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Brief Report

Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing

1
Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary
2
Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Hungary
Received: 27 February 2020 / Revised: 13 March 2020 / Accepted: 25 March 2020 / Published: 1 April 2020
This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) Pseudomonas aeruginosa 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 P. aeruginosa 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. P. aeruginosa represented n = 575 (2.72% ± 0.64%) from outpatient, and n = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, n = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, n = (64.34%) were also resistant to ciprofloxacin; n = (60.17%) to gentamicin/tobramycin; n = (58.51%) to levofloxacin; and n = (27.57%) to amikacin. From among the carbapenem-resistant isolates, n = 56 (15.59%) isolates were multidrug-resistant, while n = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (n = 57), overexpression of AmpC was observed in n = 7 cases (12.28%); carbapenemase production in n = 4 (7.02%); while overexpression of efflux pumps was present in n = 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. View Full-Text
Keywords: Pseudomonas aeruginosa; urinary tract infection; carbapenem; cephalosporin; resistance; uncommon phenotype; phenotypic; efflux pump; ampicillin C (AmpC) Pseudomonas aeruginosa; urinary tract infection; carbapenem; cephalosporin; resistance; uncommon phenotype; phenotypic; efflux pump; ampicillin C (AmpC)
MDPI and ACS Style

Gajdács, M. Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing. Antibiotics 2020, 9, 153. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9040153

AMA Style

Gajdács M. Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing. Antibiotics. 2020; 9(4):153. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9040153

Chicago/Turabian Style

Gajdács, Márió. 2020. "Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing" Antibiotics 9, no. 4: 153. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9040153

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