Three different P. aeruginosa isolates from tracheobronchial secretions of patients with sepsis due to VAP were used; a) the P. aeruginosa 6–11–19 isolate with minimal inhibitory concentration (MIC) of amikacin, ceftazidime, ciprofloxacin and meropenem >256, >512, >16 and 8 μg/ml respectively; b) the P. aeruginosa 19–2–45 isolate 2 with MIC of amikacin, ceftazidime, ciprofloxacin and meropenem >256, >512, >128 and >256 μg/ml respectively; and c) the P. aeruginosa 20–1–30 isolate with MIC of amikacin, ceftazidime, ciprofloxacin and meropenem >256, >512, >64 and >64 μg/ml respectively. Ιsolates were genetically distinct as defined by pulsed-field gel electrophoresis (PFGE) of their DNA to exclude similar isolates coming from horizontal spread (S3A Fig). Additionally, a K. pneumoniae 87Β producing carbapenemase KPC-2 isolate with MIC of amikacin, meropenem, aztreonam and colistin >512, >512, 128 and 32 μg/ml respectively. The MIC was measured with the microdilution method and the production of KPC-2 by polymerase chain reaction.

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