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Emergence of extensive-drug-resistant Pseudomonas aeruginosa in a French university hospital

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Abstract

The aim of this study was to describe the molecular epidemiology and the mechanisms of resistance to β-lactams of emerging extensive-drug-resistant Pseudomonas aeruginosa (XDRPA) in a tertiary-care university hospital over a three-year period. Analysis included antimicrobial susceptibility profiling and pulsed-field gel electrophoresis (PFGE). Resistance mechanisms to β-lactams were identified: production of naturally occurring and acquired β-lactamases, overproduction of MexAB-OprM and MexXY efflux systems and loss of porin OprD were assessed. Eighteen patients were colonised or infected with XDRPA which remained susceptible to colistin and, to a lesser extent, to rifampicin. β-lactam resistance was, in most cases, due to the overproduction of AmpC, overproduction of the MexXY efflux system and loss of porin OprD. One isolate produced the class D extended-spectrum oxacillinase (OXA-ESBL) Oxa-28, but none produced metallo-β-lactamase (MBL) or class A extended-spectrum β-lactamase (ESBL). The XDRPA clustered in eight PFGE patterns and both the acquisition and loss of resistance determinants was observed within a single clone during its spread. The emergence of XDRPA isolates in our university hospital has been characterised by genotypic heterogeneity, variation of mechanisms of resistance to β-lactams in a single clone and the predominance of chromosomally encoded resistance mechanisms

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Acknowledgements

We wish to thank Barbara Dehecq for the technical assistance and Thilo Köhler (Geneva, Switzerland) for the gift of mutant strain PT629.

Conflicts of interest

None to declare.

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Authors and Affiliations

  1. Service de Bactériologie, Centre Hospitalier Universitaire Besançon, Besançon, France

    L. Vettoretti, D. Hocquet, B. Dehecq & P. Plésiat

  2. Service d’Hygiène Hospitalière et d’Epidémiologie Moléculaire, Centre Hospitalier Universitaire Besançon, 25030, Besançon cedex, France

    N. Floret, D. Talon & X. Bertrand

  3. Centre National de Référence-Résistance chez P. aeruginosa, Centre Hospitalier Universitaire Besançon, Besançon, France

    L. Vettoretti, N. Floret, D. Hocquet, B. Dehecq, P. Plésiat, D. Talon & X. Bertrand

  4. UMR 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France

    D. Talon & X. Bertrand

Authors
  1. L. Vettoretti
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  2. N. Floret
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  3. D. Hocquet
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  4. B. Dehecq
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  5. P. Plésiat
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  6. D. Talon
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  7. X. Bertrand
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Correspondence to X. Bertrand.

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Vettoretti, L., Floret, N., Hocquet, D. et al. Emergence of extensive-drug-resistant Pseudomonas aeruginosa in a French university hospital. Eur J Clin Microbiol Infect Dis 28, 1217–1222 (2009). https://doi.org/10.1007/s10096-009-0767-8

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  • DOI: https://doi.org/10.1007/s10096-009-0767-8

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