title: Association of overexpression of efflux pump genes with antibiotic resistance in Pseudomonas aeruginosa strains clinically isolated from urinary tract infection patients.
abstract: There are several mechanisms for antibiotic-resistant Pseudomonas aeruginosa. The purpose of this study is to investigate the association between the expression of efflux pump-coding genes and antibiotic resistance in P. aeruginosa causing urinary tract infections (UTIs). We extracted the RNA from 105 clinical strains of P. aeruginosa isolated from UTI patients with full data on antibiotic MICs and assayed real-time quantitative reverse-transcription PCR. We investigated the gene expressions of four resistance nodulation cell division-type multi-drug efflux pump systems (MexAB-OprM, MexCD-OprJ, MexEF-OprN and MexXY(-OprA)) and the correlation of the MICs of nine antibiotics, risk factors and antibiotic resistance-related genes with expressions of mexB, mexC, mexE and mexY. Multivariate statistical data demonstrated a significant relationship between increased expression of mexB or mexC and complicated UTI (Odds ratio=8.03, P<0.001 and Odds ratio=8.86, P=0.032, respectively). We also found a significant association between the increased expression of mexC and resistance to levofloxacin (LVFX) (Odds ratio=4.48, P=0.035). In conclusion, increased expression of mexC leads to LVFX resistance in P. aeruginosa causing UTI. These results contribute to our knowledge of the efflux pump system and antibiotic resistance.
authors: Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.|Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.
authors: Katsumi
authors: K
authors: Shigemura
authors: Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.|Division of Infectious Diseases, Department of International Health, Kobe University, Graduate School of Health Science, Kobe, Japan.
authors: Kayo
authors: K
authors: Osawa
authors: Division of Infectious Diseases, Department of International Health, Kobe University, Graduate School of Health Science, Kobe, Japan.
authors: Ayaka
authors: A
authors: Kato
authors: Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.
authors: Issei
authors: I
authors: Tokimatsu
authors: Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.|Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.
authors: Soichi
authors: S
authors: Arakawa
authors: Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.|Division of Infectious Diseases, Department of International Health, Kobe University, Graduate School of Health Science, Kobe, Japan.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Toshiro
authors: T
authors: Shirakawa
authors: Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Masato
authors: M
authors: Fujisawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005260:Female; D015964:Gene Expression Regulation, Bacterial; D005798:Genes, Bacterial / Q000235:genetics*; D019450:Genes, MDR / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D012329:RNA, Bacterial; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D012329:RNA, Bacterial