1. Antimicrob Agents Chemother. 2016 Oct 21;60(11):6735-6741. doi:
10.1128/AAC.01046-16. Print 2016 Nov.

Antimicrobial Susceptibility of Pseudomonas aeruginosa Isolated from Cystic
Fibrosis Patients in Northern Europe.

Mustafa MH(1,)(2), Chalhoub H(1), Denis O(3), Deplano A(3), Vergison A(3),
Rodriguez-Villalobos H(4), Tunney MM(5), Elborn JS(5), Kahl BC(6), Traore H(2),
Vanderbist F(2), Tulkens PM(1), Van Bambeke F(7).

Author information: 
(1)Pharmacologie cellulaire et moléculaire, Louvain Drug Research Institute,
Université catholique de Louvain, Brussels, Belgium. (2)SMB Laboratories,
Brussels, Belgium. (3)Hôpital Erasme/Hôpital des Enfants Malades, Université
libre de Bruxelles, Brussels, Belgium. (4)Department of Microbiology, Cliniques
Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
(5)The Queen's University of Belfast, Belfast, United Kingdom. (6)University
Hospital Münster, Münster, Germany. (7)Pharmacologie cellulaire et moléculaire,
Louvain Drug Research Institute, Université catholique de Louvain, Brussels,
Belgium francoise.vanbambeke@uclouvain.be.

Pseudomonas aeruginosa is a major cause of morbidity and mortality in cystic
fibrosis patients. This study compared the antimicrobial susceptibilities of 153 
P. aeruginosa isolates from the United Kingdom (UK) (n = 58), Belgium (n = 44),
and Germany (n = 51) collected from 118 patients during routine visits over the
period from 2006 to 2012. MICs were measured by broth microdilution. Genes
encoding extended-spectrum β-lactamases (ESBL), metallo-β-lactamases, and
carbapenemases were detected by PCR. Pulsed-field gel electrophoresis and
multilocus sequence typing were performed on isolates resistant to ≥3 antibiotic 
classes among the penicillins/cephalosporins, carbapenems, fluoroquinolones,
aminoglycosides, and polymyxins. Based on EUCAST/CLSI breakpoints, susceptibility
rates were ≤30%/≤40% (penicillins, ceftazidime, amikacin, and ciprofloxacin), 44 
to 48%/48 to 63% (carbapenems), 72%/72% (tobramycin), and 92%/78% (colistin)
independent of patient age. Sixty percent of strains were multidrug resistant
(MDR; European Centre for Disease Prevention and Control criteria). Genes
encoding the most prevalent ESBL (BEL, PER, GES, VEB, CTX-M, TEM, SHV, and OXA), 
metallo-β-lactamases (VIM, IMP, and NDM), or carbapenemases (OXA-48 and KPC) were
not detected. The Liverpool epidemic strain (LES) was prevalent in UK isolates
only (75% of MDR isolates). Four MDR sequence type 958 (ST958) isolates were
found to be spread over the three countries. The other MDR clones were evidenced 
in ≤3 isolates and localized in a single country. A new sequence type (ST2254)
was discovered in one MDR isolate in Germany. Clonal and nonclonal isolates with 
different susceptibility profiles were found in 20 patients. Thus, resistance and
MDR are highly prevalent in routine isolates from 3 countries, with meropenem,
tobramycin, and colistin remaining the most active drugs.

Copyright © 2016, American Society for Microbiology. All Rights Reserved.

DOI: 10.1128/AAC.01046-16 
PMCID: PMC5075080
PMID: 27572406  [PubMed - in process]