In vivo selection of a target/efflux double mutant of Pseudomonas aeruginosa by ciprofloxacin therapy | Zendy

Immanuel Thomas | Zendy

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In vivo selection of a target/efflux double mutant of Pseudomonas aeruginosa by ciprofloxacin therapy

Author(s) -

Immanuel Thomas

Publication year - 2001

Publication title -

journal of antimicrobial chemotherapy

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.124

H-Index - 194

eISSN - 1460-2091

pISSN - 0305-7453

DOI - 10.1093/jac/48.4.553

Subject(s) - efflux , ciprofloxacin , ticarcillin , pseudomonas aeruginosa , microbiology and biotechnology , ceftazidime , amikacin , antibiotics , mutant , biology , multiple drug resistance , pseudomonadales , bacteria , gene , genetics

We report the emergence after 4 days of ciprofloxacin monotherapy of a double mutant of Pseudomonas aeruginosa overexpressing the multidrug efflux system MexAB-OprM and harbouring a mutation in the gyrB gene. Compared with its initial susceptible counterpart, this mutant exhibited a significant increase in resistance to most of the beta-lactam antibiotics tested (16 x MIC of ticarcillin) and to ciprofloxacin (128 x MIC). Combined ceftazidime and amikacin therapy finally eradicated the resistant isolate and cured the patient of his infection. This case illustrates how strains of P. aeruginosa may develop high levels of fluoroquinolone resistance by combining efflux mechanisms and target alterations.

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