Inducible beta-lactam resistance in Aeromonas hydrophila: therapeutic challenge for antimicrobial therapy

J Clin Microbiol. 1998 Nov;36(11):3188-92. doi: 10.1128/JCM.36.11.3188-3192.1998.

Abstract

Despite the abundant amount of knowledge about inducible chromosomally mediated beta-lactamases among Aeromonas species, extended-spectrum beta-lactam-resistant A. hydrophila strains selected in clinical practice were rarely reported. In the present study, two strains of A. hydrophila, A136 and A139, with markedly different susceptibilities to extended-spectrum cephalosporins were isolated from blood and the tip segment of an arterial catheter of a burn patient. Another strain (A136m) was selected in vitro by culturing A136 in a subinhibitory concentration of cefotaxime, the beta-lactam agent administered for the treatment of Aeromonas bacteremia in this patient. Typing studies by arbitrarily primed PCR and pulsed-field gel electrophoresis indicated a clonal relationship among strains A136, A136m, and A139. These strains were identified to be of DNA hybridization group 1. Wild-type strain A136 was resistant only to ampicillin and cephamycins, but A136m and A139 were highly resistant to the expanded- and broad-spectrum cephalosporins. The presence of increased beta-lactamase activity in A139 suggests that A139 is a derepressed mutant which overexpresses beta-lactamases. These results call attention to the use of beta-lactam agents for the treatment of invasive Aeromonas infections.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aeromonas hydrophila / drug effects*
  • Aeromonas hydrophila / enzymology
  • Aeromonas hydrophila / genetics
  • Bacteremia / complications
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Base Sequence
  • Burns / complications
  • Burns / surgery
  • Cephalosporin Resistance / genetics
  • Cephalosporins / therapeutic use*
  • Cross Infection / complications
  • Cross Infection / drug therapy
  • Cross Infection / microbiology
  • DNA Primers / genetics
  • DNA, Bacterial / genetics
  • DNA, Bacterial / isolation & purification
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Genotype
  • Gram-Negative Bacterial Infections / complications
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Middle Aged
  • Mutation
  • Polymerase Chain Reaction
  • Surgical Wound Infection / complications
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / microbiology
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism

Substances

  • Cephalosporins
  • DNA Primers
  • DNA, Bacterial
  • beta-Lactamases