In vivo selection of a target/efflux double mutant of Pseudomonas aeruginosa by ciprofloxacin therapy
Open Access
- 1 October 2001
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Antimicrobial Chemotherapy
- Vol. 48 (4) , 553-555
- https://doi.org/10.1093/jac/48.4.553
Abstract
We report the emergence after 4 days of ciprofloxacin monotherapy of a double mutant of Pseudomonas aeruginosa overexpressing the multidrug efflux system MexAB-OprM and harbouring a mutation in the gyrB gene. Compared with its initial susceptible counterpart, this mutant exhibited a significant increase in resistance to most of the β-lactam antibiotics tested (16 × MIC of ticarcillin) and to ciprofloxacin (128 × MIC). Combined ceftazidime and amikacin therapy finally eradicated the resistant isolate and cured the patient of his infection. This case illustrates how strains of P. aeruginosa may develop high levels of fluoroquinolone resistance by combining efflux mechanisms and target alterations.Keywords
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