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In vitro stepwise selection of resistance to quinolones, β-lactams and amikacin in nosocomial gram-negative bacilli

Schrittweise Selektion der Resistenz gegenüber Chinolonen, β-Laktam-Antibiotika und Amikacin bei gramnegativen Erregern nosokomialer Infektionen

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Summary

The ability of six antibiotics to produce resistance by stepwise selection on agar medium was assessed in 24 gram-negative rods.Escherichia coli was the strain least prone to selection of resistance, whereasPseudomonas aeruginosa frequently developed resistance to all antibiotics. When used alone, ciprofloxacin, pefloxacin, amikacin, ceftazidime and cefpirome were associated with a comparable risk of acquired resistance (in 14 to 17 out of 24 strains); imipenem selected resistant strains in 10/24 isolates (5/18 in non-pseudomonas strains). The number of strains exhibiting cross resistance with structurally unrelated antibiotics was 11 after pefloxacin treatment, eight after exposure to ciprofloxacin, six after ceftazidime, and one after imipenem or cefpirome. The combination of ciprofloxacin with amikacin was less efficient in reducing acquisition of resistance than the combination of ciprofloxacin with a beta-lactam: ciprofloxacin plus cefpirome was especially potent in this respect.

Zusammenfassung

Durch die schrittweise Selektion auf Agarmedium wurde die Fähigkeit von sechs Antibiotika zur Induktion von Resistenz bei 24 gramnegativen Stäbchen geprüft. BeiEscherichia coli war die Resistenzentwicklung durch Selektion weniger ausgeprägt,Pseudomonas aeruginosa hatte hingegen eine ausgeprägte Neigung zur Resistenzentwicklung gegen alle getesteten Antibiotika. Bei Einsatz als Einzelsubstanzen waren Ciprofloxacin, Pefloxacin, Amikacin, Ceftazidim und Cefpirom mit einem vergleichbaren Risiko erworbener Resistenz (bei 14 bis 17 von 24 der getesteten Stämme) assoziiert. Imipenem selektierte resistente Stämme von 10 der 24 Isolate (5/18 der Nicht-Pseudomonas-Stämme). Nach Behandlung mit Pefloxacin entwickelten 11 Stämme eine Kreuzresistenz mit strukturell unverwandten Antibiotika; nach Exposition gegenüber Ciprofloxacin waren es acht, nach Ceftazidim sechs und nach Imipenem oder Cefpirom einer. Die Kombination von Ciprofloxacin mit Amikacin hatte weniger Potential, die Resistenzentwicklung zu verhindern als die Kombination von Ciprofloxacin mit einem β-Laktam-Antibiotikum. Ciproflox-acin plus Cefpirom war in dieser Hinsicht besonders wirksam.

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Authors and Affiliations

  1. Dept. of Genetics and Microbiology, Centre Médical Universitaire, University of Geneva, Switzerland

    M. Michéa-Hamzehpour Ph. D., Anneliese Kahr &  J. -C. Pechère M. D.

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  1. M. Michéa-Hamzehpour Ph. D.
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  2. Anneliese Kahr
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  3. J. -C. Pechère M. D.
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Michéa-Hamzehpour, M., Kahr, A. & Pechère, J.C. In vitro stepwise selection of resistance to quinolones, β-lactams and amikacin in nosocomial gram-negative bacilli. Infection 22 (Suppl 2), S105–S110 (1994). https://doi.org/10.1007/BF01793574

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