dec. 7 [cited 2024 May 20];67(4):135-40. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/22565

Issue

Section

Original Papers