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首页> 外文期刊>Journal of Clinical Microbiology >Stable polymyxin B susceptibility to Pseudomonas aeruginosa and Acinetobacter spp. despite persistent recovery of these organisms from respiratory secretions of patients with ventilator-associated pneumonia treated with this drug.
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Stable polymyxin B susceptibility to Pseudomonas aeruginosa and Acinetobacter spp. despite persistent recovery of these organisms from respiratory secretions of patients with ventilator-associated pneumonia treated with this drug.

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In a recent article, Lee et al. (4) reported the occurrence of an increase in MICs for polymyxin B during therapy in 3 of 16 patients treated with this drug for carbapenem-resistant Klebsiella pneumoniae infections. This report is very important, since polymyxins, polymyxin B and colistin, are last-resort drugs for the treatment of multidrug-resistant gram-negative bacteria (7, 9) and rapid development of resistance occurring during exposure to polymyxins in in vitro infection models with simulated clinical dosage regimens have been reported (2, 6), including resistance to K. pneumoniae (5), but no in vivo demonstration of this phenomenon has been reported so far. The report of Lee et al. is of great concern, although no data about polymyxin B dosages were presented and, as acknowledged by the authors, it was not possible to definitively characterize whether there was the emergence of resistance in the same strain or patients were further infected by distinct strains resistant to polymyxin B during therapy.

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