Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa in a Healthcare Setting in Alexandria, Egypt

Abstract

Pseudomonas aeruginosa has emerged as a major healthcare associated pathogen that creates a serious public health disaster in both developing and developed countries. In this work we aimed at studying the occurrence of metallo-beta-lactamase (MBL) producing P. aeruginosa in a healthcare setting in Alexandria, Egypt. This cross sectional study included 1583 clinical samples that were collected from patients admitted to Alexandria University Students' Hospital. P. aeruginosa isolates were identified using standard microbiological methods and were tested for their antimicrobial susceptibility patterns using single disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations. Thirty P. aeruginosa isolates were randomly selected and tested for their MBL production by both phenotypic and genotypic methods. Diagnostic Epsilometer test was done to detect metallo-beta-lactamase enzyme producers and polymerase chain reaction test was done to detect imipenemase (IMP), Verona integron-encoded (VIM) and Sao Paulo metallo-beta-lactamase (IMP) encoding genes. Of the 1583 clinical samples, 175 (11.3%) P. aeruginosa isolates were identified. All the 30 (100%) selected P. aeruginosa isolates that were tested for MBL production by Epsilometer test were found to be positive; where 19 (63.3%) revealed blaSPM gene and 11 (36.7%) had blaIMP gene. blaVIM gene was not detected in any of the tested isolates. Isolates of MBL producing P. aeruginosa were highly susceptible to polymyxin B 26 (86.7%) and highly resistant to amikacin 26 (86.7%). MBL producers were detected phenotypically by Epsilometer test in both carbapenem susceptible and resistant P. aeruginosa isolates. blaSPM was the most commonly detected MBL gene in P. aeruginosa isolates.

Prevalence of metallo-β-lactamase genes among Pseudomonas aeruginosa isolated from various clinical samples in China

“…A study from Iran that included 19 MBL-producing P. aeruginosa reported that 31.5% of their isolates carried the bla VIM gene and 10.5% carried bla IMP , which was higher than that reported in this study [22]. In contrast to our study, a study from Egypt reported that none of their P. aeruginosa was positive for the bla VIM gene [20]. In the present study, 9.4% of our isolates were positive for the bla NDM-1 gene, which is lower than that reported from India (27%) [31].…”

“…A wide range of resistant mechanisms make P. aeruginosa swiftly change to the selective environmental pressure and makes it resistant to several classes of antibiotics. In this study, 77.5% of the isolates were found to be resistant to imipenem, which corroborates to that reported from Egypt (78.3%) [20] and China (73.3%) [21]. Compared to other studies from the Asia-Pacific region including Iran (25.2%) [22], China (17.1%, 43.3%) [23,24], Japan (28.5%) [25] and Taiwan (16%) [26], this study reported a much higher resistance toward imipenem.…”

“…Most of the MBL genes are located in the integrons within mobile genetic elements and are responsible for the dissemination of antibiotic resistance through horizontal gene transfer. In the past decade, the emergence and dissemination of the newly identified bla NDM and bla AIM and the most prevalent bla IMP , bla VIM , bla SIM and bla GIM MBL genes have been widely reported around the world [20]. In this study, bla IMP-1 (28.2%) was the most common gene detected; bla VIM-2 (18.8%) was the second most common gene detected, followed by bla VIM-1 (16.1%).…”

Serotypes, Antibiogram and Genetic Relatedness of <i>Pseudomonas aeruginosa</i> Isolates from Urinary Tract Infections at Urology and Nephrology Center, Mansoura, Egypt

“…El-Bialy et al reported similar results concerning the effectiveness of amikacin and imipenem [25]. These results disagreed with Abaza et al who reported higher resistance to imipenem (78.3%) [37]. Improper use of antibiotics explains the high resistance found among isolates.…”

Virulence Genes in Pseudomonas Aeruginosa Strains Isolated at Suez Canal University Hospitals with Respect to the Site of Infection and Antimicrobial Resistance

“…This can be interpreted in terms of anaerobic growth of the bacteria obtaining energy from oxidation of sugars thus rendering dif iculty of eradication [21]. Amany et al 2017 [26], found that acquired infection rate in ICU was higher than other hospital wards. The ubiquitous nature, including the ability to survive in a moist environment and resistance to many antibiotics, makes P. aeruginosa a common pathogen in the ICUs of hospitals.…”