Detection of Carbapenems and Colistin Resistance Genes in Pseudomonas aeruginosa and Acinetobacter baumannii: A Single-center Study in Iran
Novelty in Biomedicine,
Vol. 10 No. 3 (2022),
Background: This study aimed to determine carbapenems, colistin resistance genes, and antimicrobial susceptibility profiles of Pseudomonas aeruginosa and Acinetobacter baumannii isolates.
Materials and Methods: In this cross-sectional study, specimens of patients with bloodstream, urinary tract, and surgical site nosocomial infections were enrolled. P. aeruginosa and A. baumannii isolates were identified using conventional methods. Antimicrobial susceptibility testing (AST) on isolates was performed using the disk diffusion method and minimum inhibitory concentration (MIC) for colistin as recommended by the Clinical and Laboratory Standards Institute (CLSI). The combination meropenem disk method was used to detect metallo-β-lactamases (MBLs). The blaNDM, blaVIM, blaIMP, and mcr-1 genes were identified using the polymerase chain reaction (PCR) method and Sequencing.
Results: Forty strains of P. aeruginosa and forty strains of A. baumannii were isolated from hospitalized patients. The overall prevalence of multidrug-resistance (MDR) was 50% and 95% in P. aeruginosa and A. baumannii isolates, respectively. Almost all the MDR isolates were resistant to cefepime and piperacillin. Colistin had significant inhibitory activity against the isolates. MBL was detected in 25.0% and 15.0% of clinical isolates of P. aeruginosa and A. baumannii, respectively. We detected no blaNDM, blaVIM, blaIMP, and mcr-1 genes in our A. baumannii isolates. Moreover, only three P. aeruginosa isolates were positive for blaIMP gene.
Conclusion: The alarming proportion of MDR P. aeruginosa and A. baumannii isolates was reported in the current study. Effective infection prevention practices are required and AST should guide patients' treatment.
- Acinetobacter baumannii, Pseudomonas aeruginosa, Multidrug-resistance, Metallo-β-lactamase
How to Cite
Cerceo E, Deitelzweig SB, Sherman BM, Amin AN. Multidrug-resistant gram-negative bacterial infections in the hospital setting: overview, implications for clinical practice, and emerging treatment options. Microbial Drug Resistance. 2016;22(5):412-31.
Bassetti M, Peghin M, Vena A, Giacobbe DR. Treatment of infections due to mdr gram-negative bacteria. Frontiers in medicine. 2019;6.
Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrobial agents and chemotherapy. 2008;52(3):813-21.
Giamarellou H. Multidrug-resistant Gram-negative bacteria: how to treat and for how long. International Journal of Antimicrobial Agents. 2010;36:S50-S54.
Hawkey PM, Warren RE, Livermore DM, et al. Treatment of infections caused by multidrug-resistant Gram-negative bacteria: report of the British Society for Antimicrobial Chemotherapy/healthcare Infection Society/british Infection Association Joint Working Party. Journal of Antimicrobial Chemotherapy. 2018;73(suppl_3):iii2-iii78.
Fishbain J, Peleg AY. Treatment of Acinetobacter infections. Clinical infectious diseases. 2010;51(1):79-84.
Giacobbe DR, Mikulska M, Viscoli C. Recent advances in the pharmacological management of infections due to multidrug-resistant Gram-negative bacteria. Expert review of clinical pharmacology. 2018;11(12):1219-36.
Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clinical microbiology reviews. 2008;21(3):538-82.
Giamarellou H. Epidemiology of infections caused by polymyxin-resistant pathogens. International journal of antimicrobial agents. 2016;48(6):614-21.
Falgenhauer L, Waezsada S-E, Yao Y, et al. Colistin resistance gene mcr-1 in extended-spectrum β-lactamase-producing and carbapenemase-producing Gram-negative bacteria in Germany. The Lancet infectious diseases. 2016;16(3):282-3.
Kontopidou F, Plachouras D, Papadomichelakis E, et al. Colonization and infection by colistin-resistant Gram-negative bacteria in a cohort of critically ill patients. Clinical Microbiology and Infection. 2011;17(11):E9-E11.
Nasiri MJ, Zamani S, Fardsanei F, et al. Prevalence and mechanisms of carbapenem resistance in Acinetobacter baumannii: a comprehensive systematic review of cross-sectional studies from Iran. Microbial Drug Resistance. 2019.
Bonnin RA, Nordmann P, Poirel L. Screening and deciphering antibiotic resistance in Acinetobacter baumannii: a state of the art. Expert review of anti-infective therapy. 2013;11(6):571-83.
Malhotra-Kumar S, Xavier BB, Das AJ, Lammens C, Butaye P, Goossens H. Colistin resistance gene mcr-1 harboured on a multidrug resistant plasmid. The Lancet infectious diseases. 2016;16(3):283-4.
Liu Y-Y, Wang Y, Walsh TR, et al. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. The Lancet infectious diseases. 2016;16(2):161-8.
Isenberg HD. Clinical microbiology procedures handbook, 2nd ed: American Society of Microbiology; 2007.
