Antimicrobial susceptibility of Pseudomonas aeruginosa in China: a review of two multicentre surveillance programmes, and application of revised CLSI susceptibility breakpoints

Pseudomonas Aeruginosa : Arsenal of Resistance Mechanisms, Decades of Changing Resistance Profiles, and Future Antimicrobial Therapies

“…The resistance rates of P. aeruginosa to imipenem are also on the rise all over the world and different resistance rates have been reported in different studies from as low as 2% [41,[60][61][62][63][64][65] to as high as 42% in settings where extensive use is common [58,[66][67]. The susceptibility rates of P. aeruginosa to meropenem, which is more potent than carbapenem, are decreasing.…”

“…The susceptibility rates of P. aeruginosa to meropenem, which is more potent than carbapenem, are decreasing. Reports from different settings worldwide showed that resistance to meropenem is increasing and rates have varied from less than 10% [54] to 46% [46,[64][65][66]. In other locations, on the contrary, the susceptibility rates of P. aeruginosa to meropenem are higher and the MIC 50 and MIC 90 of meropenem have been reported to be 0.5-2 and 2-8 μg/ml, respectively [39,55].…”

“…The incidence of gentamicin resistance among P. aeruginosa isolates varies significantly worldwide and was reported in different studies from different regions to range between less than 25% [50][51]68] and more than 50% [48,69]. Resistance to tobramycin and amikacin has emerged elsewhere and resistance rates have been reported in different studies to range from 2% [36,62] to 50% [43,48,65,67,70]. In other reports, all P. aeruginosa isolates were sensitive to amikacin with MIC 50 and MIC 90 values of 8 and 8 μg/ml, respectively [39,[71][72].…”

“…Given this broad spectrum of activity, it is unfortunate that resistance to fluoroquinolones has increased due to the intensive use of these agents. Several surveillance studies and reports have highlighted the general insusceptibility of P. aeruginosa to fluoroquinolones from virtually all areas of the world [36,39,45,[65][66][67]81]. …”

Stress responses as determinants of antimicrobial resistance in Pseudomonas aeruginosa: multidrug efflux and more

“…This latter effect is, in part, attributable to (i) the organism's intrinsically high resistance to many antimicrobials (Giamarellos-Bourboulis et al 2006) and (ii) the development of increased, particularly multidrug, resistance in health care settings (Bodro et al 2013(Bodro et al , 2014Chaisathaphol and Chayakulkeeree 2014;Chen et al 2013;Chittawatanarat et al 2014;Folgori et al 2014;Medell et al 2012;Pena et al 2013;Pourakbari et al 2012;Xiao et al 2012), both of which complicate antipseudomonal chemotherapy (Chaisathaphol and Chayakulkeeree 2014;Chittawatanarat et al 2014;Chung et al 2011;Folgori et al 2014;Hirsch et al 2012;Hirsch and Tam 2010;Kallen et al 2010;Keen et al 2010; Kerr and Snelling the Multidrug and Toxic Compound Export family, and the Resistance Nodulation Division (RND) family (Li and Nikaido 2009). While examples of all of these have been reported in P. aeruginosa (Poole 2013), by far the most significant contributors to resistance to clinically relevant agents and in clinical isolates are in the RND family (Poole 2001(Poole , 2004a(Poole , 2004b(Poole , 2005b(Poole , 2007Poole and Srikumar 2001).…”