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Predicting Antibiotic Resistance in Gram-Negative Bacilli from Resistance Genes.

ABSTRACT: We developed a rapid high-throughput PCR test and evaluated highly antibiotic-resistant clinical isolates of Escherichia coli (n?= 2,919), Klebsiella pneumoniae (n?= 1,974), Proteus mirabilis (n?= 1,150), and Pseudomonas aeruginosa (n?= 1,484) for several antibiotic resistance genes for comparison with phenotypic resistance across penicillins, cephalosporins, carbapenems, aminoglycosides, trimethoprim-sulfamethoxazole, fluoroquinolones, and macrolides. The isolates originated from hospitals in North America (34%), Europe (23%), Asia (13%), South America (12%), Africa (7%), or Oceania (1%) or were of unknown origin (9%). We developed statistical methods to predict phenotypic resistance from resistance genes for 49 antibiotic-organism combinations, including gentamicin, tobramycin, ciprofloxacin, levofloxacin, trimethoprim-sulfamethoxazole, ertapenem, imipenem, cefazolin, cefepime, cefotaxime, ceftazidime, ceftriaxone, ampicillin, and aztreonam. Average positive predictive values for genotypic prediction of phenotypic resistance were 91% for E. coli, 93% for K. pneumoniae, 87% for P. mirabilis, and 92% for P. aeruginosa across the various antibiotics for this highly resistant cohort of bacterial isolates.

SUBMITTER: Walker GT 

PROVIDER: S-EPMC6496154 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Predicting Antibiotic Resistance in Gram-Negative Bacilli from Resistance Genes.

Walker G Terrance GT   Quan Julia J   Higgins Stephen G SG   Toraskar Nikhil N   Chang Weizhong W   Saeed Alexander A   Sapiro Vadim V   Pitzer Kelsey K   Whitfield Natalie N   Lopansri Bert K BK   Motyl Mary M   Sahm Daniel D  

Antimicrobial agents and chemotherapy 20190327 4

We developed a rapid high-throughput PCR test and evaluated highly antibiotic-resistant clinical isolates of <i>Escherichia coli</i> (<i>n</i> = 2,919), <i>Klebsiella pneumoniae</i> (<i>n</i> = 1,974), <i>Proteus mirabilis</i> (<i>n</i> = 1,150), and <i>Pseudomonas aeruginosa</i> (<i>n</i> = 1,484) for several antibiotic resistance genes for comparison with phenotypic resistance across penicillins, cephalosporins, carbapenems, aminoglycosides, trimethoprim-sulfamethoxazole, fluoroquinolones, and  ...[more]

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