Association Between Biofilm Formation Gene Bla exoU and Metallo and Extend Spectrum Beta-lactamase Production of Multidrug Resistance Pseudomonas aeruginosa in Clinical Samples

Abstract

Background: The presence of biofilm formation exoU gene is significant challenge to infection control management in hospitals and exposure by Pseudomonas aeruginosa may lead to further spread and development of antimicrobial resistance. Methods: Out of 227 samples 40 clinical isolates of P. aeruginosa were collected from patients attending public hospitals ( Rizgary, Teaching hospital, Laboratory center, Raparin, Nanakaly hospitals)in Erbil city/Iraq over a period during 2018 to march 2019 and fully characterized by standard bacteriological procedures and antimicrobial susceptibility test and ESBL has been carried out by Vitek 2 compact system and. by Vitek 2 compact system. The identification has been verified by all isolates as P. aeruginosa by using 16S rDNA with product size (956pb). Results: A high rate of resistance was seen against Penicillin and lincomycin and Piperacillin and chloramphenicol and rifampicin (100 %), whereas Imipenem (5%) were found to be the most effective antimicrobial drugs. Of all P. aeruginosa isolates, 30 (75% %) were identified as MDR, approximately 9(22.5%) of isolates were resistant to 9 drugs in burn samples. Quantitative biofilm determination using the Congo red method revealed that 28 isolates (70%) produced biofilm, biofilm production was significantly higher among MDR P. aeruginosa isolates while coproduction of Extended Spectrum β-lactamase (ESBL) together with Metallo β-lactamase (MBL) ESBLs MBLs recorded in (52.5%) of the isolates. Altogether 40 isolates were processed for analysis by PCR assays and showed that 26(70%) of P. aeruginosa isolates harboured the exoU encoding gene with product size (204) pb was more commonly seen in isolates obtained from burn isolates. In addition, exo U gene was significantly associated with the higher MDR (80%), 8 isolates (76.9%)had exoU gene with ESBL and( 65%) had MBL and the same for MDR (80.8%) in samples for burning. Conclusion: Our results showed surveillance of P. aeruginosa resistance against antimicrobial and ESBL and MBL is fundamental to monitor trends in susceptibility patterns and appropriately guide clinicians in choosing empirical or directed therapy.

Diversity of biofilm-specific antimicrobial resistance genes in Pseudomonas aeruginosa recovered from various clinical isolates

“…Similar results were reported, where 84.3% and 83.75% of isolates formed biofilm, respectively ( 24 , 25 ). These results were consistent with other described studies ( 26 ) found that very high rates of biofilm formation were detected in MBL and ESBL P. aeruginosa strains. According to the findings, the correlation between biofilm and antimicrobial resistance is significant for all drug categories.…”

Abundant diversity of accessory genetic elements and associated antimicrobial resistance genes in pseudomonas aeruginosa isolates from a single Chinese hospital

“…Nearly all (97.1%; 34/35,) exoS + isolates are resistant to β-lactams. Many studies have reported that high virulence isolates often also show multidrug resistance, especially fluoroquinolone resistance [49][50][51]. This correlation between T3SS virulotypes and antimicrobial resistance suggests a coevolutionary response leading to the formation of high-risk clones [8].…”