Abstract
AbstractBackgroundAlthough not fully investigated, studies show thatLegionella pneumophilacan develop antibiotic resistance. As there is limited data available for Portugal, we determined the antibiotic susceptibility profile of PortugueseL. pneumophilaserogroup 1 (LpnSg1) isolates against antibiotics used in the clinical practice in Portugal.MethodsMinimum inhibitory concentrations (MICs) were determined forLpnSg1clinical (n=100) and related environmental (n=7) isolates, collected between 2006-2022 in the context of the National Legionnaire’s Disease Surveillance Programme, against azithromycin, clarithromycin, erythromycin, levofloxacin, ciprofloxacin, moxifloxacin, rifampicin, doxycycline, tigecycline, and amoxicillin/clavulanic acid, using 3 different assays. Isolates were also PCR-screened for the presence of thelpeABgene.ResultsTwelve isolates had azithromycin MICs above the EUCAST tentative highest WT MIC, 9 of which werelpeABnegative; for erythromycin and clarithromycin, all isolates tested within the susceptible range. The number of isolates with MICs above the tentative highest WT MIC for the remaining antibiotics was: ciprofloxacin: 7; levofloxacin: 17; moxifloxacin: 8; rifampicin: 11; doxycycline: 82; tigecycline: 4. EUCAST breakpoints are not available for amoxicillin/clavulanic acid. We estimated the ECOFFs and one isolate had a MIC 8-fold higher than the E-test ECOFF. Additionally, a clinical isolate generated three colonies growing on the E-test inhibition zone that resulted in MICs 4-fold higher than for the parental isolate.ConclusionsWe report, for the first time, elevated MICs against first-line and other antibiotics (including azithromycin, fluoroquinolones and amoxicillin/clavulanic acid commonly used to treat pneumonia patients in Portugal) in PortugueseL. pneumophilastrains. Results point towards decreased susceptibility in circulating strains, justifying further investigation.
Publisher
Cold Spring Harbor Laboratory
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