CLSI. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement. M100-S24 2014.
Magiorakos AP, Srinivasan A, Carey R, et al. Multidrug‐resistant, extensively drug‐resistant and pandrug‐resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection. 2012;18(3):268-81.
Franklin C, Liolios L, Peleg AY. Phenotypic detection of carbapenem-susceptible metallo-β-lactamase-producing gram-negative bacilli in the clinical laboratory. Journal of clinical microbiology. 2006;44(9):3139-44.
Ramadan RA, Gebriel MG, Kadry HM, Mosallem A. Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: characterization of carbapenemase genes and E-test evaluation of colistin-based combinations. Infection and drug resistance. 2018;11:1261.
Rebelo AR, Bortolaia V, Kjeldgaard JS, et al. Multiplex PCR for detection of plasmid-mediated colistin resistance determinants, mcr-1, mcr-2, mcr-3, mcr-4 and mcr-5 for surveillance purposes. Eurosurveillance. 2018;23(6).
Saderi H, Owlia P. Detection of multidrug resistant (MDR) and extremely drug resistant (XDR) P. aeruginosa isolated from patients in Tehran, Iran. Iranian journal of pathology. 2015;10(4):265.
Sarhaddi N, Soleimanpour S, Farsiani H, et al. Elevated prevalence of multidrug-resistant Acinetobacter baumannii with extensive genetic diversity in the largest burn centre of northeast Iran. Journal of global antimicrobial resistance. 2017;8:60-6.
Pourakbari B, Mahmoudi S, Habibi R, et al. An Increasing Threat in an Iranian Referral Children's Hospital: Multidrug-Resistant Acinetobacter baumannii. Infectious Disorders-Drug Targets (Formerly Current Drug Targets-Infectious Disorders). 2018;18(2):129-35.
Jahromi SIP, Mardaneh J, Sharifi A, et al. Occurrence of a multidrug resistant pseudomonas aeruginosa strains in hospitalized patients in southwest of Iran: Characterization of resistance trends and virulence determinants. Jundishapur Journal of Microbiology. 2018;11(4).
Jafari Z, Harati AA, Haeili M, et al. Molecular epidemiology and drug resistance pattern of carbapenem-resistant Klebsiella pneumoniae isolates from Iran. Microbial Drug Resistance. 2019;25(3):336-43.
Hsu L-Y, Apisarnthanarak A, Khan E, Suwantarat N, Ghafur A, Tambyah PA. Carbapenem-resistant Acinetobacter baumannii and Enterobacteriaceae in south and southeast Asia. Clinical microbiology reviews. 2017;30(1):1-22.
Ahmed HJ, Ganjo AR. Detection of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli Recovered from Clinical Specimens in Erbil City Kurdistan Region of Iraq. Al-Mustansiriyah Journal of Science. 2019;30(2):10-8.
Masseron A, Poirel L, Ali BJ, Syed MA, Nordmann P. Molecular characterization of multidrug-resistance in Gram-negative bacteria from the Peshawar teaching hospital, Pakistan. New Microbes and New Infections. 2019:100605.
Savaş L, Duran N, Savaş N, Önlen Y, Ocak S. The prevalence and resistance patterns of Pseudomonas aeruginosa in intensive care units in a university hospital. Turkish Journal of Medical Sciences. 2005;35(5):317-22.
Li L, Dai J-x, Xu L, et al. Antimicrobial resistance and pathogen distribution in hospitalized burn patients: a multicenter study in Southeast China. Medicine. 2018;97(34).
De Francesco M, Ravizzola G, Peroni L, Bonfanti C, Manca N. Prevalence of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa in an Italian hospital. Journal of infection and public health. 2013;6(3):179-85.
Nwadike VU, Ojide CK, Kalu EI. Multidrug resistant acinetobacter infection and their antimicrobial susceptibility pattern in a nigerian tertiary hospital ICU. African journal of infectious diseases. 2014;8(1):14-8.
Motbainor H, Bereded F, Mulu W. Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia: a cross-sectional study. BMC Infectious Diseases. 2020;20(1):92.
Rossi F, Girardello R, Cury AP, Di Gioia TSR, de Almeida Jr JN, da Silva Duarte AJ. Emergence of colistin resistance in the largest university hospital complex of São Paulo, Brazil, over five years. The Brazilian Journal of Infectious Diseases. 2017;21(1):98-101.
Joseph NM, Sistla S, Dutta TK, Badhe AS, Rasitha D, Parija SC. Ventilator-associated pneumonia in a tertiary care hospital in India: role of multi-drug resistant pathogens. The Journal of Infection in Developing Countries. 2010;4(04):218-25.
Lin K-Y, Lauderdale T-L, Wang J-T, Chang S-C. Carbapenem-resistant Pseudomonas aeruginosa in Taiwan: Prevalence, risk factors, and impact on outcome of infections. Journal of Microbiology, Immunology and Infection. 2016;49(1):52-9.
- Abstract Viewed: 117 times
- pdf Downloaded: 72 times