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Journal of Antimicrobial Chemotherapy (1988) 22, 643-649
© 1988 The British Society for Antimicrobial Chemotherapy

research-article

Subpopulations of variants resistant to imipenem in Pseudomonas aeruginosa

Lennart Nilsson, Maud Nilsson and Johan Jendle

Department of Clinical Bacteriology, University Hospital S-58185, Linköping, Sweden

Received 4 May 1988; returned 27 June 1988; accepted 27 June 1988

Selection and regrowth of resistant variants, which were present in low frequencies in the initial inoculum, was seen when large inocula of Pseudomonas aeruginosa were incubated with imipenem. The selective growth of resistant variants resulted in an inoculum effect, and an increase in MIC with longer incubation. When large inocula taken from strains that had been classified as sensitive in conventional MIC determinations were incubated with 4, 8 and 16 mg/l imipenem, 62%, 24% and 10%, respectively, of the strains regrew. None of the resistant variants thereby selected showed cross resistance to other ß-lactam antibiotics or aminoglycosides. In vitro evaluation of regrowth of resistant variants may be justified when choosing imipenem for therapy in the treatment of serious P. aeruginosa infections.


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