Emergence of Storm Resistant Mechanisms in Pseudomonas aeruginosa Isolated from Burn Patients Hospitalized in Ghotbeddin Shirazi Burn Hospital

Neda Pirbonyeh, Mitra Zardosht, Amir Emami, Sajad Rostampour, Afagh Moattari, Abdolkhalegh Keshavarzi

Abstract


Introduction: Pseudomonas aeruginosa is a bacterium has capability of presenting different policies against antimicrobial agents. These capacities make this bacterium as one of the most important cause of nosocomial infection especially among burned patients.

Methods: In this cross sectional study, total of 253 hospitalized burned patients (During September 2013 to November 2014) in Ghotbeddin Shirazi were evaluated for P. aeruginosa. Confirmed isolates tested for Metallo-β-lactamase (MBLs) producing and related genes blaIMPI, II, blaSPM, blaKHM, blaVIM, efflux pump activity, and OprD mutations.

Results: From total of 56 (22%) P. aeruginosa isolates, 32 (57.14%) were MBLs while in genetic evaluation, only blaIMPII, blaKHM and blaVIM genes were detected. While 52 (92.8%) isolates had MexAB-OprM gene but 44(78.6%) isolates had efflux pump activity. In OprD sequencing evaluation it has been proved that the most imipenem resistance isolates have mutations in this related gene. Based on the results it has been proved that the circulating P. aeruginosa isolates in Shiraz burn center are armed with the most potential resistant mechanisms.

Conclusion: According to that the most isolates have the potential of express different mechanisms of resistance, it is highly recommended to evaluate the circulating infectious agents periodically and determine their resistant algorithm to control them before being resistant and being dominant in health centers.


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References


Lambert PA. Mechanisms of antibiotic resistance in Pseudomonas aeruginosa. J R Soc Med. 2002;95 Suppl 41:22-6. PMID: 12216271

Nordmann P, Poirel L. Emerging carbapenemases in Gram-negative aerobes. Clin Microbiol Infect. 2002;8(6):321-31. PMID: 12084099

Garrec H, Drieux-Rouzet L, Golmard JL, Jarlier V, Robert J. Comparison of nine phenotypic methods for detection of extended-spectrum beta-lactamase production by Enterobacteriaceae. J Clin Microbiol. 2011;49(3):1048-57. DOI: 10.1128/JCM.02130-10 PMID: 21248086

Hafiane A, Ravaoarinoro M. Characterization of Pseudomonas aeruginosa strains isolated from cystic fibrosis patients by different typing methods. Pathol Biol (Paris). 2011;59(5):e109-14. DOI: 10.1016/j.patbio.2009.06.002 PMID: 19896303

Sader HS, Reis AO, Silbert S, Gales AC. IMPs, VIMs and SPMs: the diversity of metallo-beta-lactamases produced by carbapenem-resistant Pseudomonas aeruginosa in a Brazilian hospital. Clin Microbiol Infect. 2005;11(1):73-6. DOI: 10.1111/j.1469-0691.2004.01031.x PMID: 15649310

Queenan AM, Bush K. Carbapenemases: the versatile beta-lactamases. Clin Microbiol Rev. 2007;20(3):440-58, table of contents. DOI: 10.1128/CMR.00001-07 PMID: 17630334

Sekiguchi J, Morita K, Kitao T, Watanabe N, Okazaki M, Miyoshi-Akiyama T, et al. KHM-1, a novel plasmid-mediated metallo-beta-lactamase from a Citrobacter freundii clinical isolate. Antimicrob Agents Chemother. 2008;52(11):4194-7. DOI: 10.1128/AAC.01337-07 PMID: 18765691

Ocampo-Sosa AA, Cabot G, Rodriguez C, Roman E, Tubau F, Macia MD, et al. Alterations of OprD in carbapenem-intermediate and -susceptible strains of Pseudomonas aeruginosa isolated from patients with bacteremia in a Spanish multicenter study. Antimicrob Agents Chemother. 2012;56(4):1703-13. DOI: 10.1128/AAC.05451-11 PMID: 22290967

Miller AD, Ball AM, Bookstaver PB, Dornblaser EK, Bennett CL. Epileptogenic potential of carbapenem agents: mechanism of action, seizure rates, and clinical considerations. Pharmacotherapy. 2011;31(4):408-23. DOI: 10.1592/phco.31.4.408 PMID: 21449629

Kohler T, Michea-Hamzehpour M, Epp SF, Pechere JC. Carbapenem activities against Pseudomonas aeruginosa: respective contributions of OprD and efflux systems. Antimicrob Agents Chemother. 1999;43(2):424-7. PMID: 9925552

Clinical And Laboratory Standards Institute. Performance standards for Antimicrobial susceptibility Testing; Twenthy-Second Information Supplement PA, USA: Wayne; 2007 2012.

Arvanitidou M, Katikaridou E, Douboyas J, Tsakris A. Prognostic factors for nosocomial bacteraemia outcome: a prospective study in a Greek teaching hospital. J Hosp Infect. 2005;61(3):219-24. DOI: 10.1016/j.jhin.2005.03.006 PMID: 16039015

Castanheira M, Toleman MA, Jones RN, Schmidt FJ, Walsh TR. Molecular characterization of a beta-lactamase gene, blaGIM-1, encoding a new subclass of metallo-beta-lactamase. Antimicrob Agents Chemother. 2004;48(12):4654-61. DOI: 10.1128/AAC.48.12.4654-4661.2004 PMID: 15561840

Sahiratmadja E, Nagelkerke N. Smoking habit as a risk factor in tuberculosis: a case-control study. Univ Med. 2011;30(3):110-9.

