Table 5 Modifications in target genes of the QRDR, efflux pump regulators, the oprD gene and antimicrobial susceptibility to fluoroquinolones and carbapenems in exoU+ and exoU− isolates.

From: High frequency of the exoU+/exoS+ genotype associated with multidrug-resistant “high-risk clones” of Pseudomonas aeruginosa clinical isolates from Peruvian hospitals

exoU Genotype	Isolates	gyrA	parC	nalD	nalC	mexR	nfxB	mexZ	mexS	mexT	FQ MIC (mg/L)			oprD	IMI	MER
exoU Genotype	Isolates	gyrA	parC	nalD	nalC	mexR	nfxB	mexZ	mexS	mexT	LVX	OFX	CIP	oprD	IMI	MER
exoU+	1069	—	—	—	G71E	—	—	—	NA-c	—	0.5	2	0.5	2	S	S
exoU+	1070	T83I	S87L	∆_nt397-398	G71E,S209R	V126E	—	L105R	—	—	64	128	32	W65* + 2	R	R
exoU+	1071	T83I	S87L	—	G71E,S209R	V126E	—	L105R	—	—	64	128	32	W65* + 2	R	R
exoU+	1072	T83I	S87L	NA	G71E,S209R	V126E,L131P	—	L105R	NA-b	—	64	128	64	NA	R	R
exoU+	1073	E153K	—	R44P	G71E,S209R,A145V	V126E	—	L105R,R167S	—	—	32	64	8	3	S	S
exoU+	1074	—	—	—	G71E,S209R	V126E	—	NA	NA-c	—	1	2	0.5	3	S	S
exoU+	1075	T83I	S87L	—	G71E,S209R,D79E	V126E	—	G56S	V73A	—	16	64	16	3	R	R
exoU+	1076	—	S87L	—	G71E,S209R	—	—	—	—	—	128	>256	128	T103S,K115T,F170L, E185Q,P186G,V189T,G307D	R	R
exoU+	1077	T83I	S87L	—	G71E,S209R	V126E	—	—	—	—	64	32	64	ins_{nt 1201-1205} (GTCCA) + 3	R	R
exoU+	1078	T83I	S87L	∆_{nt 263-279}	—	V126E	—	—	—	—	128	256	64	ins_{nt 1201-1205} (GTCCA) + 3	R	R
exoU+	1079	T83I/D87N	S87L	∆_{nt 263-279}	G71E,S209R	V126E	—	—	—	—	256	256	256	3	S	S
exoU+	1080	T83I	S87L	∆_{nt 263-279}	G71E,S209R	V126E	—	—	NA-b	-	64	128	64	ins_{nt 1201-1205} (GTCCA) + 3	R	R
exoU+	1081	T83I	S87L	L194R	G71E,S209R	V126E	—	—	—	—	64	256	64	3	S	S
exoU−	1082	—	—	—	G71E,S209R	—	—	—	—	NA	0.5	1	0.5	4	S	S
exoU−	1084	T83I	S87L	NA	G71E,A145V,S209R	—	—	—	NA-c	P185R	128	256	64	ins_nt941–942(GC)	R	R
exoU−	1085	T83I	S87L	∆_nt451-461	G71E,S209R	—	—	Y18C	NA-c	—	128	256	128	—	S	S
exoU−	1086	T83I	S87L	∆_{nt 397-398}	G71E,S209R	V126E	—	∆_{AA F103-V112}	—	—	64	128	64	ins_nt678 (G) + C	R	R
exoU−	1087	—	—	—	NA	V126E	—	L105R	NA-c	—	1	2	0.25	3	R	S
exoU−	1088	—	—	—	NA	V126E	—	—	NA-c	NA	0.5	1	0.5	2	S	S
exoU−	1089	T83I	S87L	∆_{nt 397-398}	G71E,S209R	V126E	—	L105R	—	—	128	128	32	2	R	R
exoU−	1092	D87N	S87L	1	G71E,S209R	V126E	—	S66L	—	—	4	4	2	NA	S	S
exoU−	1093	T83I	—	∆_{nt 397-398}	G71E,S209R	V126E	—	L105R	—	—	64	256	32	NA	R	R
exoU−	1094	—	—	—	∆_nt234-243 + G71E,Q81P	—	—	—	NA-b	—	4	16	0.5	2	S	S
exoU−	1095	T83I	S87L	—	G71E,S209R	NA	—	H18Y	NA-b	—	64	64	32	Y49* + 4	R	R
exoU−	1096	T83I	S87L	∆_{nt 391}	G71E,S209R	V126E	—	V72L	G224S	—	128	128	64	V127L	S	S
exoU-	1097	—	—	∆_{nt 391}	G71E,S209R	—	—	—	NA-b	—	4	2	0.25	3	S	S
exoU−	1098	—	—	T188A	G71E,S209R,P210L	—	—	Q21*	—	—	1	1	1	ins_{nt 605-609} (CAACA) + 4	R	S
exoU−	1100	T83I	S87L	—	G71E,S209R	NA	—	H18Y	—	—	64	128	32	Y49* + 4	R	R
exoU−	1102	T83I	S87L	—	G71E,S209R	V126E	—	H18Y	—	—	16	64	8	Y49* + 4	R	R
exoU−	1103	—	—	—	G71E,A186T	—	—	E124K	—	—	2	2	0.25	NA	S	S
exoU−	1104	—	—	—	G71E,S209R	L131P	—	—	NA-c	—	8	32	32	4	R	R
exoU−	1105	T83I	S87L	∆_{nt 397-398}	G71E,S209R	V126E	—	L105R	—	—	64	64	32	W65* + 2	R	R
exoU−	1106	—	S87L	—	—	NA	—	∆_nt408-409	NA-c	—	4	2	1	—	S	S
exoU−	1107	—	—	—	G71E,S209R,P210L	NA	—	L95M	NA-c	D290E	2	2	0.5	4	S	S
exoU−	1108	—	—	T188A	G71E,S209R	—	—	—	—	—	0.5	2	0.5	3	S	S
exoU−	1109	—	—	—	G71E,S209R,D79E	—	—	—	—	NA	0.5	1	0.5	4	S	S
exoU−	1110	T83I	S87L	—	G71E,S209R	—	—	—	—	P185R	128	256	128	ins_nt941–942(GC)	R	S
exoU−	1111	T83I	S87L	—	—	NA	—	H18Y	NA-b	—	128	> 256	128	Y49* + 4	R	R
exoU−	1112	T83I	S87L	—	G71E,S209R	NA	—	H18Y	NA-b	—	64	128	64	Y49* + 4	R	R
exoU−	1113	T83I	S87L	∆_{nt 397-398}	G71E,S209R	V126E	—	L105R	—	—	128	128	32	W65* + 2	R	R
exoU−	1114	—	S87L	—	G71E,S209R	—	—	—	—	—	16	32	16	4	S	S
exoU−	1115	T83I	S87L	—	G71E,S209R	—	—	—	—	—	32	64	32	4	S	S
exoU−	1116	T83I	S87L	—	G71E,S209R	—	—	—	—	—	32	64	32	4	S	S
exoU−	1117	—	—	—	—	—	—	—	NA-c	—	16	4	0.25	4	S	S
exoU−	1118	T83I/D87N	S87L	∆_{nt 263-279}	G71E,S209R	V126E	—	—	—	—	128	>256	>256	3	S	S
exoU−	1119	T83I	—	—	S209R	V126E	—	—	NA-b	—	8	16	4	4	S	S
exoU−	1120	—	—	—	G71E,S209R	V126E	—	—	NA-d	—	8	4	2	4	S	S
exoU−	1121	—	—	—	G71E,S209R	NA	—	L141Q	NA-c	—	8	64	1	ins_nt1087(A) + ∆_{nt 1294}(T) + T103S,K115T,F170L	R	R
exoU−	1122	D87N	—	—	G71E,S209R	—	—	—	NA-c	—	64	64	64	Y49* + 4	R	R
exoU−	1123	T83I	S87L	—	G71E,S209R	NA	—	H18Y	—	—	64	128	32	Y49* + 4	R	R

