Vet Med - Czech, 2010, 55(4):172-182 | DOI: 10.17221/64/2010-VETMED

Molecular mechanisms of ceftazidime resistance in Pseudomonas aeruginosa isolates from canine and human infections

S.-J. Du1, H.-C. Kuo2, C.-H. Cheng1, A.C.Y. Fei1, H.-W. Wei3, S.-K. Chang1
1 Graduate Institute of Veterinary Medicine, National Taiwan University, Taiwan, ROC
2 Department of Veterinary Medicine, National Chiayi University, Chiayi, Taiwan, ROC
3 Department of Animal Science and Technology, National Taiwan University, Taipei, Taiwan, ROC

Sixty-six clinical P. aeruginosa isolates, 17 obtained from canine otitis specimens and 49 received from human patients with bloodstream infections, were collected between February 2007 and January 2008. The minimal inhibitory concentrations (MICs) of the antimicrobial agents of these isolates were determined. Multidrug resistance was common, with 23 (34.8%) isolates found to be ceftazidime resistant. To explore the mechanisms of ceftazidime resistance, PCR analyses were performed to detect drug-resistance genes. The prevalence rate of Ambler class A, B, and D β-lactamase genes were obtained, with blaTEM-1 100%, blaPSE-1 100%, blaOXA-2 96.2%, blaSHV-18 91.3%, blaOXA-17 78.3%, blaVIM-3 26.1%, blaOXA-10 21.7% and blaSHV-1 8.7%. An efflux inhibition assay with the PAβN compound was conducted. The ceftazidime resistance isolates were also tested by RT-qPCR to determine the mRNA expression levels of the oprM and ampC genes. Five (21.7%) of the ceftazidime resistance isolates appeared to overactivate the OprM efflux system. The ampD, ampE, and ampR genes and the ampC-ampR intergenic region were subsequently amplified and sequenced. Five (21.7%) of the ceftazidime resistance isolates from humans and canines had a point mutation in AmpR (Asp135-Asn, n = 3; Als194-Ser, n = 2), which induces AmpC overproduction from 10- to 80-fold. This study first reported ceftazidime resistance in P. aeruginosa from canine otitis specimens, which are closely related to ESBLs (50%), including the overproduction of AmpC (25%) and the OprM efflux system (25%). The ESBLs (100%) played an important role in all ceftazidime resistance isolates from humans, and either AmpC (21.1%) or OprM (21.1%) might be overexpressed within the same isolate. A human patient isolate (H307B) showed simultaneous expression of ESBLs, the OprM efflux system, and AmpC overproduction.

Keywords: ampC; ampR; extended spectrum β-lactamases; OprM efflux system

Published: April 30, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Du S-J, Kuo H-C, Cheng C-H, Fei ACY, Wei H-W, Chang S-K. Molecular mechanisms of ceftazidime resistance in Pseudomonas aeruginosa isolates from canine and human infections. Vet Med - Czech. 2010;55(4):172-182. doi: 10.17221/64/2010-VETMED.
Download citation

