Characterization of Pseudomonas aeruginosa isolates from patients with urinary tract infections during antibiotic therapy.
Characterization of Pseudomonas aeruginosa isolates from patients with urinary tract infections during antibiotic therapy.
复制标题
抗生素治疗期间尿路感染患者分离的铜绿假单胞菌的特征。
DOI：
10.1089/107662903765826831
复制
发表时间：
2003
影响因子：
2.6
通讯作者：
M. Maekawa
中科院分区：
文献类型：
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作者：
T. Horii;Hideaki Muramatsu;Motoki Morita;M. Maekawa
我们对来自5例尿路感染（uti）的一系列铜绿假单胞菌分离株的敏感性和基因型进行了分析，以评估碳青霉烯类耐药性的克隆转移。在一个案例中，一系列分离株对碳青霉烯类具有不同的敏感性模式，但具有相同的基因型。在另一个病例中，在9个月内从复发性尿路感染中分离出的4株铜绿假单胞菌基因型不同。尽管患者在隔离前未立即接受抗生素治疗，但对碳青霉烯类和头孢他啶的敏感性模式各不相同。对这两例外膜蛋白谱的进一步分析表明，OprD生产的损失导致所有碳青霉烯类耐药菌株对碳青霉烯类的敏感性降低。由于碳青霉烯耐药的分离株与碳青霉烯敏感的分离株相比，对左氧氟沙星和氯霉素没有交叉耐药，因此在这两种情况下，OprD产量的减少可能是由于OprD基因失活所致。在另一个病例中，所有分离株对碳青霉烯类和头孢他啶的敏感性相似，并且在间歇性使用抗生素超过5个月期间具有相同的基因型。在两个病例中，一个疗程的抗生素治疗导致铜绿假单胞菌的根除。我们的研究结果表明，铜绿假单胞菌碳青霉烯耐药性的克隆转移可能是由于抗生素治疗过程中OprD的丢失。因此，临床医生监测治疗过程中分离的铜绿假单胞菌对抗生素，特别是碳青霉烯类药物的敏感性是很重要的。
We characterized susceptibilities and genotypes in a series of Pseudomonas aeruginosa isolates from five cases of urinary tract infections (UTIs) to evaluate clonal shifts of carbapenem resistance. In one case, a series of isolates showed different susceptibility patterns for carbapenems but an identical genotype. In another case, genotypes varied among 4 P. aeruginosa isolates from recurrent UTIs over 9 months. Although the patient had been treated with no antibiotic immediately before isolation, the susceptibility patterns for carbapenems and ceftazidime varied. Further analysis in these two cases of outer membrane protein profiles showed that loss of OprD production resulted in reduced susceptibilities to carbapenems in all of the carbapenem-resistant isolates. Loss of OprD production was likely due to oprD gene inactivation in both of cases, since the carbapenem-resistant isolates showed no cross resistance to levofloxacin and chloramphenicol compared with the carbapenem-susceptible isolates. There was another case in which all isolates showed similar susceptibility patterns for carbapenems and ceftazidime, and an identical genotype during the intermittent use of antibiotics over 5 months. In two cases, a single course of antibiotic therapy resulted in eradication of P. aeruginosa. Our results suggest that clonal shifts of carbapenem resistance in P. aeruginosa may result from loss of OprD during antibiotic treatment. Therefore, it is important for clinicians to monitor susceptibilities to antibiotics, especially carbapenems, in P. aeruginosa isolated during therapy.
Shintaro Ito 等人：“兔子大脑皮层初级体感皮层中切牙和磨牙牙周膜机械敏感神经元的反应”日本基础牙科医学会杂志 41(s)。
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