Four strains of Pseudomonas aeruginosa clinical isolates were studied for resistance to antipseudomonal beta-lactams and aminoglycosides. Two of these strains were isolated from two different patients before antibiotic treatment, the other two strains, isolated during therapy, developed resistance to many of antipseudomonal beta-lactams and, in addition, to aminoglycoside antibiotics. All the strains produced a constitutive chromosomal beta-lactamase, while the latter two showed a significant reduction in permeability coefficient. Thus, a permeability change may be the major factor involved in the resistance to most antipseudomonal beta-lactams and may be responsible for development of cross-resistance to aminoglycosides.
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Clin Infect Dis
December 2024
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Background: Timely antibiotic initiation is critical to sepsis management, but there are limited data on the impact of giving β-lactams first vs vancomycin first amongst patients prescribed both agents.
Methods: We retrospectively analyzed all adults admitted to 5 US hospitals from 2015-2022 with suspected sepsis (blood culture collected, antibiotics administered, and organ dysfunction) treated with vancomycin and a broad-spectrum β-lactam within 24h of arrival. We estimated associations between β-lactam vs vancomycin first strategies and in-hospital mortality using inverse probability weighting (IPW) to adjust for potential confounders.
Antibiotics (Basel)
October 2024
Department of Medicine, University of South Carolina School of Medicine, Columbia, SC 29209, USA.
Antipseudomonal β-lactams (APBL) are commonly used for empirical therapy of Gram-negative bloodstream infections (BSI). This retrospective cohort study examines risk factors for prolonged APBL use (≥48 h) in patients with Enterobacterales BSI and compares 28-day mortality between early de-escalation of APBL and prolonged APBL therapy. Adult patients admitted to two community hospitals in South Carolina with Enterobacterales BSI from January 2010 to June 2015 were included in this study.
View Article and Find Full Text PDFEur J Clin Microbiol Infect Dis
February 2025
Emerging Antibiotic Resistance Unit, Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 18, Fribourg, CH-1700, Switzerland.
Purpose: Overproduction of the intrinsic chromosomally-encoded AmpC β-lactamase is one of the main mechanisms responsible for broad-spectrum β-lactam resistance in Pseudomonas aeruginosa. Our study aimed to evaluate the in-vitro activity of anti-pseudomonal β-lactam molecules associated with the recently-developed and commercially-available β-lactamase inhibitors, namely avibactam, relebactam and vaborbactam, against P. aeruginosa isolates overproducing their AmpC.
View Article and Find Full Text PDFPLoS One
November 2024
Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom, Thailand.
Pseudomonas aeruginosa associated with hospital-acquired infection is often resistant to various antibiotics and is associated with high mortality worldwide. The appropriate treatment of Pseudomonas aeruginosa resistant to carbapenems but susceptible to traditional antipseudomonal non-carbapenem β-lactam agents (Car-R/NonCar-S P. aeruginosa) remains unclear.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
College of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
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