Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa

Ye Xu,1 Xiangkuo Zheng,2 Weiliang Zeng,2 Tao Chen,1 Wenli Liao,1 Jiao Qian,1 Jie Lin,1 Cui Zhou,1 Xuebin Tian,2 Jianming Cao,2 Tieli Zhou1 1Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of China...

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Main Authors: Xu Y, Zheng X, Zeng W, Chen T, Liao W, Qian J, Lin J, Zhou C, Tian X, Cao J, Zhou T
Format: Article
Language:English
Published: Dove Medical Press 2020-05-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/mechanisms-of-heteroresistance-and-resistance-to-imipenem-in-pseudomon-peer-reviewed-article-IDR
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spelling doaj-209637daa51d4fab82edc61136c659362020-11-25T02:09:33ZengDove Medical PressInfection and Drug Resistance1178-69732020-05-01Volume 131419142853779Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosaXu YZheng XZeng WChen TLiao WQian JLin JZhou CTian XCao JZhou TYe Xu,1 Xiangkuo Zheng,2 Weiliang Zeng,2 Tao Chen,1 Wenli Liao,1 Jiao Qian,1 Jie Lin,1 Cui Zhou,1 Xuebin Tian,2 Jianming Cao,2 Tieli Zhou1 1Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of China; 2Department of Medical Laboratory Science, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of ChinaCorrespondence: Jianming Cao; Tieli Zhou Tel +86-577-88069595; +86-577-86689885Email wzcjming@163.com; wyztli@163.comBackground: Heteroresistance is a phenomenon that occurs in all bacteria and can cause treatment failure. Yet, the exact mechanisms responsible for heteroresistance still remain unknown. The following study investigated the mechanisms of imipenem-heteroresistance and -resistance in Pseudomonas aeruginosa clinical isolates from Wenzhou, China.Methods: Imipenem resistance was detected by the agar dilution method; heteroresistance was determined by population analysis profiles. Biofilm formation assay and modified carbapenem inactivation methods were also performed. Polymerase chain reaction (PCR) was conducted to detect oprD, and quantitative real-time PCR was used to determine expression levels of oprD, ampC and four efflux pump coding genes (mexB, mexD, mexE and mexY).Results: Six imipenem-heteroresistant and -resistant P. aeruginosa isolates were selected respectively. Deficient oprD was detected in all resistant isolates and two heteroresistant isolates. No strains produced carbapenemases. Expression levels of oprD were down-regulated in heteroresistant isolates. Transcription levels of the mexE and mexY were significantly increased in all heterogeneous subpopulations compared with their respective native ones. Compared with the susceptible group, increased mean relative expression levels of mexE and mexY or the decreased mean relative expression levels of oprD were observed in the resistant group (P < 0.05), whereas transcription levels of the mexB and mexD remained unchanged.Conclusion: Down-regulation of oprD contributed to the resistance and heteroresistance of imipenem in our P. aeruginosa clinical isolates. In addition, the marginal up-regulation of efflux systems may indirectly affect imipenem resistance. Contrarily, defective oprD was less common in our experimental heteroresistant strains than resistant strains.Keywords: Pseudomonas aeruginosa, imipenem, resistance, heteroresistance, molecular mechanism, oprDhttps://www.dovepress.com/mechanisms-of-heteroresistance-and-resistance-to-imipenem-in-pseudomon-peer-reviewed-article-IDRpseudomonas aeruginosaimipenemresistanceheteroresistancemolecular mechanismoprd
collection DOAJ
language English
format Article
sources DOAJ
author Xu Y
Zheng X
Zeng W
Chen T
Liao W
Qian J
Lin J
Zhou C
Tian X
Cao J
Zhou T
spellingShingle Xu Y
Zheng X
Zeng W
Chen T
Liao W
Qian J
Lin J
Zhou C
Tian X
Cao J
Zhou T
Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa
Infection and Drug Resistance
pseudomonas aeruginosa
imipenem
resistance
heteroresistance
molecular mechanism
oprd
author_facet Xu Y
Zheng X
Zeng W
Chen T
Liao W
Qian J
Lin J
Zhou C
Tian X
Cao J
Zhou T
author_sort Xu Y
title Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa
title_short Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa
title_full Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa
title_fullStr Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa
title_full_unstemmed Mechanisms of Heteroresistance and Resistance to Imipenem in Pseudomonas aeruginosa
title_sort mechanisms of heteroresistance and resistance to imipenem in pseudomonas aeruginosa
publisher Dove Medical Press
series Infection and Drug Resistance
issn 1178-6973
publishDate 2020-05-01
description Ye Xu,1 Xiangkuo Zheng,2 Weiliang Zeng,2 Tao Chen,1 Wenli Liao,1 Jiao Qian,1 Jie Lin,1 Cui Zhou,1 Xuebin Tian,2 Jianming Cao,2 Tieli Zhou1 1Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of China; 2Department of Medical Laboratory Science, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, Zhejiang Province, People’s Republic of ChinaCorrespondence: Jianming Cao; Tieli Zhou Tel +86-577-88069595; +86-577-86689885Email wzcjming@163.com; wyztli@163.comBackground: Heteroresistance is a phenomenon that occurs in all bacteria and can cause treatment failure. Yet, the exact mechanisms responsible for heteroresistance still remain unknown. The following study investigated the mechanisms of imipenem-heteroresistance and -resistance in Pseudomonas aeruginosa clinical isolates from Wenzhou, China.Methods: Imipenem resistance was detected by the agar dilution method; heteroresistance was determined by population analysis profiles. Biofilm formation assay and modified carbapenem inactivation methods were also performed. Polymerase chain reaction (PCR) was conducted to detect oprD, and quantitative real-time PCR was used to determine expression levels of oprD, ampC and four efflux pump coding genes (mexB, mexD, mexE and mexY).Results: Six imipenem-heteroresistant and -resistant P. aeruginosa isolates were selected respectively. Deficient oprD was detected in all resistant isolates and two heteroresistant isolates. No strains produced carbapenemases. Expression levels of oprD were down-regulated in heteroresistant isolates. Transcription levels of the mexE and mexY were significantly increased in all heterogeneous subpopulations compared with their respective native ones. Compared with the susceptible group, increased mean relative expression levels of mexE and mexY or the decreased mean relative expression levels of oprD were observed in the resistant group (P < 0.05), whereas transcription levels of the mexB and mexD remained unchanged.Conclusion: Down-regulation of oprD contributed to the resistance and heteroresistance of imipenem in our P. aeruginosa clinical isolates. In addition, the marginal up-regulation of efflux systems may indirectly affect imipenem resistance. Contrarily, defective oprD was less common in our experimental heteroresistant strains than resistant strains.Keywords: Pseudomonas aeruginosa, imipenem, resistance, heteroresistance, molecular mechanism, oprD
topic pseudomonas aeruginosa
imipenem
resistance
heteroresistance
molecular mechanism
oprd
url https://www.dovepress.com/mechanisms-of-heteroresistance-and-resistance-to-imipenem-in-pseudomon-peer-reviewed-article-IDR
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