Prevalence of ESBL-producing Pseudomonas aeruginosa isolates in Warsaw, Poland, detected by various phenotypic and genotypic methods

Abstract

Knowledge of the prevalence of ESBL enzymes among P. aeruginosa strains compared to the Enterobacteraiceae family is limited. The phenotypic tests recommended by EUCAST for the detection of ESBL-producing Enterobacteriaceae are not always suited for P. aeruginosa strains. This is mainly due to the presence of other families of ESBLs in P. aeruginosa isolates more often than in Enterobacteriaceae, production of natural AmpC cephalosporinase and its overexpression, and co-production of metallo-β-lactamases. The aim of this study was to determine the occurrence of ESBLs in P. aeruginosa isolated from patients from hospitals in Warsaw, to evaluate the ESBL production of these isolates using currently available phenotypic tests, their modifications, multiplex PCR and molecular typing of ESBL-positive isolates by PFGE. Clinical isolates of P. aeruginosa were collected in 2000-2014 from four Warsaw hospitals. Based on the data obtained in this study, we suggest using three DDST methods with inhibitors, such as clavulanic acid, sulbactam and imipenem, to detect ESBL-producing P. aeruginosa strains. Depending on the appearance of the plates, we suggest a reduction in the distance between discs with antibiotics to 15 mm and the addition of boronic acid at 0.4 mg per disc. The analysed isolates carried genes encoding ESBL from the families VEB (69 isolates with VEB-9), GES (6 with GES-1, 1 GES-5, 5 GES-13 and 2 with GES-15), OXA-2 (12 with OXA-15, 1 OXA-141, 1 OXA-210, 1 OXA-543 and 1 with OXA-544) and OXA-10 (5 isolates with OXA-74 and one with OXA-142). The most important result of this study was the discovery of three new genes, blaGES-15, blaOXA-141 and blaOXA-142; their nucleotide sequences have been submitted to the NCBI GenBank. It is also very important to note that this is the first report on the epidemiological problem of VEB-9-producing bacterial strains, not only in Poland but also worldwide.

β-lactamase-mediated Resistance in MDR-Pseudomonas Aeruginosa from Qatar

“…(32-34) 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. (30,35) In this study, VEB-9-producing MDR-P. aeruginosa belonged to ST235 (8/16), ST357 (7/8), ST308 (1/3) and ST3022 (1/1) ( Table 1 and Table 2). This pattern suggests dissemination within speci c P. aeruginosa STs in Qatar that may be different from neighboring countries.…”

β-Lactamase-Mediated Resistance in MDR-Pseudomonas Aeruginosa from Qatar

“…Interestingly, those 7 isolates belonged to seven different STs ( Thailand and Eastern Europe, to the best of our knowledge, it has not been previously reported from the Middle East. (30,35) In this study, VEB-9-producing MDR-P. aeruginosa belonged to ST235 (8/16), ST357 (7/8), ST308 (1/3) and ST3022 (1/1) ( Table 1 and Table 2). This pattern suggests dissemination within speci c P. aeruginosa STs in Qatar that may be different from neighboring countries.…”

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 some countries such as Korea, plasmids encoding class A β-lactamases (TEM, SHV, PER and VEB) were not found in P. aeruginosa (15). However, these plasmids are reportedly prevalent in other Asian countries, Southeastern Europe and Africa (Kosovo, Algeria, and Tunisia) (18, [30][31][32]. 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).…”