TABLE 1.

Multiresistant P. aeruginosa strains from CF and non-CF patientsa

EpidemiologyPhenotypic test result(s)Genotypic test result(s)
StrainPatientMaterialWardType of wardCenterMutation frequencybCephalosporinase inhibition testMBL testEPI testChromosomal alteration(s) in indicated repressorAcquired resistance and integrase genes
MexRcNalCcNfxBcMexTcMexScMexZcOprDGyrAParC
From CF patients
    IASPUCFA1(3.26 ± 0.65) × 10−9Leu138Argd, deletion C595, frameshiftdDeletion bp 745-748, frameshiftThr83Ile
    IIASPUCFA1(3.56 ± 1.67) × 10−6NR+Gly71GluGln134stopdTrp138stop
    IIIBSPUCFA1(1.09 ± 0.21) × 10−5+NGTyr49CysdTrp277stop, Asp318AsnAsp87Asn
    IVCSPUCFA1(2.00 ± 0.19) × 10−6NRLeu123stopdTyr91stopAsp87Asn
    VDSPUCFN1(1.27 ± 0.93) × 10−5NR+Gly71GluLeu62Prod Arg186HisVal58Ala, Gly89Serd, Arg143GlndTrp138stopThr83Ile
    VIESPUCFA1(6.57 ± 1.14) × 10−7,+NGFunctionalGly68SerdArg65HisThr83Ile
    VIagSPUCF    3.61 × 10−9Val23GlydC insertion after A1205, frameshift
    VIIFSPUCFA1(2.50 ± 0.82) × 10−6++Val126GluGly71Glu, Arg209SerFunctionalPhe273Ileddeletion G142, frameshiftdThr83Val
    VIIagSPUCFFunctional Val199AlaThr83Ala
    VIIIGSPUCFA1(7.30 ± 4.91) × 10−7NGNGGly71Glu, Arg209SerThr32Iled, Ala175ValDeletion G1017, frameshiftThr83Ile
    IXHSPUCFA1(1.94 ± 0.24) × 10−6+Ser44PhedTrp277stopThr83Ile
    XISPUCFA1(5.85 ± 0.68) × 10−7+Asp155GlydG insertion after G635, frameshiftThr83Ile
    XIJSPUCFA1(1.43 ± 0.15) × 10−5, 1,71 × 10−7+Arg45LeudTrp277stopAsp87Asn
    XIIKSPUCFA2(1.20 ± 0.14) × 10−6++Val126GluGly71Glu, Arg209SerArg21His Asp56Glyd Ser167ProLeu138Argd, deletion bp 447-630, frameshiftdTrp277stopThr83Ile
From non-CF patients
    XIIILSPUMEDN1(8.03 ± 3.68) × 10−9++Gly71Glu, Arg209Serbp 318-592d,fTrp277stopThr83Ile
    XIVMSPUINFN1(1.47 ± 0.48) × 10−8+Deletion bp 491-496, frameshiftdTrp339stopThr83Ile
    XVNBALIDI2(3.06 ± 1.26) × 10−6+Leu138Arg, deletion bp 515-532, frameshiftdDeletion bp 155-167, frameshiftThr83Ile
    XVIOBALNEUI2(2.01 ± 0.66) × 10−8++Val126GluGly71GluDeletion C393, frameshiftThr83IleSer80Leuaac(6′)Ib′, intI1
    XVIIPSPUMEDI2(3.50 ± 0.66) × 10−8+Gly89Serd, Asp155GlydTrp138stopThr83IleaadA1, aadB, aphA1-IAB, intI1
    XVIIIQBLOMEDI2(3.24 ± 0.55) × 10−8++Lys44Mete Val126GluGly71Glu Glu153GlnVal48AlaeDeletion A1007, frameshiftThr83Ile Asp87HisSer80LeuaacA7, aacA8, blaOXA-2, intI1
    XIXRURMHGCN2(1.57 ± 0.44) × 10−8+FunctionalThr83IleSer80Leuaac(6′)Ib, aadA2, blaPSE-1, intI1
    XXSSPUINFN3(5.86 ± 1.41) × 10−8++C insertion after G75, frameshiftdVal48AlaeGln327stopThr83Ileaac(6′)Ib′, aadA2, intI1
    XXITWUPANAI3(2.26 ± 0.23) × 10−6+Asn insertion after Leu52dFunctionalThr83Ile Asp87GlySer80Leu
    XXIIUTRSNECN3(5.40 ± 1.65) × 10−6+Val126GluC19 deletion Gly71Glu Ala145ValArg21His Asp56GlydVal48Alae, Asn186SerC insertion after T1002, frameshift
    PAO1(3,07 ± 0.58) × 10−8
  • a MBL, metallo-β-lactamase; BAL, bronchoalveolar lavage sample; BLO, blood culture; SPU, sputum; TRS, tracheal secretion; URM, midstream urine; WUP, wound pus; ANA, anesthesiology; HGC, heart vessel surgery; INF, infection ward; ID, interdisciplinary ICU; MED, internal medicine; NEC, neurosurgery; NEU, neurology; A, ambulant; I, intensive; N, normal; +, positive test result; −, negative test result or no modification or resistance gene found; NR, no result; NG, no growth in the presence of the inhibitors.

  • b Mutation frequencies of mutator strains are indicated in bold. Each strain was tested in triplicate; the additionally tested variant of clone VI and another strain with a PFGE pattern identical to that of clone XI showed divergent results for hypermutability (tested once).

  • c Modifications that are relevant for the function of the regulator are indicated in bold.

  • d Relevance postulated on the basis of the localization and sort of the amino acid change.

  • e Relevance elsewhere experimentally proven.

  • f Repeated sequencing attempts revealed nondifferentiable multisignals for bp 318 to 592.

  • g Clones VIa and VIIa are additionally tested variants of clones VI and VII, respectively, showing differences in mutation frequencies and/or chromosomal alterations.