Prevalence and Clonal Dissemination of Metallo-Beta-Lactamase-Producing Pseudomonas aeruginosa in Kermanshah

Abstract

Background:Pseudomonas aeruginosa is an opportunistic pathogen associated with nosocomial infections. The emergence and dissemination of metallo-beta-lactamases (MBLs) has contributed to the high rate of resistance among P. aeruginosa isolates.Objectives:The purpose of this study was to describe the prevalence and the clonal dissemination of MBL- producing P. aeruginosa isolates collected from major hospitals in Kermanshah.Materials and Methods:Antibiotic susceptibility testing was performed using the minimal inhibitory concentrations. The MBLs were investigated using the Double-Disk Synergy Test (DDST) and Polymerase Chain Reaction. Molecular typing was performed by Pulsed-Field Gel Electrophoresis (PFGE).Results:Of the 60 P. aeruginosa isolates included in this study, 30 (50%) were resistant to Gentamicin, 38 (63.3%) to Piperacillin, 42 (70%) to Ceftazidime, and 45 (75%) to Cefepime. Twenty-nine (48.3%) isolates were MBL producers in the DDST test. Five (8.3%) isolates were positive for the VIM gene. PFGE analysis among the MBL producers revealed 12 distinct clonal patterns.Conclusions:The inter- and intra-hospital dissemination of resistant clones is a matter of concern and is an indicator of the level of the improvement and surveillance of standard hygiene, particularly disinfection and hand washing before and after contact with patients. Given the emergence of MBL-producing strains, surveillance has become an important procedure to control the transmission of resistant strains.

Extended spectrum and metalo beta-lactamase producing airborne Pseudomonas aeruginosa and Acinetobacter baumanii in restricted settings of a referral hospital: a neglected condition

“…In our finding, 37.5% MBL production by P. aeruginosa was observed. A study conducted in India, Brazil and Iran revealed 32.9%, 30%, 48.3% MBL production respectively [ 48 – 50 ]; however those studies used clinical specimen. These P. aeruginosa isolates could be causes for several nosocomial infections, illustrating the need for proper infection control practices [ 51 ].…”

Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil

“…In addition to the multi-drug resistance, special attention was given in this study to P . aeruginosa resistant to carbapenems, considering the significant increase of this resistance in Latin America and widespread of different clones associated with the production enzymes of the MBL type [ 55 – 58 ]. The predominant MBL-encoding gene in Brazil is bla SPM-1 , which has been disseminated by the MDR P .…”

Determination of Acquired Resistance Profiles of Pseudomonas aeruginosa Isolates and Characterization of an Effective Bacteriocin-Like Inhibitory Substance (BLIS) Against These Isolates

“…Epidemiological studies have shown that infections caused by drug-resistant strains of P. aeruginosa are associated with significant increases in mortality, morbidity, lengths of hospital stay or chronic care, need for surgical interventions, and overall costs of treating the infection (21). The emergence of PDR strains of P. aeruginosa , which are resistant to all current antibiotics, has led to concerted efforts to find alternative approaches to treatment, including older antibiotics that may have activity against these strains (22-25). In light of the increased antibiotic resistance of MDR microorganisms for which no adequate therapeutic options exist, a joint initiative by the ECDC and the CDC recently created standardized international definitions for MDR, XDR, and PDR in some bacteria.…”