Pirnay JP, De Vos D, Cochez C, Bilocq F, Vanderkelen A, Zizi M, et al. Pseudomonas aeruginosa displays an epidemic population structure. Environ Microbiol. 2002;4(12):898-911. PMID: 12534471

Franco MR, Caiaffa-Filho HH, Burattini MN, Rossi F. Metallo-beta-lactamases among imipenem-resistant Pseudomonas aeruginosa in a Brazilian university hospital. Clinics (Sao Paulo). 2010;65(9):825-9. PMID: 21049207

Auda Al-Grawi IG, Al-Absali AK, Kareem NH, Abdul-Latif Belal S. Occurrence of MexAB-OprM Efflux Pump Operon on Septicemic Pseudomonas Aeruginosa Chromosome IraqI Postgrat Med J. 2012;11(1):97-102.

Emami A, Bazargani A, Mohammadi AA, Zardosht M, Seyed Jafari SM. Detection of blaPER-1 & blaOxa10 among imipenem resistant isolates of Pseudomonas aeruginosa isolated from burn patients hospitalized in Shiraz Burn Hospital. Iran J Microbiol. 2015;7(1):7-11. PMID: 26644867

RostamPour S, Gorzin AA, Motamedi GH. Frequency of blaKHM-1, blaIMP-1,2 and blaSPM-1 genes in clinical isolates of metallo β-lactamase producing Pseudomonas aeruginosa in hospitalized burned patients in Ghotbeddin Shirazi Hospital. JQUMS. 2015;19(2):21-9.

Jacome PR, Alves LR, Cabral AB, Lopes AC, Maciel MA. Phenotypic and molecular characterization of antimicrobial resistance and virulence factors in Pseudomonas aeruginosa clinical isolates from Recife, State of Pernambuco, Brazil. Rev Soc Bras Med Trop. 2012;45(6):707-12. PMID: 23295873

Bayram Y, Parlak M, Aypak C, Bayram I. Three-year review of bacteriological profile and antibiogram of burn wound isolates in Van, Turkey. Int J Med Sci. 2013;10(1):19-23. DOI: 10.7150/ijms.4723 PMID: 23289001

Patzer JA, Dzierzanowska D. Increase of imipenem resistance among Pseudomonas aeruginosa isolates from a Polish paediatric hospital (1993-2002). Int J Antimicrob Agents. 2007;29(2):153-8. DOI: 10.1016/j.ijantimicag.2006.08.044 PMID: 17157481

Lee K, Park AJ, Kim MY, Lee HJ, Cho JH, Kang JO, et al. Metallo-beta-lactamase-producing Pseudomonas spp. in Korea: high prevalence of isolates with VIM-2 type and emergence of isolates with IMP-1 type. Yonsei Med J. 2009;50(3):335-9. DOI: 10.3349/ymj.2009.50.3.335 PMID: 19568593

Lister PD, Wolter DJ, Hanson ND. Antibacterial-resistant Pseudomonas aeruginosa: clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clin Microbiol Rev. 2009;22(4):582-610. DOI: 10.1128/CMR.00040-09 PMID: 19822890

Hadadi A, Rasoulinejad M, Maleki Z, Yonesian M, Shirani A, Kourorian Z. Antimicrobial resistance pattern of Gram-negative bacilli of nosocomial origin at 2 university hospitals in Iran. Diagn Microbiol Infect Dis. 2008;60(3):301-5. DOI: 10.1016/j.diagmicrobio.2007.10.010 PMID: 18036759

Japoni A, Alborzi A, Kalani M, Nasiri J, Hayati M, Farshad S. Susceptibility patterns and cross-resistance of antibiotics against Pseudomonas aeruginosa isolated from burn patients in the South of Iran. Burns. 2006;32(3):343-7. DOI: 10.1016/j.burns.2005.10.017 PMID: 16527415

Li XZ, Nikaido H. Efflux-mediated drug resistance in bacteria: an update. Drugs. 2009;69(12):1555-623. DOI: 10.2165/11317030-000000000-00000 PMID: 19678712

Burgess DS. Use of pharmacokinetics and pharmacodynamics to optimize antimicrobial treatment of Pseudomonas aeruginosa infections. Clin Infect Dis. 2005;40 Suppl 2(Suppl 2):S99-104. DOI: 10.1086/426189 PMID: 15712103

Hocquet D, Berthelot P, Roussel-Delvallez M, Favre R, Jeannot K, Bajolet O, et al. Pseudomonas aeruginosa may accumulate drug resistance mechanisms without losing its ability to cause bloodstream infections. Antimicrob Agents Chemother. 2007;51(10):3531-6. DOI: 10.1128/AAC.00503-07 PMID: 17682106

Pirnay JP, De Vos D, Mossialos D, Vanderkelen A, Cornelis P, Zizi M. Analysis of the Pseudomonas aeruginosa oprD gene from clinical and environmental isolates. Environ Microbiol. 2002;4(12):872-82. PMID: 12534469




DOI: http://dx.doi.org/10.20286/nova-jmbs-050185

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DOI Prefix: 10.20286