The symbol “−” represent wild type isolates; NA: No amplification; the symbol ∆_nt represents nucleotide deletion being noted the first and last nucleotides deleted; the symbol ∆_AA represents amino acid deletions being noted the first and last amino acid deleted; ins_nt: nucleotide insertion; The symbol “*” represents codon STOP. FQ-MIC: MIC to fluoroquinolones (LVX: Levofloxacin; OFX: Ofloxacin; CIP: Ciprofloxacin); IMI/MER are isolates showing susceptibility (S); resistance or intermediate susceptibility (R) to imipenem or meropenem performed by the disk diffusion assay.
Alterations at nalC, nalD, mexR, mexS and mexT as well as the patterns of OprD were previously described¹⁷. The patterns of OprD are named accordingly to Horna et al.¹⁷.
1. Amino acid substitutions: Q134H, Q142H, A145P, D147H, E148K, C149R, H154P, R160K, D176E, D185Y, G206S, S209I.
2. oprD-Pattern C¹⁷: V127L, E185Q, P186G, V189T, E202Q, I210A, E230K, S240T, N262T, T276A, A281G, K296Q, Q301E, R310E, (±G312R), A315G, L347M, S403A, Q424E + 372V-DSSSSYAGL-383.
3. oprD-Pattern B¹⁷: T103S, K115T, F170L, E185Q, P186G, V189T, R310E, A315G, (±G425A).
4. oprD-Pattern A¹⁷: E202Q, I210A, E230K, S240T, N262T, A267S, A281G, K296Q, Q301E, R310G, (±V352I), V359L, (±Q424R) + 372V-DSSSSYAGL-383.
NA-b: No amplification of mexS gene but amplification of N- and C-terminal regions.
NA-c: No amplification of mexS gene but amplification of N-terminal region.
NA-d: No amplification of mexS gene and no amplification of N- and C- terminal regions.

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Table 5 Modifications in target genes of the QRDR, efflux pump regulators, the oprD gene and antimicrobial susceptibility to fluoroquinolones and carbapenems in exoU+ and exoU− isolates.

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