Table 1 List of studied P. aeruginosa isolates with antibiotic susceptibility profiles, antibiotics received by patients, genomic variations found between the earliest isolate and late isolates of each patient, and clinical evolution.

From: Rapid genetic and phenotypic changes in Pseudomonas aeruginosa clinical strains during ventilator-associated pneumonia

Isolate

Clinical specimen

Days of mechanical ventilation

Sequence Type

MICs (mg/L)a

Antibiotic treatment (initiation day)a

Genomic variationb

Coding region change

Amino acid changec

Clinical evolution

TIC

TCC

PIP

CAZ

IPM

CIP

Patient 1 ( strain PA-VAP-1 )

1A

BAL

3 days

1027

16

16

≤4

2

2

≤0.25

CAZ (day 6)

  

death in intensive care unit

1B

BAL

14 days

1027

16

16

≤4

≤1

2

≤0.25

 

  

1C

BAL

14 days

1027

>64

>64

>64

32

2

≤0.25

IPM/AN (day 17)

SNP

ampD: 358 G > T

AmpD: Glu120*

 

SNP

gacA: 601 T > G

GacA: Ser201Ala

Patient 2 ( strain PA-VAP-2 )

2A

BAL

4 days

2960

32

32

8

4

0.5

≤0.25

CAZ/CS (day 5)

  

death in intensive care unit

2B

BAL

27 days

2960

64

32

16

4

≥16

≤0.25

 

INS

oprD: 672_673insC

OprD: Tyr225fs

 

SNP

groEL: 560 C > T

GroEL: Pro187Leu

2C

BAL

27 days

2960

32

32

16

4

0.5

≤0.25

FEP/CS (day 30)

SNP

groEL: 560 C > T

GroEL: Pro187Leu

 

SNP

pilM: 808 C > T

PilM: Gln270*

INS

pilE: 208_209insTCGG

PilE: Thr70fs

Patient 3 ( strain PA-VAP-3 )

3A

BAL

1 day

253

32

32

16

4

1

2

IPM/TN (day 1)

  

discharge from intensive care unit

3B

BAL

11 days

253

32

16

8

4

1

2

IPM (day 11); CAZ/CS (day 13)

DEL

lasR: 138_148delCTACGAGAACG

LasR: Tyr47fs

 

INS

algB: 853_854insCCGCGACCAA

AlgB: Trp288fs

3C

BAL

35 days

253

32

32

8

4

≥16

2

FEP (day 37)

DEL

lasR: 138_148delCTACGAGAACG

LasR: Tyr47fs

 

INS

algB: 853_854insCCGCGACCAA

AlgB: Trp288fs

 

DEL

oprD: 16_132del117-bp

OprD: loss of 39 AA

SNP

mpl: 314 T > G

Mpl: Val105Gly

Patient 4 ( strain PA-VAP-4 )

4A

BAL

21 days

2042

32

32

16

2

1

≤0.25

FEP/LVX (day 22)

  

discharge from intensive care unit

4B

BAL

46 days

2042

≥128

≥128

64

8

1

1

IPM (day 46)

SNP

lasR: 676 G >A

LasR: Val226Ile

 

DEL

rhlA, rhlB, and rhlR: 175_1 del 2186-bp

loss of RhlR & RhlB RhlA: Phe59fs

INS

mexR: 80_81insT

MexR: Glu27fs

4C

blood culture

48 days

2042

32

16

8

2

1

≤0.25

 

  
  1. aAN, amikacin; CAZ, ceftazidime; CIP, ciprofloxacin; CS, colistin; FEP, cefepime; IPM, imipenem; LVX, levofloxacin; PIP, piperacillin; TCC, ticarcillin-clavulanate; TIC, ticarcillin; TN, tobramycin.
  2. bDEL, deletion; INS, insertion; SNP, Single Nucleotide Polymorphism.
  3. c,*STOP codon; AA, amino acids; fs, frameshift mutation.