Imipenem-resistant Pseudomonas aeruginosa gastrointestinal carriage among hospitalized patients: risk factors and resistance mechanisms

被引：22

作者：

Lepelletier, Didier ^{[1
,2
]}

Cady, Anne ^{[1
]}

Caroff, Nathalie ^{[1
,2
]}

Marraillac, Julie ^{[1
]}

Reynaud, Alain ^{[1
,2
]}

Lucet, Jean-Christophe ^{[3
]}

Corvec, Stephane ^{[1
,2
]}

机构：

[1] Nantes Univ Hosp, Dept Bacteriol Hyg, Nantes, France

[2] Univ Nantes, UFR Med, Therapeut Clin & Expt Infect EA3826, F-44035 Nantes, France

[3] Grp Hosp Bichat Claude Bernard, Infect Control Dept, Paris, France

来源：

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE | 2010年 / 66卷 / 01期

关键词：

Imipenem resistance; Pseudomonas aeruginosa; case-control study; gastrointestinal carriage; INTENSIVE-CARE UNITS; ANTIBIOTIC-RESISTANCE; COLONIZATION; INFECTION; OPRD; ENDEMICITY; EMERGENCE;

D O I：

10.1016/j.diagmicrobio.2009.08.014

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Risk factors for imipenem (IMP)-resistant Pseudomonas aeruginosa (IRPA) digestive carriage were analyzed, and genetic events contributing to select resistant isolates in patients exposed to IMP were investigated. Among the 150 patients with hospital-acquired P. aeruginosa digestive carriage, 38 isolates were IRPA. DNA pulsotypes revealed 16 distinct clones. In 4 patients, a second P. aeruginosa isolate showed resistance to IMP compared with the initial susceptible isolate. By comparing the different oprD sequences between IMP-susceptible P. aeruginosa and IRPA strains, a genetic event was systematically found for each resistant isolate, leading to either the absence of OprD or a truncated porin. The multivariate analysis demonstrated that prior IMP exposure was associated with IRPA carriage. In summary, we confirmed that IMP use selects for IRPA in the gut flora. Cross-transmission, however, was frequently observed in intensive care units. Combining epidemiologic approach and molecular analysis is a powerful tool to delineate mechanisms of emerging resistance. (C) 2010 Elsevier Inc. All rights reserved.

引用

页码：1 / 6

页数：6

共 24 条

[1] Endemicity, molecular diversity and colonisation routes of Pseudomonas aeruginosa in intensive care units [J].