References

  1. Aires JR, Kohler T, Nikaido H, Plesiat P (1999): Involvement of an active efflux system in the natural resistance of Pseudomonas aeruginosa to aminoglycosides. Antimicrobial Agents and Chemotherapy, 43, 2624-2628. Go to original source... Go to PubMed...
  2. Altschul SF, Madden TL, Schaffer AA, Zhang J, Zhang Z, Miller W, Lipman DJ (1997): Gapped BLAST and PSIBLAST: a new generation of protein database search programs. Nucleic Acids Research, 25, 3389-3402. Go to original source... Go to PubMed...
  3. Bagge N, Ciofu O, Hentzer M, Campbell JIA, Givskov M, Hoiby N (2002): Constitutive high expression of chromosomal β-lactamase in Pseudomonas aeruginosa caused by a new insertion sequence (IS1669) located in ampD. Antimicrobial Agents and Chemotherapy, 46, 3406-3411. Go to original source... Go to PubMed...
  4. Berthelot P, Grattard F, Mallaval FO, Ros A, Lucht F, Pozzetto B (2005): Epidemiology of nosocomial infections due to Pseudomonas aeruginosa, Burkholderia cepacia and Stenotrophomonas maltophilia. Pathologie Biologie, 53, 341-348. Go to original source... Go to PubMed...
  5. Bratu S, Landman D, Gupta J, Quale J (2007): Role of AmpD, OprF and penicillin-binding proteins in betalactam resistance in clinical isolates of Pseudomonas aeruginosa. Journal of Medical Microbiology, 56, 809-814. Go to original source... Go to PubMed...
  6. Campbell JIA, Ciofu O, Hoiby N (1997): Pseudomonas aeruginosa isolates from patients with cystic fibrosis have different β-lactamase expression phenotypes but are homogeneous in the ampC-ampR genetic region. Antimicrobial Agents and Chemotherapy, 41, 1380-1384. Go to original source... Go to PubMed...
  7. CLSI (Clinical and Laboratory Standards Institute) (2006): Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Document M7-A7. Wayne, PA.
  8. Cole LK, Kwochka KW, Kowalski JJ, Hillier A (1998): Microbial flora and antimicrobial susceptibility patterns from canines with otitis media. Journal of the American Veterinary Medical Association, 212, 534-538. Go to original source...
  9. De Champs C, Poirel L, Bonnet R, Sirot D, Chanal C, Sirot J, Nordmann P (2002): Prospective survey of beta-lactamases produced by ceftazidime-resistant Pseudomonas aeruginosa isolated in a French hospital in 2000. Antimicrobial Agents and Chemotherapy, 46, 3031-3034. Go to original source... Go to PubMed...
  10. El Amary EB, Chamot E, Auckenthaler R, Pechere JC, Van Delden C (2001): Influence of previous exposure to antibiotic therapy on the susceptibility pattern of Pseudomonas aeruginosa bacteremic isolates. Clinical Infectious Diseases, 33, 1859-1864. Go to original source... Go to PubMed...
  11. Gales AC, Menezes LC, Silbert S, Sader HS (2003): Dissemination in distinct Brazilian regions of an epidemic carbapenem-resistant Pseudomonas aeruginosa producing SPM metallo-beta-lactamase. The Journal of Antimicrobial Chemotherapy, 52, 699-702. Go to original source... Go to PubMed...
  12. Griffin CE (1993): Otitis externa and otitis media. In: Griffin CE, Kwochka KW, MacDonald JM (eds.): Current Veterinary Dermatology. Mosby Year Book, St. Louis. 245-262.
  13. Henrichfreise B, Wiegand I, Pfister W, Wiedemann B (2007): Resistance mechanisms of multiresistant Pseudomonas aeruginosa strains from Germany and correlation with hypermutation. Antimicrobial Agents and Chemotherapy, 51, 4062-4070. Go to original source... Go to PubMed...
  14. Jiang X, Zhang Z, Li M, Zhou D, Ruan F, Lu Y (2006): Detection of extended-spectrum beta-lactamases in clinical isolates of Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy, 50, 2990-2995. Go to original source... Go to PubMed...
