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. 2021 Sep 7;20:64. doi: 10.1186/s12941-021-00468-1

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 4 — Antibiotic resistance development of P. aeruginosa in a single patient during antibiotic therapy. a The disc diffusion inhibition zones for piperacillin/tazobactam (TZP), meropenem (MEM), ciprofloxacin (CIP), ceftazidime (CAZ), cefepime (FEP), tobramycin (TOB) and gentamicin (GEN) are shown for eight consecutive isolates (labeled from 1 to 8), collected after 9, 10, 16, 17, 18, 22, 29 and 37 days of ICU admission. Horizontal dashed lines indicate the EUCAST clinical resistant breakpoint values for TZP (18 mm), MEM (18 mm), CIP (26 mm), CAZ (17 mm), FEP (21 mm), TOB (18 mm) and GEN (15 mm), respectively. The bracket describes the resistance determinant detected in the P. aeruginosa isolates by whole-genome sequencing. b Antibiotic therapy of the patient. Piperacillin/tazobactam (TZP), meropenem (MEM), ciprofloxacin (CIP), gentamicin (GEN), ceftazidime/avibactam (CZA) and tobramycin (TOB)