Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1990 Nov;34(11):2142–2147. doi: 10.1128/aac.34.11.2142

Development of quinolone-imipenem cross resistance in Pseudomonas aeruginosa during exposure to ciprofloxacin.

G Rådberg 1, L E Nilsson 1, S Svensson 1
PMCID: PMC172014  PMID: 2127345

Abstract

Selection and regrowth of ciprofloxacin-resistant variants, which were present in low frequencies in the initial inoculum, were seen when large inocula of Pseudomonas aeruginosa were incubated with ciprofloxacin. These variants showed cross resistance to other quinolones. In 8 of 13 strains tested, ciprofloxacin selected imipenem-resistant variants in a similar way to imipenem. The opposite phenomenon of ciprofloxacin-imipenem cross resistance after exposure to imipenem was not detected. None of the ciprofloxacin-resistant variants showed cross resistance to aztreonam, piperacillin, or tobramycin. These findings indicate that widespread and uncritical use of ciprofloxacin gives a potential risk of development of resistance in P. aeruginosa not only to quinolones but also to another unrelated useful agent, imipenem. In vitro evaluation of this phenomenon in isolates from patients with P. aeruginosa infections may be justified, since strains differ in development of quinolone-imipenem cross resistance after ciprofloxacin exposure.

Full text

PDF
2142

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barry A. L., Jones R. N. Cross-resistance among cinoxacin, ciprofloxacin, DJ-6783, enoxacin, nalidixic acid, norfloxacin, and oxolinic acid after in vitro selection of resistant populations. Antimicrob Agents Chemother. 1984 Jun;25(6):775–777. doi: 10.1128/aac.25.6.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cullmann W., Stieglitz M., Baars B., Opferkuch W. Comparative evaluation of recently developed quinolone compounds--with a note on the frequency of resistant mutants. Chemotherapy. 1985;31(1):19–28. doi: 10.1159/000238309. [DOI] [PubMed] [Google Scholar]
  3. Daikos G. L., Lolans V. T., Jackson G. G. Alterations in outer membrane proteins of Pseudomonas aeruginosa associated with selective resistance to quinolones. Antimicrob Agents Chemother. 1988 May;32(5):785–787. doi: 10.1128/aac.32.5.785. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Kaatz G. W., Seo S. M. Mechanism of ciprofloxacin resistance in Pseudomonas aeruginosa. J Infect Dis. 1988 Sep;158(3):537–541. doi: 10.1093/infdis/158.3.537. [DOI] [PubMed] [Google Scholar]
  5. Legakis N. J., Tzouvelekis L. S., Makris A., Kotsifaki H. Outer membrane alterations in multiresistant mutants of Pseudomonas aeruginosa selected by ciprofloxacin. Antimicrob Agents Chemother. 1989 Jan;33(1):124–127. doi: 10.1128/aac.33.1.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Limb D. I., Dabbs D. J., Spencer R. C. In-vitro selection of bacteria resistant to the 4-quinolone agents. J Antimicrob Chemother. 1987 Jan;19(1):65–71. doi: 10.1093/jac/19.1.65. [DOI] [PubMed] [Google Scholar]
  7. Michéa-Hamzehpour M., Auckenthaler R., Regamey P., Pechère J. C. Resistance occurring after fluoroquinolone therapy of experimental Pseudomonas aeruginosa peritonitis. Antimicrob Agents Chemother. 1987 Nov;31(11):1803–1808. doi: 10.1128/aac.31.11.1803. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Nilsson L., Nilsson M., Jendle J. Subpopulations of variants resistant to imipenem in Pseudomonas aeruginosa. J Antimicrob Chemother. 1988 Nov;22(5):643–649. doi: 10.1093/jac/22.5.643. [DOI] [PubMed] [Google Scholar]
  9. Nilsson L., Sörén L., Rådberg G. Frequencies of variants resistant to different aminoglycosides in Pseudomonas aeruginosa. J Antimicrob Chemother. 1987 Aug;20(2):255–259. doi: 10.1093/jac/20.2.255. [DOI] [PubMed] [Google Scholar]
  10. Piddock L. J., Wijnands W. J., Wise R. Quinolone/ureidopenicillin cross-resistance. Lancet. 1987 Oct 17;2(8564):907–907. doi: 10.1016/s0140-6736(87)91387-0. [DOI] [PubMed] [Google Scholar]
  11. Robillard N. J., Scarpa A. L. Genetic and physiological characterization of ciprofloxacin resistance in Pseudomonas aeruginosa PAO. Antimicrob Agents Chemother. 1988 Apr;32(4):535–539. doi: 10.1128/aac.32.4.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sanders C. C., Sanders W. E., Jr, Goering R. V., Werner V. Selection of multiple antibiotic resistance by quinolones, beta-lactams, and aminoglycosides with special reference to cross-resistance between unrelated drug classes. Antimicrob Agents Chemother. 1984 Dec;26(6):797–801. doi: 10.1128/aac.26.6.797. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES