title: Antimicrobial Susceptibility of Pseudomonas aeruginosa Isolated from Cystic Fibrosis Patients in Northern Europe.
abstract: Pseudomonas aeruginosa is a major cause of morbidity and mortality in cystic fibrosis patients. This study compared the antimicrobial susceptibilities of 153 P. aeruginosa isolates from the United Kingdom (UK) (n = 58), Belgium (n = 44), and Germany (n = 51) collected from 118 patients during routine visits over the period from 2006 to 2012. MICs were measured by broth microdilution. Genes encoding extended-spectrum β-lactamases (ESBL), metallo-β-lactamases, and carbapenemases were detected by PCR. Pulsed-field gel electrophoresis and multilocus sequence typing were performed on isolates resistant to ≥3 antibiotic classes among the penicillins/cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and polymyxins. Based on EUCAST/CLSI breakpoints, susceptibility rates were ≤30%/≤40% (penicillins, ceftazidime, amikacin, and ciprofloxacin), 44 to 48%/48 to 63% (carbapenems), 72%/72% (tobramycin), and 92%/78% (colistin) independent of patient age. Sixty percent of strains were multidrug resistant (MDR; European Centre for Disease Prevention and Control criteria). Genes encoding the most prevalent ESBL (BEL, PER, GES, VEB, CTX-M, TEM, SHV, and OXA), metallo-β-lactamases (VIM, IMP, and NDM), or carbapenemases (OXA-48 and KPC) were not detected. The Liverpool epidemic strain (LES) was prevalent in UK isolates only (75% of MDR isolates). Four MDR sequence type 958 (ST958) isolates were found to be spread over the three countries. The other MDR clones were evidenced in ≤3 isolates and localized in a single country. A new sequence type (ST2254) was discovered in one MDR isolate in Germany. Clonal and nonclonal isolates with different susceptibility profiles were found in 20 patients. Thus, resistance and MDR are highly prevalent in routine isolates from 3 countries, with meropenem, tobramycin, and colistin remaining the most active drugs.
authors: Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.|SMB Laboratories, Brussels, Belgium.
authors: Muhammad-Hariri
authors: MH
authors: Mustafa
authors: Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.
authors: Hussein
authors: H
authors: Chalhoub
authors: Hôpital Erasme/Hôpital des Enfants Malades, Université libre de Bruxelles, Brussels, Belgium.
authors: Olivier
authors: O
authors: Denis
authors: Hôpital Erasme/Hôpital des Enfants Malades, Université libre de Bruxelles, Brussels, Belgium.
authors: Ariane
authors: A
authors: Deplano
authors: Hôpital Erasme/Hôpital des Enfants Malades, Université libre de Bruxelles, Brussels, Belgium.
authors: Anne
authors: A
authors: Vergison
authors: Department of Microbiology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
authors: Hector
authors: H
authors: Rodriguez-Villalobos
authors: The Queen's University of Belfast, Belfast, United Kingdom.
authors: Michael M
authors: MM
authors: Tunney
authors: The Queen's University of Belfast, Belfast, United Kingdom.
authors: J Stuart
authors: JS
authors: Elborn
authors: University Hospital Münster, Münster, Germany.
authors: Barbara C
authors: BC
authors: Kahl
authors: SMB Laboratories, Brussels, Belgium.
authors: Hamidou
authors: H
authors: Traore
authors: SMB Laboratories, Brussels, Belgium.
authors: Francis
authors: F
authors: Vanderbist
authors: Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.
authors: Paul M
authors: 0000-0002-7121-3623
authors: PM
authors: Tulkens
authors: Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium francoise.vanbambeke@uclouvain.be.
authors: Françoise
authors: 0000-0002-0052-7991
authors: F
authors: Van Bambeke
mesh_terms: D000617:Aminoglycosides / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001530:Belgium; D015780:Carbapenems / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D002999:Clone Cells; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D024841:Fluoroquinolones / Q000494:pharmacology; D015870:Gene Expression; D005858:Germany; D006801:Humans; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D011113:Polymyxins / Q000494:pharmacology; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D012137:Respiratory System / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D006113:United Kingdom; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D024841:Fluoroquinolones; D011113:Polymyxins; D001618:beta-Lactamases