  15. Juan C, Macia MD, Gutierrez O, Vidal C, Perez JL, Oliver A (2005): Molecular mechanisms of β-lactam resistance mediated by AmpC hyperproduction in Pseudomonas aeruginosa clinical strains. Antimicrobial Agents and Chemotherapy, 49, 4733-4738. Go to original source... Go to PubMed...
  16. Kuga A, Okamoto R, Inoue M (2000): ampR gene mutations that greatly increase class C β-lactamase activity in Enterobacter cloacae. Antimicrobial Agents and Chemotherapy, 44, 561-567. Go to original source... Go to PubMed...
  17. Langaee TY, Gagnon L, Huletsky A (2000): Inactivation of the ampD gene in Pseudomonas aeruginosa leads to moderate-basal-level and hyperinducible AmpC β-lactamase expression. Antimicrobial Agents and Chemotherapy, 44, 583-589. Go to original source... Go to PubMed...
  18. Lindberg F, Lindquist S, Normark S (1987): Inactivation of the ampD gene causes semiconstitutive overproduction of the inducible Citrobacter freundii β-lactamase. Journal of Bacteriology, 169, 1923-1928. Go to original source... Go to PubMed...
  19. Li XZ, Ma D, Livermore DM, Nikaido H (1994): Role of efflux pump(s) in intrinsic resistance of Pseudomonas aeruginosa: active efflux as a contributing factor to betalactam resistance. Antimicrobial Agents and Chemotherapy, 38, 1742-1752. Go to original source... Go to PubMed...
  20. Li XZ, Zhang L, Poole K (2000): Interplay between the MexA-MexB-OprM multidrug efflux system and the outer membrane barrier in the multiple antibiotic resistance of Pseudomonas aeruginosa. The Journal of Antimicrobial Chemotherapy, 45, 433-436. Go to original source... Go to PubMed...
  21. Livak KJ, Schmittgen TD (2001): Analysis of relative gene expression data using real-time quantitative PCR and the 2-ΔΔCT method. Methods, 25, 402-408. Go to original source... Go to PubMed...
  22. Livermore DM (2002): Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare? Clinical Infectious Diseases, 34, 634-640. Go to original source... Go to PubMed...
  23. Masuda N, Sakagawa E, Ohya S, Gotoh N, Tsujimoto H, Nishino T (2000): Substrate specificities of MexABOprM, MexCD-OprJ, and MexXY-OprM efflux pumps in Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy, 44, 3322-3327. Go to original source... Go to PubMed...
  24. Mesaros N, Glupczynski Y, Avrain L, Caceres NE, Tulkens PM, Van Bambeke F (2007): A combined phenotypic and genotypic method for the detection of Mex efflux pumps in Pseudomonas aeruginosa. The Journal of Antimicrobial Chemotherapy, 59, 378-386. Go to original source... Go to PubMed...
  25. Mueller-Premru M, Gubina M (2000): Serotype, antimicrobial susceptibility and clone distribution of Pseudomonas aeruginosa in a University hospital. Zentralblatt fur Bakteriologie, 8, 857-867. Go to original source... Go to PubMed...
  26. Nordmann P, Guibert M (1998): Extended-spectrum β-lactamase in Pseudomonas aeruginosa. The Journal of Antimicrobial Chemotherapy, 42, 128-131. Go to original source... Go to PubMed...
  27. Panayotis TT, Gennimata V, Maniatis AN, Fock C, Legakis NJ, The Greek Pseudomonas aeruginosa Study Group (1998): Emergence of multidrug resistance in ubiquitous and dominant Pseudomonas aeruginosa serogroup O:11. Journal of Clinical Microbiology, 36, 897-901. Go to original source... Go to PubMed...
  28. Peterson AD, Walker RD, Bowman MM, Schott HC, Rosser EJ (2002): Frequency of isolation of and antimicrobial susceptibility patterns of Staphylococcus intermedius and Pseudomonas aeruginosa isolates from canine skin and ear samples over a 6-year period (1992-1997). Journal of the American Animal Hospital Association, 38, 407-413. Go to original source... Go to PubMed...
  29. Sambrook J, Fritsch EF, Maniatis T (1989): Molecular Cloning: A Laboratory Manual. 2nd ed. Cold Spring Harbor Laboratory Press, NY. 9, 14.
