engleski

Resistance mechanisms of Pseudomonas aeruginosa to fluoroquinolones

The bacterium Pseudomonas aeruginosa is the cause of difficult-to-treat opportunistic infections in humans and animals with innate resistance to a variety of antimicrobial drugs commonly used in human and veterinary medicine. This innate resistance significantly limits the range of antimicrobials effective against this bacterium to carboxypenicillins (carbenicillin, ticarcillin), ureidopenicillins (piperacillin), third (cefoperazone, ceftazidime) and fourth generation cephalosporins (cefepime, cefpirome), carbapenems, aminoglycosides, fluoroquinolones, and polymyxins. All those antimicrobial groups are categorized by the World Health Organization as critically important antimicrobials in human medicine, so their use in veterinary medicine is strongly discouraged. In addition, P. aeruginosa is rapidly evolving new resistance mechanisms by acquiring resistance genes or adapting to environmental conditions, which is manifested by overexpression of efflux pumps, decreased expression of porin for antimicrobial entry, and modified target sites for antimicrobials. Of concern is the fact that multiple resistance mechanisms can manifest simultaneously in a single isolate, resulting in a multidrug-resistant phenotype. Fluoroquinolones are synthetic antimicrobial drugs with broad spectrum of antibacterial activity against Gram- negative pathogens, including P. aeruginosa. Their efficacy depends on the applied dose, i.e., the concentration reached in the tissues. In addition to better antibacterial efficacy, the optimal dose and treatment duration prevents the selection of resistant bacterial strains and the spread of resistance. In this paper, we provide an overview of the resistance mechanisms of P. aeruginosa to fluoroquinolones: decreased permeability, increased activity of efflux pumps, target site modifications, and acquisition of plasmids carrying resistance genes.

acquired resistance ; fluoroquinolones ; innate resistance ; Pseudomonas aeruginosa ; resistance mechanisms

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