Spanish nationwide survey on Pseudomonas aeruginosa antimicrobial resistance mechanisms and epidemiology

作者：Ester del Barrio-Tofiño, Laura Zamorano, Sara Cortés-Lara, Carla López-Causapé, Irina Sánchez-Diener, Gabriel Cabot, Germán Bou, Luis Martı́nez-Martı́nez, Antonio Oliver, GEMARA-SEIMC/REIPI Pseudomonas study Group, Fátima Galán‐Sánchez, Irene Gracia, Manuel Antonio Agüero Rodríguez, L. Hibberd Martin, Juan Manuel Sánchez, Laura Viñuela, Ma Victoria García, José Antonio Lepe, Javier Aznar, Inma López-Hernández, Cristina Seral, Francisco Javier Castillo, Ana Isabel López‐Calleja, Carmen Aspíroz, Pedro de la Iglesia, Susana Sánchez Ramón, Elena Riera, María Cruz Pérez, Carmen Gallegos, J. H. Calvo, María Dolores Quesada, Francesc Marco, Yannick Hoyos, Juan Pablo Horcajada, Nieves Larrosa, Juan José González‐López, Fé Tubau, Sílvia Capilla, Mar Olga Pérez-Moreno, Ma José Centelles, Emma Padilla, Alba Rivera, Beatriz Mirelis, Raquel Elisa Rodríguez-Tarazona, Noelia Arenal-Andrés, María del Pilar Ortega, Gregoria Megías, Inmaculada García, Cristina Colmenarejo, José Carlos González, Nora Mariela Martínez, Bárbara Gomila, Salvador Giner, Nuria Tormo, Eugenio Garduño, José Andrés Agulla, Alejandro Seoane, J. Pita, Isabel Paz Vidal, David Mauricio Guzmán, Marta García, María Luisa Pérez del Molino, Gema Barbeito, Fernando Artiles, José Manuel Azcona, Yolanda Sáenz, José A. Oteo, Ana Rodríguez González, Jennifer Villa, Fernando Cháves, Emilia Cercenado, Teresa Alarcón, Nelly Daniela Zurita, Irene Merino, María Isabel Morosini, Rafael Cantón, María Isabel Sánchez, Laura Moreno, Genoveva Yagüe, José Leiva, José Luís González Barrios, Andrés Canut, Jesús Oteo · 发表于：Journal of Antimicrobial Chemotherapy · 年份：2019 · DOI：10.1093/jac/dkz147 · 被引用次数：153 · 研究领域：Antibiotic Resistance in Bacteria、Infections and bacterial resistance、Antibiotic Use and Resistance

OBJECTIVES: To undertake a Spanish nationwide survey on Pseudomonas aeruginosa molecular epidemiology and antimicrobial resistance. METHODS: Up to 30 consecutive healthcare-associated P. aeruginosa isolates collected in 2017 from each of 51 hospitals were studied. MICs of 13 antipseudomonal agents were determined by broth microdilution. Horizontally acquired β-lactamases were detected by phenotypic methods and PCR. Clonal epidemiology was evaluated through PFGE and MLST; at least one XDR isolate from each clone and hospital (n = 185) was sequenced. RESULTS: The most active antipseudomonals against the 1445 isolates studied were colistin and ceftolozane/tazobactam (both 94.6% susceptible, MIC50/90 = 1/2 mg/L) followed by ceftazidime/avibactam (94.2% susceptible, MIC50/90 = 2/8 mg/L). Up to 252 (17.3%) of the isolates were XDR. Carbapenemases/ESBLs were detected in 3.1% of the isolates, including VIM, IMP, GES, PER and OXA enzymes. The most frequent clone among the XDR isolates was ST175 (40.9%), followed by CC235 (10.7%), ST308 (5.2%) and CC111 (4.0%). Carbapenemase production varied geographically and involved diverse clones, including 16.5% of ST175 XDR isolates. Additionally, 56% of the sequenced XDR isolates showed horizontally acquired aminoglycoside-modifying enzymes, which correlated with tobramycin resistance. Two XDR isolates produced QnrVC1, but fluoroquinolone resistance was mostly caused by QRDR mutations. Beyond frequent mutations (>60%) in OprD and AmpC regulator...