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Impact of anticancer chemotherapy on the extension of beta-lactamase spectrum: an example with KPC-type carbapenemase activity towards ceftazidime-avibactam.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-01-17 , DOI: 10.1038/s41598-020-57505-w
Claire Amaris Hobson 1 , Stéphane Bonacorsi 1, 2 , Didier Hocquet 3 , André Baruchel 4 , Mony Fahd 4 , Thomas Storme 5 , Raksamy Tang 5 , Catherine Doit 1, 2 , Olivier Tenaillon 1 , André Birgy 1, 2
Affiliation  

Through their action on DNA replication, anticancer chemotherapies could increase the basal mutation rate in bacteria and increase the risk of selecting antibiotic resistant mutants. We investigated the impact of several drugs on a beta-lactamase model using KPC-type carbapenemase-producing Enterobacteriaceae. We studied the impact of anticancer chemotherapies used in pediatric hematologic malignancies on 7 clinical isolates of Enterobacteriaceae producing KPC-type carbapenemases. We compared the mutation rates from cultures with/without chemotherapy on ceftazidime-avibactam, rifampicin and ceftazidime-avibactam combined with meropenem media. Mechanisms of ceftazidime-avibactam resistance were explored on a subset of mutants. After exposure to some cytotoxic molecules, the bacterial mutation rates leading to ceftazidime-avibactam and to rifampicin resistance increased up to 104-fold while we observed no emergence of resistant mutants (frequency of <10-10) on a meropenem combined with ceftazidime-avibactam media. Compared to the parental strains, an increased susceptibility to meropenem was observed in the ceftazidime-avibactam resistant mutants. The blaKPC genes of ceftazidime-avibactam mutants harbored either mutations, deletions or insertions, especially in the region encoding the Ω-loop of the KPC-type carbapenemase. Anticancer chemotherapy can increase the mutation rates of bacteria accelerating the extension of KPC-type carbapenemases towards ceftazidime-avibactam, one of the last resort antimicrobial chemotherapy.

中文翻译:


抗癌化疗对 β-内酰胺酶谱扩展的影响:以 KPC 型碳青霉烯酶对头孢他啶-阿维巴坦的活性为例。



通过对 DNA 复制的作用,抗癌化疗可能会增加细菌的基础突变率,并增加选择抗生素耐药突变体的风险。我们使用 KPC 型产碳青霉烯酶肠杆菌科细菌研究了几种药物对 β-内酰胺酶模型的影响。我们研究了儿童血液恶性肿瘤中使用的抗癌化疗对 7 种产生 KPC 型碳青霉烯酶的肠杆菌科临床分离株的影响。我们比较了使用/未使用头孢他啶-阿维巴坦、利福平和头孢他啶-阿维巴坦联合美罗培南培养基进行化疗的培养物的突变率。在一部分突变体中探索了头孢他啶-阿维巴坦耐药机制。暴露于一些细胞毒性分子后,导致头孢他啶-阿维巴坦和利福平耐药的细菌突变率增加至 104 倍,而我们观察到美罗培南与头孢他啶-阿维巴坦联合使用时没有出现耐药突变体(频率为 <10-10)媒体。与亲本菌株相比,在头孢他啶-阿维巴坦抗性突变体中观察到对美罗培南的敏感性增加。头孢他啶-阿维巴坦突变体的 blaKPC 基因存在突变、缺失或插入,特别是在编码 KPC 型碳青霉烯酶 Ω 环的区域。抗癌化疗可以增加细菌的突变率,加速KPC型碳青霉烯酶向头孢他啶-阿维巴坦的延伸,头孢他啶-阿维巴坦是最后的抗菌化疗手段之一。
更新日期:2020-01-17
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