  30. Savli H, Karadenizli A, Kolayli F, Gundes S, Ozbek U, Vahaboglu H (2003): Expression stability of six housekeeping genes: a proposal for resistance gene quantification studies of Pseudomonas aeruginosa by real-time quantitative RT-PCR. Journal of Medical Microbiology, 52, 403-408. Go to original source... Go to PubMed...
  31. Scott DW, Miller WH, Griffin CE (2001): Muller and Kirk's Small Animal Dermatology. 6th ed. WB Saunders, Philadelphia. 729-740.
  32. Senda K, Arakawa Y, Nakashima K, Ito H, Ichiyama S, Shimokata K, Kato N, Ohta M (1996): Multifocal outbreaks of metallo-β-lactamase-producing Pseudomonas aeruginosa resistant to broad-spectrum-β-lactams, including carbapenems. Antimicrobial Agents and Chemotherapy, 40, 349-353. Go to original source... Go to PubMed...
  33. Seol B, Naglic T, Madic J, Bedekovic M (2002): In vitro antimicrobial susceptibility of 183 Pseudomonas aeruginosa strains isolated from canines to selected antipseudomonal agents. Journal of Veterinary Medicine B, Infectious Diseases and Veterinary Public Health, 49, 188-192. Go to original source... Go to PubMed...
  34. Shawar R, MacLeod MDL, Garber RL, Burns JL, Stapp JR, Clausen CR, Tanaka SK (1999): Activities of tobramycin and six other antibiotics against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrobial Agents and Chemotherapy, 43, 2877-2880. Go to original source... Go to PubMed...
  35. Spencer RC (1996): An 8 year microbe base survey of the epidemiology, frequency and antibiotic susceptibility of Pseudomonas aeruginosa hospital isolates in United Kingdom. The Journal of Antimicrobial Chemotherapy, 37, 295-301. Go to original source... Go to PubMed...
  36. Stapleton P, Shannon K, Phillips I (1995): DNA sequence differences of ampD mutants of Citrobacter freundii. Antimicrobial Agents and Chemotherapy, 39, 2494-2498. Go to original source... Go to PubMed...
  37. Strateva T, Ouzounova-Raykova V, Markova B, Todorova A, Marteva-Proevska Y, Mitov I (2007): Problematic clinical isolates of Pseudomonas aeruginosa from the university hospitals in Sofia, Bulgaria: current status of antimicrobial resistance and prevailing resistance mechanisms. Journal of Medical Microbiology, 56, 956-963. Go to original source... Go to PubMed...
  38. Tam VH, Schilling AN, LaRocco MT, Gentry LO, Lolans K, Quinn JP, Garey KW (2007): Prevalence of AmpC over-expression in bloodstream isolates of Pseudomonas aeruginosa. Clinical Microbiology and Infection, 13, 413-418. Go to original source... Go to PubMed...
  39. Weldhagen GF (2004): Sequence-selective recognition of extended-spectrum beta-lactamase GES-2 by a competitive, peptide nucleic acid-based multiplex PCR assay. Antimicrobial Agents and Chemotherapy, 48, 3402-3406. Go to original source... Go to PubMed...
  40. Yan JJ, Hsueh PR, Ko WC, Luh KT, Tsai SH, Wu HM, Wu JJ (2001): Metallo-beta-lactamases in clinical Pseudomonas isolates in Taiwan and identification of VIM3, a novel variant of the VIM-2 enzyme. Antimicrobial Agents and Chemotherapy, 45, 2224-2228. Go to original source... Go to PubMed...
  41. Yu WL, Chuang YC, Walther-Rasmussen J (2006): Extended-spectrum beta-lactamases in Taiwan: epidemiology, detection, treatment and infection control. Journal of Microbiology, Immunology, and Infection, 39, 264-277.
  42. Ziha-Zarifi I, Llanes C, Kohler T, Pechere JC, Pleaist P (1999): In vivo emergence of multidrug resistant mutants of Pseudomonas aeruginosa overexpressing the active efflux system MexA-MexB-OprM. Antimicrobial Agents and Chemotherapy, 43, 287-291. Go to original source... Go to PubMed...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.