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Titolo:
Nosocomial outbreak due to a multiresistant strain of Pseudomonas aeruginosa P12: Efficacy of cefepime-amikacin therapy and analysis of beta-lactam resistance
Autore:
Dubois, V; Arpin, C; Melon, M; Melon, B; Andre, C; Frigo, CC; Quentin, C;
Indirizzi:
Univ Bordeaux 2, Fac Pharm, Microbiol Lab, F-33076 Bordeaux, France Univ Bordeaux 2 Bordeaux France F-33076 ol Lab, F-33076 Bordeaux, France Hop Pau, Microbiol Lab, Pau, France Hop Pau Pau FranceHop Pau, Microbiol Lab, Pau, France Hop Pau, Serv Reanimat, Pau, France Hop Pau Pau FranceHop Pau, Serv Reanimat, Pau, France
Titolo Testata:
JOURNAL OF CLINICAL MICROBIOLOGY
fascicolo: 6, volume: 39, anno: 2001,
pagine: 2072 - 2078
SICI:
0095-1137(200106)39:6<2072:NODTAM>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTENSIVE-CARE UNIT; MEXA-MEXB-OPRM; MULTIDRUG EFFLUX SYSTEM; OUTER-MEMBRANE PROTEIN; RESPIRATORY-INFECTIONS; PERMEABILITY BARRIERS; ACTIVE EFFLUX; NFXB MUTANTS; ANTIBIOTICS; EXPRESSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Dubois, V Univ Bordeaux 2, Fac Pharm, Microbiol Lab, 146 Rue Leo Saignat, F-33076 Bordeaux, France Univ Bordeaux 2 146 Rue Leo Saignat Bordeaux France F-33076 nce
Citazione:
V. Dubois et al., "Nosocomial outbreak due to a multiresistant strain of Pseudomonas aeruginosa P12: Efficacy of cefepime-amikacin therapy and analysis of beta-lactam resistance", J CLIN MICR, 39(6), 2001, pp. 2072-2078

Abstract

Over a 3-year period, 67 patients of the Hospital of Pau (Pau, Prance), including 64 patients hospitalized in the adult intensive care unit (ICU), were colonized and/or infected by strains of Pseudomonas aeruginosa P12, resistant to all potentially active antibiotics except colistin. Most patients were mechanically ventilated and presented respiratory tract infections. Since cefepime and amikacin were the least inactive antibiotics by MIC determination, all ICU patients were treated with this combination, and most of them benefited. Cefepime-amikacin was found highly synergistic in vitro. Ribotyping and arbitrary primer-PCR analysis confirmed the presence of a single clonal isolate. Isoelectrofocusing revealed that the epidemic strain produced large amounts of the chromosomal cephalosporinase and an additional enzyme with a pI of 5.7, corresponding to PSE-1, as demonstrated by PCR and sequencing. Outer membrane protein profiles on sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed the absence of a ca. 46-kDa protein, likely to be OprD, and increased production of two ca. 49- and 50-kDa proteins, consistent with the outer membrane components of the efflux systems, MexAB-OprM and MexEF-OprN. Thus, we report here a nosocomial outbreak due to multiresistant P. aeruginosa P12 exhibiting at least four mechanisms of beta-lactam resistance, i.e., production of the penicillinase PSE-1, overproduction of the chromosomal cephalosporinase, loss of OprD, and overexpressionof efflux systems, associated with a better activity of cefepime than ceftazidime.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 17:54:31