Evaluation of multidrug resistance patterns in siderophore-producing Pseudomonas aeruginosa from clinical and environmental samples in Gorgan, Iran

Abstract

Siderophores secreted by nonfermentative negative bacilli such as Pseudomonas aeruginosa are capable of increasing rates of resistance to carbapenem antibiotics. Furthermore, the resistance of these isolates to antibiotics has been enhanced by producing siderophores, and their frequencies have erratic patterns. We studied the outbreak of P. aeruginosa strains and their antibiotic patterns in different clinical samples. In this descriptive cross-sectional study, 100 P. aeruginosa samples were isolated from different clinical specimens at the 5th Azar Hospital, Gorgan, Iran, in 2017. These strains were identified by biochemical tests, and their antibiotic resistance patterns were measured via the disc diffusion method. Next imipenem and EDTA-imipenem (10–30 μg) antibiotics were employed for the detection of siderophores. Amongst 100 P. aeruginosa samples, 31 isolates (31%) were siderophore carriers. The frequency of this enzyme among specimens was as follows: 56.2% in burn wounds, 36.4% in urine, 22.2% in respiratory secretion, 19.4% in blood and 16.7% in wounds (p > 0.05). Moreover, P. aeruginosa isolates producing siderophores had the highest range of resistance to ciprofloxacin (47.6%), gentamicin (46.7%), ceftazidime (34.9%), nalidixic acid (34.3%), amikacin (34.1%) and cefotaxime (31.6%). The prevalence of siderophore producers, and especially their antibiotic patterns have no specific algorithms; in addition, an antibiogram is recommended to identify the most effective antibiotics against those isolates.

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“…The production of siderophores has been correlated with resistance to carbanepam antibiotics, particularly in P. aeruginosa clinical isolates 22. However, the occurrence of resistance to individual antibiotics did not follow any particular pattern 23. Moreover, siderophores have a wide variety of functions including the regulation of gene expression and quorum sensing 24.…”

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“…Competition for limited iron availability in the host can be a key driver of competitive relationships within polymicrobial communities. P. aeruginosa produces higher levels of its siderophores, pyochelin and pyoverdin, in co-biofilms [47] and increased siderophore production has been linked with emergence of AMR [47,166]. Siderophore-antibiotic conjugates that essentially hijack the iron-mediated active transport systems of microorganisms have been designed and enhance uptake of antibiotics.…”

“…Increased siderophore production, pyochelin and pyoverdin, by P. aeruginosa in co-biofilms was observed to be linked to increased antibiotic tolerance [47]. In a study of 100 P. aeruginosa clinical isolates, a correlation between siderophore production and AMR emerged [166]. No mechanism for this siderophore-directed resistance has been elucidated.…”