Purpose
Pseudomonas aeruginosa
is an important pathogen that causes urinary tract infections. Carbapenems are the drugs of choice for the treatment of
P. aeruginosa
infections. However, the emergence and spread of carbapenem-resistant
P. aeruginosa
(CRPA) is a serious global health threat. In this study, we investigated the epidemiology, molecular characteristics, drug resistance, and virulence factors of CRPA isolated from urine samples.
Methods
A total of 124
P. aeruginosa
isolates were obtained from urine samples collected between March 2020 and February 2021. Clonal relatedness was evaluated using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). We performed antimicrobial susceptibility tests and investigated the presence of carbapenemase genes and virulence factors in CRPA isolates.
Results
The carbapenem resistance rate of the isolated
P. aeruginosa
was 46.7% (59/124). A total of 54 (91.5%) out of the 59 CRPA isolates were identified as multidrug-resistant. The majority of the CRPA isolates (81.4%, 48/59) harbored carbapenemase genes, such as
bla
IMP-6
or
bla
NDM-1
. In an epidemiological analysis using MLST, 88.1% of CRPA isolates were confirmed to be ST773 (50.8%, 30/59) or ST235 (37.3%, 22/59). The CRPA isolates harboring
bla
IMP-6
and
bla
NDM-1
belonged to ST235 (PFGE pulsotypes E1-E18, F) and ST773 (PFGE pulsotypes H1-H2, I1-I16) subtypes, respectively. The studied CRPA isolates simultaneously harbored 10 to 14 virulence factors of the 16 virulence factors examined. Nine virulence factor genes (
toxA, exoT, plcH, plcN, phzM, phzS, lasB, aprA
, and
algD
) were identified in all CRPA isolates.
Conclusion
Our study shows that
P. aeruginosa
ST235 harboring
bla
IMP-6
and ST773 harboring
bla
NDM-1
—known internationally as high-risk clones with multiple virulence factors—are widely spread in the study area. These findings suggest that continuous monitoring is necessary to prevent the further spread of carbapenemase-producing CRPA.