https://scholars.lib.ntu.edu.tw/handle/123456789/528273
標題: | Overproduction of active efflux pump and variations of OprD dominate in imipenem-resistant Pseudomonas aeruginosa isolated from patients with bloodstream infections in Taiwan | 作者: | Kao C.-Y. Chen S.-S. Hung K.-H. Wu H.-M. PO-REN HSUEH Yan J.-J. Wu J.-J. |
公開日期: | 2016 | 卷: | 16 | 期: | 1 | 來源出版物: | BMC Microbiology | 摘要: | Background: The emergence of imipenem-resistant Pseudomonas aeruginosa (IRPA) has become a great concern worldwide. The aim of this study was to investigate resistance mechanisms associated with bloodstream isolated IRPA strains in Taiwan. Results: A total of 78 non-duplicated IRPA isolates were isolated from patients with bloodstream infection. The average prevalence of imipenem-resistance in those isolates was 5.9 % during a 10-year longitudinal surveillance in Taiwan. PFGE results showed high clonal diversity among the 78 isolates. VIM-2, VIM-3, OXA-10, and OXA-17 β-lactamases were identified in 2 (2.6 %), 3 (3.8 %), 2 (2.6 %), and 1 (1.3 %) isolates, respectively. Active efflux pumps, AmpC β-lactamase overproduction, and extended-spectrum AmpC cephalosporinases (ESACs) were found in 58 (74.4 %), 25 (32.1 %) and 15 (19.2 %) of IRPA isolates, respectively. oprD mutations with amino acid substitution, shortened putative loop L7, premature stop codon caused by point mutation, frameshift by nucleotide insertion or deletion, and interruption by insertion sequence were found in 19 (24.4 %), 18 (23.1 %), 15 (19.2 %), 14 (17.9 %), and 10 (12.8 %) of isolates, respectively. Conclusions: This study suggests that alterations in the OprD protein and having an active efflux pump are the main mechanisms associated with bloodstream isolated IRPA. Overproduction of AmpC, ESACs, and the presence of VIM- and OXA-type β-lactamases play additional roles in reduced susceptibility to imipenem in P. aeruginosa isolates in Taiwan. ? 2016 The Author(s). |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/528273 | ISSN: | 1471-2180 | DOI: | 10.1186/s12866-016-0719-2 | SDG/關鍵字: | amikacin; aztreonam; beta lactamase; cefepime; ceftazidime; ciprofloxacin; cloxacillin; doripenem; gentamicin; imipenem; levofloxacin; meropenem; antiinfective agent; beta lactamase; imipenem; OprD protein, Pseudomonas aeruginosa; porin; stop codon; amino acid substitution; antibiotic sensitivity; Article; bacterial colonization; bacterial gene; bacterial strain; bacterium isolation; bloodstream infection; controlled study; disease surveillance; enzyme analysis; enzyme synthesis; genetic variation; human; microbial diversity; minimum inhibitory concentration; nonhuman; oprD gene; point mutation; Pseudomonas aeruginosa; sequence analysis; stop codon; bacteremia; biosynthesis; drug effects; genetics; indel mutation; isolation and purification; metabolism; microbial sensitivity test; microbiology; multidrug resistance; Pseudomonas aeruginosa; Pseudomonas infection; Taiwan; Amino Acid Substitution; Anti-Bacterial Agents; Bacteremia; beta-Lactamases; Codon, Terminator; Drug Resistance, Multiple, Bacterial; Humans; Imipenem; INDEL Mutation; Microbial Sensitivity Tests; Point Mutation; Porins; Pseudomonas aeruginosa; Pseudomonas Infections; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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