Distribution of the bla OXA , bla VEB-1 , and bla GES-1 genes and resistance patterns of ESBL-producing Pseudomonas aeruginosa isolated from hospitals in Tehran and Qazvin, Iran

Abstract

Introduction:Pseudomonas aeruginosa is one of the most common nosocomial pathogens. The emergence of extended spectrum β-lactamases (ESBLs) has been increasingly reported as a major clinical concern worldwide. The main aim of the present study was to determine the distribution of bla OXA , bla PER-1, bla VEB-1, and bla GES-1 genes among ESBL-producing P. aeruginosa isolated from two distinct provinces in Iran. Methods: In this study, a total of 75 (27.5%) ESBL-producing isolates were identified from 273 P. aeruginosa isolates collected from patients in Qazvin and Tehran. Phenotypic detection of ESBLs and antimicrobial susceptibility testing were performed according to the Clinical and Laboratory Standards Institute guidelines. PCR and sequencing were employed to detect bla OXA-1 , bla OXA , bla GES-1, bla PER-1 , and bla VEB-1 genes. Isolate genetic relationships were evaluated by repetitive extragenic palindromic sequence-based PCR (REP-PCR). Results: In total, 59 (78.7%) of the ESBLproducing isolates showed multidrug resistance. The highest rates of susceptibility were observed against colistin (75 isolates, 100%) and polymyxin B (75, 100%) followed by amikacin (44, 58.7%), and piperacillin-tazobactam (40, 53.3%). The bla OXA-1 (37.3%) gene was the most common of the genes investigated, followed by bla OXA-4 (32%), bla GES-1 (16%), and bla VEB-1 (13.3%). REP-PCR identified three different genotypes: types A (89.3%), B (6.7%), and C (4%). Conclusions: We found a significant presence of bla OXA-1 , bla OXA-4 , bla GES-1, and bla VEB-1 genes among P. aeruginosa isolates, highlighting the need for suitable infection control strategies to effectively treat patients and prevent the further distribution of these resistant organisms.

Distribution of Ambler Class A Β-lactamase Genes and Evaluation of Resistance Patterns in Multi-Drug and Extensively-Drug Resistant P. aeruginosa Clinical Isolates

“…In a study in Thailand, from 118 nonduplicate clinical isolates of P. aeruginosa, 6.7% carried the bla VEB-1, bla PER-1 and bla TEM-1 (and derivatives) genes, and bla SHV-1 was not observed (21). The notably high prevalence of bla PER-1 , bla VEB-1 , bla TEM and bla SHV observed in this study indicates the wide-spread dissemination of ESBL-encoding β-lactamase genes in Iran, which is in accordance with previous reports (22,25,33 (25). In another study in Tehran (Iran), 21.6% of P. aeruginosa isolates carried the bla PER-1 gene (33).…”

“…In a study in Thailand, the rate of resistance to ceftazidime, cefepime, amikacin, gentamicin, ciprofloxacin, levofloxacin, imipenem, meropenem and ciprofloxacin was 44.91%, 28.81%, 18.64%, 25.42%, 43%, 49.15%, 31.36%, 33% and 48.3%, respectively (21). In Iran, most studies have reported high resistance rates to amikacin and aztreonam and low resistance rate to levofloxacin and polymexin B (22,23), which might indicate the imprudent use of amikacin and aztreonam in Iran. In the present study, 95% of the P. aeruginosa isolates were MDR, which is similar to the results of studies performed by Safaei et al (24) and Mirsalehian et al (25).…”

β-lactamase-mediated resistance in MDR-Pseudomonas aeruginosa from Qatar

“…The β-lactamase bla VEB-9 (19, 25.33%), formerly known as bla VEB-1a , was the most frequent ESBL gene identified in the present study [ 11 ]. bla VEB-1 is one of the most frequently reported ESBLs in P. aeruginosa from the Middle East including Kuwait, Saudi Arabia and Iran [ 13 – 15 ]. Though bla VEB-9 was reported from Thailand and Eastern Europe, to the best of our knowledge, it has not been previously reported from the Middle East [ 11 , 16 ].…”

Molecular Characteristics and Antimicrobial Susceptibility Profile of Pseudomonas aeruginosa isolated from patients attending Healthcare Facilities in Mthatha, South Africa

“…Antimicrobial treatment is further hampered by the production of extended spectrum beta-lactamases and metallo beta-lactamases [20,47]. As at now, ESBLs in P. aeruginosa are described globally with MBLs also being reported on a growing basis in recent years [15,22].…”