@article{3160629,
    title = "Accumulation of carbapenem resistance mechanisms in VIM-2-producing
Pseudomonas aeruginosa under selective pressure",
    author = "Meletis, G. and Vavatsi, N. and Exindari, M. and Protonotariou, E. and and Sianou, E. and Haitoglou, C. and Sofianou, D. and Pournaras, S. and and Diza, E.",
    journal = "European Journal of Clinical Microbiology & Infectious Diseases",
    year = "2014",
    volume = "33",
    number = "2",
    pages = "253-258",
    publisher = "Springer-Verlag",
    issn = "0934-9723, 1435-4373",
    doi = "10.1007/s10096-013-1952-3",
    abstract = "Pseudomonas aeruginosa has the potential to achieve resistance to
carbapenems via the acquisition of carbapenemase-encoding genes, the
downregulation of the OprD porin, the overexpression of efflux systems
and the overproduction of cephalosporinases. One hundred and fifty
carbapenem-non-susceptible isolates from 2008 to 2010 were screened for
carbapenemase production, OprD porin loss, efflux pumps overexpression
and inducible AmpC beta-lactamase production. For comparison reasons,
the presence of the same mechanisms was also assessed in a previous
collection of 30 carbapenem-non-susceptible P. aeruginosa isolated
between 2003 and 2005. Results showed the accumulation of various
resistance mechanisms among VIM-2 producers isolated between 2008 and
2010 with a parallel considerable increase in imipenem MIC90 and the
geometric mean of the MIC values of imipenem and meropenem between the
two study groups. The accumulation of carbapenem resistance mechanisms
highlights the potential of this formidable pathogen for evolutionary
success under antibiotic selective pressure."
}