Prevalence and Antimicrobial Susceptibility Pattern of Pseudomonas aeruginosa Isolated from Various Clinical Samples in a Tertiary Care Hospital

Mahaseth, Surya Narayan; Chaurasia, Lokeshwar; Jha, Brajesh Kumar; Sanjana, Raj Kumari

doi:10.3126/jmcjms.v8i2.33972

Cited by 5 publications

(5 citation statements)

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“…In our study, half of the total isolates were found to be multidrug resistant. Such high rates of MDR P. aeruginosa were also reported in previous studies from Nepal that ranges from 50 to 55.5% [ 25 , 27 ].…”

Section: Discussionsupporting

confidence: 77%

“…Therefore, our findings infers that P. aeruginosa is one of the predominant organism to cause respiratory tract infections. P. aeruginosa are developing resistance to different anti-pseudomonal drugs via various mechanisms that is resulting them to develop into most dangerous and dreaded bug [ 22 , 27 ]. In our study, half of the total isolates were found to be multidrug resistant.…”

Section: Discussionmentioning

confidence: 99%

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Detection of blaNDM−1,mcr-1 and MexB in multidrug resistant Pseudomonas aeruginosa isolated from clinical specimens in a tertiary care hospital of Nepal

et al. 2023

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Introduction Pseudomonas aeruginosa is an opportunistic pathogen, which causes healthcare-associated infections in immunosuppressed patients. They exhibit resistance to multiple classes of antibiotics via various mechanisms such as the over-expression of efflux pumps, decreased production of the outer membrane protein (D2 porin), over-expression of the chromosomally encoded AmpC cephalosporinase, modification of drugs, and mutation(s) at the target site of the drug. The bacteria also develop antibiotic resistance through the acquisition of resistance genes carried on mobile genetic elements. Limited data on phenotypic as well as genotypic characterization of MDR P. aeruginosa in Nepal infers the needs for this study. This study was carried out to determine the prevalence rate of metallo-β-lactamase (MBL-producer) as well as colistin resistant multidrug resistant (MDR) P. aeruginosa in Nepal and also to detect MBL, colistin resistance, and efflux pump encoding genes i.e. blaNDM−1, mcr-1 and MexB respectively in MDR P. aeruginosa isolated from clinical samples. Methods/methodology A total of 36 clinical isolates of P. aeruginosa were collected. All bacterial isolates were phenotypically screened for antibiotic susceptibility using Kirby Bauer Disc Diffusion method. All the multidrug resistant P. aeruginosa were phenotypically screened for MBL producer by Imipenem-EDTA combined disc diffusion test (CDDT). Similarly, MIC value for colistin was also determined by broth microdilution method. Genes encoding carbapenemase (blaNDM−1), colistin resistant (mcr-1) and efflux pump activity (MexB) were assayed by PCR. Results Among 36 P. aeruginosa, 50% were found to be MDR among which 66.7% were found to be MBL producer and 11.2% were found to be colistin resistant. Among MDR P. aeruginosa, 16.7%, 11.2% and 94.4% were found to be harbouring blaNDM−1, mcr-1 and MexB genes respectively. Conclusion In our study, carbapenemase production (encoded by blaNDM−1), colistin resistant enzyme production (encoded by mcr-1), and expression of efflux pump (encoded by MexB) are found to be one of the major causes of antibiotic resistance in P. aeruginosa. Therefore, periodic phenotypic as well as genotypic study in Nepal on P. aeruginosa would provide the scenario of resistance pattern or mechanisms in P. aeruginosa. Furthermore, new policies or rules can be implemented in order to control the P. aeruginosa infections.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Detection of blaNDM−1,mcr-1 and MexB in multidrug resistant Pseudomonas aeruginosa isolated from clinical specimens in a tertiary care hospital of Nepal

et al. 2023

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“…Several other studies reported a higher resistance figure with ceftazidime, contrary to ours. A study by Maharjan 51 reported about 53% resistance with ceftazidime, and similar figures (49%) were also reported by Mahaseth et al, 69 whereas Shidiki et al, 71 (90%) reported a comparatively very higher figure of resistance with ceftazidime. However, current analysis, isolates of P. aeruginosa were moderately susceptible to imipenem, ciprofloxacin, levofloxacin, and gentamycin.…”

Section: Discussionsupporting

confidence: 62%

“….Adedeji et al, in their study conducted in Africa on various clinical samples, observed a higher prevalence (50%) of P. aeruginosa in ear infections68 . A study conducted by Mahaseth et al, reported a prevalence of 11.6% in the clinical samples69 . The study by Maharjan et al, conducted on 1049 clinical samples showing growth reported a lower prevalence of P. aeruginosa in the clinical samples51 .…”

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confidence: 96%

Roles of intrinsic and acquired resistance determinants in multidrug-resistant clinical Pseudomonas aeruginosa in Bangladesh

