ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2024
Antimicrobial susceptibility testing reveals reduced susceptibility to azithromycin and other antibiotics in Legionella pneumophila serogroup 1 isolates from Portugal.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 8 citations in OpenAlex.
- Longitudinal Antimicrobial Susceptibility Shifts in EnvironmentalPathogens (Basel, Switzerland) · 2026Article
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- Antimicrobial Susceptibility Determination of Less Frequently IsolatedAntibiotics (Basel, Switzerland) · 2025Article
- Comparison of Phenotypic and Whole-Genome Sequencing-Derived Antimicrobial Resistance Profiles ofAntibiotics (Basel, Switzerland) · 2025Article
- Antimicrobial susceptibility of Legionella gormanii: species-specific ECOFFs, distinct MICs for rifampin versus Legionella pneumophila.Annals of clinical microbiology and antimicrobials · 2025Article
- A retrospective observational cohort study of oral azithromycin treatment for Legionnaires' disease.The Journal of antimicrobial chemotherapy · 2025Observational
- Antimicrobial Resistance Genes inAntibiotics (Basel, Switzerland) · 2024Article
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6 authors at 2 institutions in 4 countries.
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Abstract
backgroudAlthough not fully investigated, studies show that Legionella pneumophila can develop antibiotic resistance. As there is limited data available for Portugal, we determined the antibiotic susceptibility profile of Portuguese L. pneumophila serogroup 1 (LpnSg1) isolates against antibiotics used in the clinical practice in Portugal.
methodsMinimum inhibitory concentrations (MICs) were determined for LpnSg1 clinical (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 three different assays. Isolates were also PCR-screened for the presence of the lpeAB gene.
resultsTwelve isolates had azithromycin MICs above the EUCAST tentative highest WT MIC, 9 of which were lpeAB negative; 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 eightfold higher than the E-test ECOFF. Additionally, a clinical isolate generated three colonies growing on the E-test inhibition zone that resulted in MICs fourfold 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 Portuguese L. pneumophila strains. Results point towards decreased susceptibility in circulating strains, justifying further investigation.
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