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Mechanisms of Resistance

Carbapenem Resistance Mechanisms in Pseudomonas aeruginosa Clinical Isolates

Hyunjoo Pai, Jong-Won Kim, Jungmin Kim, Ji Hyang Lee, Kang Won Choe, Naomasa Gotoh
Hyunjoo Pai
Division of Infectious Disease, Department of Internal Medicine, and
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Jong-Won Kim
Department of Clinical Pathology, Sungkyunkwan University College of Medicine, and
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Jungmin Kim
Department of Microbiology, College of Medicine, University of Dankook, Chonan,
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Ji Hyang Lee
Division of Infectious Disease, Department of Internal Medicine, and
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Kang Won Choe
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, and
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Naomasa Gotoh
Department of Microbiology, Kyoto Pharmaceutical University, Kyoto, Japan
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DOI: 10.1128/AAC.45.2.480-484.2001
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ABSTRACT

In order to define the contributions of the mechanisms for carbapenem resistance in clinical strains of Pseudomonas aeruginosa, we investigated the presence of OprD, the expressions of the MexAB-OprM and MexEF-OprN systems, and the production of the β-lactamases for 44 clinical strains. All of the carbapenem-resistant isolates showed the loss of or decreased levels of OprD. Three strains overexpressed the MexAB-OprM efflux system by carrying mutations inmexR. These three strains had the amino acid substitution in MexR protein, Arg (CGG) → Gln (CAG), at the position of amino acid 70. None of the isolates, however, expressed the MexEF-OprN efflux system. For the characterization of β-lactamases, at least 13 isolates were the depressed mutants, and 12 strains produced secondary β-lactamases. Based on the above resistance mechanisms, the MICs of carbapenem for the isolates were analyzed. The MICs of carbapenem were mostly determined by the expression of OprD. The MICs of meropenem were two- to four-fold increased for the isolates which overexpressed MexAB-OprM in the background of OprD loss. However, the elevated MICs of meropenem for some individual isolates could not be explained. These findings suggested that other resistance mechanisms would play a role in meropenem resistance in clinical isolates of P. aeruginosa.

  • Copyright © 2001 American Society for Microbiology
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Carbapenem Resistance Mechanisms in Pseudomonas aeruginosa Clinical Isolates
Hyunjoo Pai, Jong-Won Kim, Jungmin Kim, Ji Hyang Lee, Kang Won Choe, Naomasa Gotoh
Antimicrobial Agents and Chemotherapy Feb 2001, 45 (2) 480-484; DOI: 10.1128/AAC.45.2.480-484.2001

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Carbapenem Resistance Mechanisms in Pseudomonas aeruginosa Clinical Isolates
Hyunjoo Pai, Jong-Won Kim, Jungmin Kim, Ji Hyang Lee, Kang Won Choe, Naomasa Gotoh
Antimicrobial Agents and Chemotherapy Feb 2001, 45 (2) 480-484; DOI: 10.1128/AAC.45.2.480-484.2001
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KEYWORDS

Pseudomonas Infections
Pseudomonas aeruginosa

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