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Antimicrobial Agents and Chemotherapy, November 2009, p. 4783-4788, Vol. 53, No. 11
0066-4804/09/$08.00+0     doi:10.1128/AAC.00574-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology and Mechanisms of Carbapenem Resistance in Pseudomonas aeruginosa{triangledown}

José-Manuel Rodríguez-Martínez, Laurent Poirel, and Patrice Nordmann*

Service de Bactériologie-Virologie, INSERM U914, Emerging Resistance to Antibiotics, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, Hôpital de Bicêtre, 94275 K.-Bicêtre, France

Received 29 April 2009/ Returned for modification 26 June 2009/ Accepted 27 August 2009

The contributions of different mechanisms of resistance to carbapenems among a collection of imipenem- and meropenem-nonsusceptible Pseudomonas aeruginosa isolates were investigated. This screening included the recently reported extended-spectrum cephalosporinases (ESACs) weakly hydrolyzing carbapenems. Eighty-seven percent of the studied isolates were resistant to imipenem. Genes encoding metallo-β-lactamases or carbapenem-hydrolyzing oxacillinases were not identified. The main mechanism associated with imipenem resistance was the loss of outer membrane protein OprD. Identification of overexpressed ESACs and loss of OprD were observed for 65% of the isolates, all being fully resistant to imipenem. Resistance to meropenem was observed in 78% of the isolates, with all but one also being resistant to imipenem. Overexpression of the MexAB-OprM, MexXY-OprM, or MexCD-OprJ efflux systems was observed in 60% of the isolates, suggesting the contribution of efflux mechanisms in resistance to meropenem. The loss of porin OprD and the overproduction of ESACs were observed in 100% and 92% of the meropenem-resistant isolates, respectively. P. aeruginosa can very often accumulate different resistance mechanisms, including ESAC production, leading to carbapenem resistance.

* Corresponding author. Mailing address: Service de Bactériologie-Virologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex, France. Phone: 33-1-45-21-36-32. Fax: 33-1-45-21-63-40. E-mail: nordmann.patrice{at}bct.aphp.fr

{triangledown} Published ahead of print on 8 September 2009.

Antimicrobial Agents and Chemotherapy, November 2009, p. 4783-4788, Vol. 53, No. 11
0066-4804/09/$08.00+0     doi:10.1128/AAC.00574-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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