Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;20(2):762-769.
doi: 10.3892/etm.2020.8777. Epub 2020 May 20.

Polymyxin B resistance rates in carbapenem-resistant Pseudomonas aeruginosa isolates and a comparison between Etest® and broth microdilution methods of antimicrobial susceptibility testing

Xu Chen  1 , Jie Xu  1 , Qiongfang Zhu  1 , Yalu Ren  1 , Lina Zhao  1
Affiliations

Polymyxin B resistance rates in carbapenem-resistant Pseudomonas aeruginosa isolates and a comparison between Etest® and broth microdilution methods of antimicrobial susceptibility testing

Xu Chen et al. Exp Ther Med. 2020 Aug.

Abstract

Polymyxin B has been considered to be the last line of defense for life-threatening infections caused by multiple drug resistant gram-negative pathogens, including carbapenem-resistant Pseudomonas aeruginosa (CRPA). The present study analyzed CRPA resistance to polymyxin B in the Suzhou district of China. Additionally, polymyxin B resistance rates were compared in different parts of the world to determine global trends. The present study also assessed the reliability and effectiveness of the Etest® in a clinical setting, as laboratories lack a reliable and efficient susceptibility test for polymyxin B. The susceptibility rate of polymyxin B reached 96.0%, which is in accordance with results obtained from the United States of America, Europe, Africa and the majority of Asian countries. However, the rate of polymyxin B non-susceptibility (resistant or intermediate) in Singapore is 0.53 (95% confidence interval, 0.12-0.93). In addition, the susceptibility rate of polymyxin B determined via Etest® was not significantly increased compared with that determined via broth microdilution (98.0 vs. 96.0%; P=0.558). Essential and categorical agreement rates reached 98.0%. In conclusion, the polymyxin B resistance rate of CRPA isolates is relatively low in the majority of countries, with the exception of Singapore. Furthermore, Etest® may be a reliable clinical method for the measurement of polymyxin B resistance in CRPA isolates.

Keywords: Etest®; Pseudomonas aeruginosa; antimicrobial susceptibility testing; broth microdilution; minimal inhibitory concentrations; polymyxin B.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percentage distribution of carbapenem-resistant Pseudomonas aeruginosa isolates from different clinical departments of the First Affiliated Hospital of Soochow University. ICU, intensive care unit.
Figure 2
Figure 2
Percentage distribution of carbapenem-resistant Pseudomonas aeruginosa isolates from the First Affiliated Hospital of Soochow University by specimen type.
Figure 3
Figure 3
Resistance rates of carbapenem-resistant Pseudomonas aeruginosa isolates from the First Affiliated Hospital of Soochow University to several crucial antibacterial agents. Y-axis is the percentage of different antibacterial agents.
Figure 4
Figure 4
Search process used for the comparison analysis performed in the present study.
See this image and copyright information in PMC

References

    1. Khosravi AD, Shafie F, Abbasi Montazeri E, Rostami S. The frequency of genes encoding exotoxin A and exoenzyme S in Pseudomonas aeruginosa strains isolated from burn patients. Burns. 2016;42:1116–1120. doi: 10.1016/j.burns.2016.02.012. - DOI - PubMed
    1. Leseva M, Arguirova M, Nashev D, Zamfirova E, Hadzhyiski O. Nosocomial infections in burn patients: Etiology, antimicrobial resistance, means to control. Ann Burns Fire Disasters. 2013;26:5–11. - PMC - PubMed
    1. Liu PY, Sun YX, Gu DQ, Cheng JL. Drug resistance of imipenem-resistant Gram-negative bacilli in coal worker's pneumoconiosis chronic obstructive pulmonary disease patients with lower respiratory tract infection. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2013;31:700–702. (In Chinese) - PubMed
    1. Gales AC, Jones RN, Sader HS. Global assessment of the antimicrobial activity of polymyxin B against 54 731 clinical isolates of Gram-negative bacilli: Report from the SENTRY antimicrobial surveillance programme (2001-2004) Clin Microbiol Infect. 2006;12:315–321. doi: 10.1111/j.1469-0691.2005.01351.x. - DOI - PubMed
    1. Vaez H, Moghim S, Nasr Esfahani B, Ghasemian Safaei H. Clonal relatedness among imipenem-resistant Pseudomonas aeruginosa isolated from ICU-hospitalized patients. Crit Care Res Pract. 2015;2015(983207) doi: 10.1155/2015/983207. - DOI - PMC - PubMed