Rådberg G, Nilsson L E, Svensson S
Department of Clinical Bacteriology, University Hospital, Linköping, Sweden.
Antimicrob Agents Chemother. 1990 Nov;34(11):2142-7. doi: 10.1128/AAC.34.11.2142.
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.
当大量铜绿假单胞菌接种物与环丙沙星一起孵育时，可观察到初始接种物中低频存在的环丙沙星耐药变体的选择和再生长。这些变体对其他喹诺酮类药物表现出交叉耐药性。在13株受试菌株中的8株中，环丙沙星以与亚胺培南类似的方式选择了亚胺培南耐药变体。未检测到暴露于亚胺培南后环丙沙星-亚胺培南交叉耐药的相反现象。没有环丙沙星耐药变体对氨曲南、哌拉西林或妥布霉素表现出交叉耐药性。这些发现表明，环丙沙星的广泛和无差别使用不仅会使铜绿假单胞菌产生对喹诺酮类药物的耐药性，还会使其对另一种不相关的有用药物亚胺培南产生耐药性。对铜绿假单胞菌感染患者分离株中这种现象进行体外评估可能是合理的，因为不同菌株在环丙沙星暴露后喹诺酮-亚胺培南交叉耐药性的发展情况有所不同。
