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Tytuł:
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Distinct epidemiology and resistance mechanisms affecting ceftolozane/tazobactam in Pseudomonas aeruginosa isolates recovered from ICU patients in Spain and Portugal depicted by WGS.
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Autorzy:
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Hernández-García M; Servicio de Microbiología, Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.
García-Castillo M; Servicio de Microbiología, Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.
García-Fernández S; Servicio de Microbiología, Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.
Melo-Cristino J; Serviço de Microbiologia Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
Pinto MF; Laboratório de Microbiologia, Serviço de Patologia Clínica, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal.
Gonçalves E; Laboratório de Microbiologia Clínica Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Alves V; Laboratório de Microbiologia, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.
Vieira AR; Serviço de Patologia Clínica, Centro Hospitalar Universitário São João, Porto, Portugal.
Ramalheira E; Serviço Patologia Clínica, Hospital Infante Dom Pedro, Aveiro, Portugal.
Sancho L; Serviço de Patologia Clínica, Hospital Prof. Dr. Fernando da Fonseca, Amadora, Portugal.
Diogo J; Serviço de Microbiologia, Hospital Garcia de Orta, Almada, Portugal.
Ferreira R; Serviço de Patologia Clínica-Microbiologia-CHUA-Unidade de Portimão, Portimão, Portugal.
Silva T; Serviço de Microbiologia do Centro Hospitalar Universitário do Porto, Porto, Portugal.
Chaves C; Serviço de Microbiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
Bou G; Servicio de Microbiología, Hospital Universitario A Coruña, A Coruña, Spain.
Cercenado E; Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Delgado-Valverde M; UGC Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Sevilla, Spain.
Oliver A; Servicio de Microbiología, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
Pitart C; Servicio de Microbiología, Hospital Clínic i Provincial, Barcelona, Spain.
Rodríguez-Lozano J; Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Tormo N; Servicio de Microbiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
Romano J; MSD Portugal, Paço de Arcos, Portugal.
Pássaro L; MSD Portugal, Paço de Arcos, Portugal.
Paixão L; MSD Portugal, Paço de Arcos, Portugal.
López-Mendoza D; Departamento Médico, MSD España, Madrid, Spain.
Díaz-Regañón J; Departamento Médico, MSD España, Madrid, Spain.
Cantón R; Servicio de Microbiología, Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.
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Corporate Authors:
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STEP and SUPERIOR study groups
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Źródło:
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The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2021 Jan 19; Vol. 76 (2), pp. 370-379.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 1997- : London : Oxford University Press
Original Publication: London, New York, Academic Press.
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MeSH Terms:
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Pseudomonas Infections*/drug therapy
Pseudomonas Infections*/epidemiology
Pseudomonas aeruginosa*/genetics
Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Cephalosporins/pharmacology ; Drug Resistance, Multiple, Bacterial/genetics ; Humans ; Intensive Care Units ; Microbial Sensitivity Tests ; Portugal/epidemiology ; Spain/epidemiology ; Tazobactam/pharmacology
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Contributed Indexing:
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Investigator: J Melo-Cristino; MF Pinto; C Marcelo; H Peres; I Lourenço; I Peres; J Marques; O Chantre; T Pina; E Gonçalves; C Toscano; V Alves; M Ribeiro; E Costa; AR Vieira; S Ferreira; R Diaz; E Ramalheira; S Schäfer; L Tancredo; L Sancho; A Rodrigues; J Diogo; R Ferreira; H Ramos; T Silva; D Silva; C Chaves; C Queiroz; A Nabiev; L Pássaro; L Paixao; J Romano; C Moura
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Substance Nomenclature:
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0 (Anti-Bacterial Agents)
0 (Cephalosporins)
37A4IES95Q (ceftolozane)
SE10G96M8W (Tazobactam)
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Entry Date(s):
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Date Created: 20201025 Date Completed: 20210630 Latest Revision: 20210630
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Update Code:
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20240105
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DOI:
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10.1093/jac/dkaa430
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PMID:
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33099623
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Objectives: To analyse the epidemiology, the resistome and the virulome of ceftolozane/tazobactam-susceptible or -resistant Pseudomonas aeruginosa clinical isolates recovered from surveillance studies in Portugal (STEP, 2017-18) and Spain (SUPERIOR, 2016-17).
Methods: P. aeruginosa isolates were recovered from intra-abdominal, urinary tract and lower respiratory tract infections in ICU patients admitted to 11 Portuguese and 8 Spanish hospitals. MICs were determined (ISO-standard broth microdilution, EUCAST 2020 breakpoints). A subset of 28 ceftolozane/tazobactam-resistant P. aeruginosa isolates were analysed and compared with 28 ceftolozane/tazobactam-susceptible P. aeruginosa strains by WGS.
Results: Clonal complex (CC) 235 (27%) and CC175 (18%) were the most frequent, followed by CC244 (13%), CC348 (9%), CC253 (5%) and CC309 (5%). Inter-hospital clonal dissemination was observed, limited to a geographical region (CC235, CC244, CC348 and CC253 in Portugal and CC175 and CC309 in Spain). Carbapenemases were detected in 25 isolates (45%): GES-13 (13/25); VIM type (10/25) [VIM-2 (4/10), VIM-20 (3/10), VIM-1 (2/10) and VIM-36 (1/10)]; and KPC-3 (2/25). GES-13-CC235 (13/15) and VIM type-CC175 (5/10) associations were observed. Interestingly, KPC-3 and VIM-36 producers showed ceftolozane/tazobactam-susceptible phenotypes. However, ceftolozane/tazobactam resistance was significantly associated with GES-13 and VIM-type carbapenemase production. Six non-carbapenemase producers also displayed ceftolozane/tazobactam resistance, three of them showing known ceftolozane/tazobactam resistance-associated mutations in the PBP3 gene, ftsI (R504C and F533L). Overall, an extensive virulome was identified in all P. aeruginosa isolates, particularly in carbapenemase-producing strains.
Conclusions: GES-13-CC235 and VIM type-CC175 were the most frequent MDR/XDR P. aeruginosa clones causing infections in Portuguese and Spanish ICU patients, respectively. Ceftolozane/tazobactam resistance was mainly due to carbapenemase production, although mutations in PBP-encoding genes may additionally be involved.
(© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