Anjum,

Arefin,

Jahan

et al. 2023

Bangladesh J Med Sci

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Introduction: Pseudomonas aeruginosa is an ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, P. aeruginosa, and Enterobacter spp.) pathogen and one of the leading etiologies in multiple nosocomial infections. Treatment of P. aeruginosa is becoming increasingly difficult due to its ever-increasing antibiotic resistance trends. This study investigated clinical multidrug resistance (MDR) P. aeruginosa (MDR-PA), their intrinsic resistance determinants, including the presence of chromosomal AmpC β-lactamase (Ampicillinase), decreased expression of outer membrane porin protein OprD and selected acquired β-lactamase resistance genes. Methods: Out of 238 clinical specimens, including urines from urinary tract-infected patients, wound swabs, burn swabs, and catheter aspirates, were collected from two major hospitals in Savar, Dhaka, Bangladesh. Samples were inoculated with Cetrimide agar to isolate presumptive P. aeruginosa. Bacteria were identified by cultural, biochemical characterization, 16S rDNA sequencing, and phylogenetic analysis. Virulence-associated genes of P. aeruginosa, namely, toxA, lasB, and plcH, were identified by polymerase chain reaction (PCR). Antibiotic susceptibilities of the isolates were investigated against ten antibiotics belonging to seven groups by disc-diffusion method followed by a selected minimum inhibitory concentration (MIC) assay. Phenotypic expression of Metallo-β-lactamases (MBLs) production was checked by the double disc synergistic test selectively among the imipenem-resistant isolates. Acquisition of β-lactam resistance trait was examined by PCR detection of bla-genes variants. Mutational loss of the OprD was analyzed by PCR to investigate intrinsic resistance determinants. Phenotypic overexpression of chromosomal AmpC was assayed with the identification of the AmpC gene by PCR. The expression level of OprD was assessed by real-time quantitative PCR (RT-qPCR). Results: Fifty-three P. aeruginosa was identified, with an overall isolation of 22.3% (53/238), where urine remains the most prevalent source. Virulence genes toxA, lasB, and plcH were identified in the isolates of 92.4%, 96.2%, and 94.3%. The highest phenotypic antimicrobial resistance was observed against ampicillin and ceftriaxone (100%), followed by cefotaxime (96%), tetracycline (89%), azithromycin (72%), imipenem (31%), ciprofloxacin (29%), levofloxacin (29%), gentamycin (27%) and ceftazidime (14%). The antibiogram pattern revealed 85% of isolates as multidrug-resistant, while 12% were considered extensively drug-resistant (XDR)-P. aeruginosa. The carriage of β-lactamase genes blaTEM, blaSHV, and blaOXA was detected in 4%, 2%, and 2% cephalosporin-resistant isolates, respectively. Double disc synergistic test revealed 87% of imipenem-resistant isolates expressing MBL-mediated resistance phenomenon. All seven ceftazidime-resistant isolates showed the presence of the AmpC gene with phenotypic overproduction of the AmpC enzyme, indicating AmpC-mediated ceftazidime resistance. Mutational loss of OprD was observed in 12% of phenotypically multidrug-resistant isolates, and RT-qPCR analysis revealed reduced expression of OprD porin protein at various levels in the outer membrane of multidrug-resistant isolates. Conclusions: This study depicts the high prevalence of MDR-PA in clinical specimens in Bangladesh. The identified intrinsic and acquired antimicrobial resistance determinants play synergistic roles in emerging MDR-PA. Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 489-507

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“…The prominence of multidrug resistant P. aeruginosa is growing in the world, limiting the therapeutic options (26,27). Despite the emergence of modern antibacterial agents with anti-Pseudomonal activity, P. aeruginosa continues to be the leading cause of lifethreatening infections in hospitals (28,29). Even though increase of multi-drug resistant Pseudomonas aeruginosa strains, which are intractable to be treated, some available antibiotics still able to dominate pseudomonal infections with a reasonable percentage of success, for example, colistin sulfate and quinolones (ciprofloxacin and levofloxacin) (30,31).…”

Section: Introductionmentioning

confidence: 99%

Molecular Investigation of Outer Membrane Channel Genes Among Multidrug Resistance Clinical Pseudomonas Aeruginosa Isolates

Al-Thabhawee

Al-Dahmoshi²

2022

rbmb.net

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Background: Multidrug resistance Pseudomonas aeruginosa (MDRPA) is most important issue in healthcare setting. It can secrete many virulence effector proteins via its secretion system type (T1SS-T6SS). They are using them as conductor for delivering the effector proteins outside to begins harmful effect on host cell increasing pathogenicity, competition against other microorganism and nutrient acquisition. Methods:The study include investigation of 50 isolates of MDRPA for transport secretion system and resistance for antibiotics. Molecular diagnosis using P. aeruginosa specific primer pairs, investigation of AprF, HasF, XcpQ, HxcQ, PscC, CdrB, CupB3, and Hcp using specific primer pairs by PCR were also performed. Results:The results revealed high resistance to beta lactam antibiotics (78% for ceftazidime, 78% for cefepime and 46% for piperacillin) can indicate possessing of isolates for beta lactamases and this confirmed by dropping resistance to piperacillin to 16% when combined with tazobactam. Also, the results shown the ability of MDRPA for pyocyanin biosynthesis using the system of genes. Conclusions:The current study conclude that all isolates of P. aeruginosa were highly virulent due to their possessing of all transport secretion system to deliver different effector proteins with possible harmful effects of these proteins.

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Prevalence and Antimicrobial Susceptibility Pattern of Pseudomonas aeruginosa Isolated from Various Clinical Samples in a Tertiary Care Hospital

Cited by 5 publications

References 10 publications

Detection of blaNDM−1,mcr-1 and MexB in multidrug resistant Pseudomonas aeruginosa isolated from clinical specimens in a tertiary care hospital of Nepal

Detection of blaNDM−1,mcr-1 and MexB in multidrug resistant Pseudomonas aeruginosa isolated from clinical specimens in a tertiary care hospital of Nepal

Roles of intrinsic and acquired resistance determinants in multidrug-resistant clinical Pseudomonas aeruginosa in Bangladesh

Molecular Investigation of Outer Membrane Channel Genes Among Multidrug Resistance Clinical Pseudomonas Aeruginosa Isolates

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