Clinical Significance of Carbapenem-Tolerant Pseudomonas aeruginosa Isolated in the Respiratory Tract
Abstract
:1. Introduction
2. Patients and Methods
2.1. Bacterial Strains
2.2. Susceptibility Testing for Planktonic Bacteria
2.3. Patient Recruitment
2.4. Susceptibility Testing for the Adherent Bacteria
2.5. In Vitro Phenotypic Characterization
2.6. Detection of the pslA Gene
2.7. Gene Expression of the pelA and pslA Genes
2.8. Statistical Analyses
3. Results
3.1. MIC Distribution and Resistance Ratio
3.2. Distribution of MICAD and MBCAD
3.3. Clinical Features
Case 1: Low-tolerance
Case 2: High-tolerance
3.4. Bacterial Phenotypic Characterization
3.5. pslA Gene Detection and Transcription of pslA and pelA Genes in Adherent Cells
4. Discussion
5. Conclusions
6. Ethics Approval and Consent to Participate
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Low-Tolerance (n = 6) | High-Tolerance (n = 9) | p Value |
---|---|---|---|
Age (years) | 55 ± 27 | 55 ± 26 | |
Male sex | 2 (33) | 7 (78) | 0.136 |
Pseudomonas infection | |||
Acute pneumonia | 1 (17) | 3 (33) | 0.604 |
Persistent infection | 5 (83) | 6 (67) | 0.604 |
Respiratory symptoms | |||
Cough/Sputum | 6 (100) | 9 (100) | 1.00 |
Comorbidities | |||
Solid tumor | 0 (0) | 2 (22) | 0.486 |
Autoimmune disease | 3 (50) | 1 (11) | 0.235 |
Sinusitis | 3 (50) | 0 (0) | 0.044 * |
Congenital heart disease | 1 (17) | 1 (11) | 1.00 |
NTM | 1 (17) | 0 (0) | 0.341 |
Underlying lung diseases | |||
Bronchiectasis | 5 (83) | 4 (44) | 0.286 |
DPB | 0 (0) | 2 (22) | 0.486 |
COPD | 0 (0) | 2 (22) | 0.486 |
Chest CT finding | |||
Diffuse type | 1 (17) | 7 (78) | 0.041 * |
Local type | 5 (83) | 2 (22) | 0.041 * |
Inflammatory markers | |||
CRP (mg/mL) | 1.5 ± 1.5 | 4.0 ± 6.2 | 0.319 |
WBC (103/μL) | 6.6 ± 2.4 | 8.8 ± 5.0 | 0.362 |
Patients requiring hospitalization | 1 (17) | 8 (89) | 0.011 * |
No. of dead patients | 0 (0) | 1 (11) | 1.00 |
Baseline respiratory parameters | |||
SpO2 (%) | 97 ± 1 | 95 ± 3 | 0.21 |
Oxygen inhalation | 0 (0) | 3 (33) | 0.229 |
Respiratory failure | 0 (0) | 4 (44) | 0.103 |
Characteristics | Number of Patients in Low-Tolerance (Total Days) | Number of Patients in High-Tolerance (Total Days) |
---|---|---|
β-lactams | ||
Ampicillin | 0 | 1 (7) |
Sulbactam/Ampicillin | 0 | 2 (40) |
Clavulanic acid/Amoxicillin | 0 | 2 (6) |
Tazobactam/Piperacillin | 0 | 1 (4) |
Cefcapene pivoxil | 3 (26) | 2 (7) |
Cefazolin | 0 | 1 (6) |
Cefmetazole | 0 | 2 (13) |
Ceftriaxone | 1 (10) | 0 |
Cefozopran | 0 | 1 (5) |
Sulbactam/Cefoperazone | 1 (5) | 0 |
Ceftazidime | 0 | 3 (35) |
Meropenem | 1 (5) | 1 (3) |
Quinolones | ||
Levofloxacin | 1 (21) | 1 (4) |
Garenoxacin | 0 | 2 (12) |
Moxifloxacin | 0 | 1 (7) |
Macrolides | ||
Clarithromycin | 0 | 1 (5) |
Clindamycin | 0 | 1 (3) |
Tetracycline | ||
Minocycline | 0 | 1 (5) |
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Azuma, M.; Murakami, K.; Murata, R.; Kataoka, K.; Fujii, H.; Miyake, Y.; Nishioka, Y. Clinical Significance of Carbapenem-Tolerant Pseudomonas aeruginosa Isolated in the Respiratory Tract. Antibiotics 2020, 9, 626. https://doi.org/10.3390/antibiotics9090626
Azuma M, Murakami K, Murata R, Kataoka K, Fujii H, Miyake Y, Nishioka Y. Clinical Significance of Carbapenem-Tolerant Pseudomonas aeruginosa Isolated in the Respiratory Tract. Antibiotics. 2020; 9(9):626. https://doi.org/10.3390/antibiotics9090626
Chicago/Turabian StyleAzuma, Momoyo, Keiji Murakami, Rina Murata, Keiko Kataoka, Hideki Fujii, Yoichiro Miyake, and Yasuhiko Nishioka. 2020. "Clinical Significance of Carbapenem-Tolerant Pseudomonas aeruginosa Isolated in the Respiratory Tract" Antibiotics 9, no. 9: 626. https://doi.org/10.3390/antibiotics9090626