In vivo selection of a target/efflux double mutant of Pseudomonas aeruginosa by ciprofloxacin therapy.
In vivo selection of a target/efflux double mutant of Pseudomonas aeruginosa by ciprofloxacin therapy.
复制标题
通过环丙沙星治疗体内选择铜绿假单胞菌的靶标/外排双突变体。
DOI：
10.1093/jac/48.4.553
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
É. Bingen
中科院分区：
文献类型：
--
作者：
I. Thomas;G. Couetdic;O. Clermont;N. Brahimi;P. Plésiat;É. Bingen
我们报告出现后4天的环丙沙星单药治疗的双突变的铜绿假单胞菌过表达多药外排系统MexAB-OprM和窝藏gyrB基因突变。与其初始敏感对应物相比，该突变体对大多数测试的β-内酰胺类抗生素（替卡西林的16 x MIC）和环丙沙星（128 x MIC）的耐药性显著增加。头孢他啶和阿米卡星联合治疗最终根除了耐药菌株，治愈了患者的感染。该病例说明了铜绿假单胞菌菌株如何通过结合外排机制和靶点改变而产生高水平的氟喹诺酮耐药性。
We report the emergence after 4 days of ciprofloxacin monotherapy of a double mutant of Pseudomonas aeruginosa overexpressing the multidrug efflux system MexAB-OprM and harbouring a mutation in the gyrB gene. Compared with its initial susceptible counterpart, this mutant exhibited a significant increase in resistance to most of the beta-lactam antibiotics tested (16 x MIC of ticarcillin) and to ciprofloxacin (128 x MIC). Combined ceftazidime and amikacin therapy finally eradicated the resistant isolate and cured the patient of his infection. This case illustrates how strains of P. aeruginosa may develop high levels of fluoroquinolone resistance by combining efflux mechanisms and target alterations.