{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:24:04Z","timestamp":1777922644367,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:p>\n                    This study evaluated the presence of distinct mechanisms of beta-lactam resistance in 122\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    isolates, causing bloodstream infections at Hospital S\u00e3o Paulo (HSP, Brazil; 82 isolates) and Virginia Commonwealth University Medical Center (VCU, United States; 40 isolates). By Clinical Laboratory Standards Institute agar dilution, Brazilian\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    isolates showed higher resistance rates to most antimicrobials tested than those collected from the United States, except for ciprofloxacin. Carbapenem hydrolysis was detected in seven\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    from HSP, in which\n                    <jats:italic toggle=\"yes\">\n                      bla\n                      <jats:sub>SPM-1<\/jats:sub>\n                    <\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    =5),\n                    <jats:italic toggle=\"yes\">\n                      bla\n                      <jats:sub>IMP-1<\/jats:sub>\n                    <\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    =1), and\n                    <jats:italic toggle=\"yes\">\n                      bla\n                      <jats:sub>IMP-16<\/jats:sub>\n                    <\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    =1) were detected by polymerase chain reaction (PCR) followed by DNA sequencing. The production of GES-5 was observed in 1.25% of HSP isolates. No extended-spectrum beta-lactamase-encoding genes were detected in the VCU isolates. Expression of efflux systems genes (\n                    <jats:italic toggle=\"yes\">mexB<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">mexD<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">mexF<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">mexY<\/jats:italic>\n                    ) was evaluated by quantitative reverse transcriptase\u2013PCR. In HSP isolates MexXY-OprM (41.4%) efflux system was more frequently overexpressed, in contrast to what was observed in the VCU isolates, where both MexXY-OprM (25.0%) and MexAB-OprM (25.0%) were equally overexpressed. The\n                    <jats:italic toggle=\"yes\">oprD<\/jats:italic>\n                    downregulation was similar among isolates collected from the HSP (92.7%) and VCU (95.0%). On the other hand,\n                    <jats:italic toggle=\"yes\">ampC<\/jats:italic>\n                    overexpression was observed only among HSP isolates (31.7%). The distinct antimicrobial susceptibility profile and mechanisms of beta-lactam resistance found among\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    isolated from teaching hospitals located in Brazil and the United States exemplify the importance of local epidemiology in determining antimicrobial resistance rates.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2011.0174","type":"journal-article","created":{"date-parts":[[2012,3,28]],"date-time":"2012-03-28T14:24:09Z","timestamp":1332944649000},"page":"402-407","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Beta-Lactam Resistance Mechanisms in\n                    <i>Pseudomonas aeruginosa<\/i>\n                    Strains Causing Bloodstream Infections: Comparative Results Between Brazilian and American Isolates"],"prefix":"10.1177","volume":"18","author":[{"given":"Lorena C.C.","family":"Fehlberg","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danilo E.","family":"Xavier","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula P.","family":"Peraro","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre R.","family":"Marra","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["Brazil"]},{"name":"Hospital Israelita Albert Einstein","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Edmond","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana C.","family":"Gales","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,8]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"3","article-title":"Antimicrobial susceptibility of Gram-negative bacilli isolated in Brazilian hospitals participating in the SENTRY Program (2003\u20132008)","volume":"12","author":"Andrade S.","year":"2008","unstructured":"Andrade S., , Sader H.S., , Barth A., , Ribeiro J., , Zoccolli C., , Pignatari A.C.C. et al. 2008. Antimicrobial susceptibility of Gram-negative bacilli isolated in Brazilian hospitals participating in the SENTRY Program (2003\u20132008) Braz. J. Infec. Dis., 12:3\u20139.","journal-title":"Braz. J. Infec. Dis."},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1128\/AAC.01645-10","article-title":"Overexpression of AmpC and efflux pumps in Pseudomonas aeruginosa isolates from bloodstream infections: prevalence and impact on resistance in Spanish Multicenter Study","volume":"55","author":"Cabot G.","year":"2011","unstructured":"Cabot G., , Ocampo-Sosa A.A., , Tubau F., , Macia M.D., , Rodriguez C., , Moya B. et al. 2011. Overexpression of AmpC and efflux pumps in Pseudomonas aeruginosa isolates from bloodstream infections: prevalence and impact on resistance in Spanish Multicenter Study. Antimicrob. Agents Chemother., 55:1906\u20131911.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_4_2","volume-title":"Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically: approved standard","author":"Clinical, Laboratory Standards Institute","year":"2009","unstructured":"Clinical, Laboratory Standards Institute. 2009. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically: approved standard, eighth. Wayne, PADocument M07-A8."},{"key":"e_1_3_3_5_2","volume-title":"Performance standards for antimicrobial susceptibility testing, twentieth informational supplement","author":"Clinical, Laboratory Standards Institute","year":"2010","unstructured":"Clinical, Laboratory Standards Institute. 2010. Performance standards for antimicrobial susceptibility testing, twentieth informational supplement. 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