1
|
Garousi M, MonazamiTabar S, Mirazi H, Farrokhi Z, Khaledi A, Shakerimoghaddam A. Epidemiology of Pseudomonas aeruginosa in diabetic foot infections: a global systematic review and meta-analysis. Germs 2023; 13:362-372. [PMID: 38361543 PMCID: PMC10866166 DOI: 10.18683/germs.2023.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/09/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024]
Abstract
Pseudomonas aeruginosa is one of the most common causes of diabetic foot infection globally. This study aimed to determine the global distribution of P. aeruginosa isolated from diabetic foot ulcer infection. PRISMA procedure was used to perform the current systematic review and meta-analysis. The Web of Science, MEDLINE/PubMed, Scopus, and other databases were searched for studies published in English from 2000 to 2022. Data was analyzed using the Comprehensive Meta-Analysis software (CMA). Keywords and MESH phrases included Pseudomonas aeruginosa, diabetic foot ulcer, P. aeruginosa, and diabetic foot infection. As a result of this review, 16.6% of diabetic foot wound infections were caused by P. aeruginosa. About 37.9% of strains were multidrug resistant (MDR). P. aeruginosa infection rates in diabetic foot ulcers ranged from 0.5 to 100% globally. In total, the prevalence rates of P. aeruginosa in diabetic foot ulcer infection from Asia, Africa, and Western countries were reported at 18.5%, 16.3%, and 11.1%, respectively. Data have shown that the prevalence of P. aeruginosa, particularly MDR strains, isolated from diabetic foot ulcer infection was relatively high; inherent resistance to antibiotics is also high; the wound either does not heal or if it does, it will be delayed. Therefore, timely treatment is essential.
Collapse
Affiliation(s)
- Mitra Garousi
- MD, Department of Internal Medicine, Faculty of Medical Sciences, Hamedan University of Medical Sciences, Shaheed Fahmideh Ave, postal code: 6517838636, Hamedan, Iran
| | - Sina MonazamiTabar
- MD, Department of Internal Medicine, Faculty of Medical Sciences, Hamedan University of Medical Sciences, Shaheed Fahmideh Ave, postal code: 6517838636, Hamedan, Iran
| | - Hosein Mirazi
- PhD, Department of Biomedical Engineering, Faculty of New Sciences and Technology, University of Tehran, 16 Azar St., Enghelab Sq, postal address: 1417466191, Tehran, Iran
| | - Zahra Farrokhi
- MD, Medical School, Shahid Beheshti University of Medical Sciences, P.O. Box 4739-19395, 7 Floor, Bldg. No.2, SBUMS Sh. Arabi Ave, Tehran, Iran
| | - Azad Khaledi
- PhD, Infectious Diseases Research Center, Kashan University of Medical Sciences, 5 of Qotb –e Ravandi Blvd. P.O. Box: 87155-111, Postal code: 87154, Kashan, Iran
| | - Ali Shakerimoghaddam
- PhD, Medical Biotechnology Research Center, AJA University of Medical Sciences, Etemad Zadeh street, Fatemi-Gharbi Street. P.O. Box: 1411718541, Tehran, Iran
| |
Collapse
|
2
|
Polse RF, Khalid HM, Mero WMS. Distribution of bla OXA-10, bla PER-1, and bla SHV genes in ESBL-producing Pseudomonas aeruginosa strains isolated from burn patients. Sci Rep 2023; 13:18402. [PMID: 37884651 PMCID: PMC10603109 DOI: 10.1038/s41598-023-45417-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
Pseudomonas aeruginosa is resistant to a wide range of extended spectrum-lactamases (ESBLs) antibiotics because it produces several kinds of ESBLs. The goal of the current investigation was to identify the bacteria that produce extended spectrum -lactamases and the genes that encode three different ESBLs, such as blaOXA-10, blaPER-1 and blaSHV genes in Pseudomonas aeruginosa isolated from burn patients. In this investigation, 71 Pseudomonas aeruginosa isolates were isolated from burn wounds in Burn and Plastic Surgery Hospital, Duhok City between July 2021 to June 2022. For the purpose of finding the blaOXA-10, blaPER-1, and blaSHV ESBL expressing genes, Polymerase Chain Reaction (PCR) was used. Among 71 Pseudomonas aeruginosa isolates, 26.36% (29/71) were isolated from males and 38.18% (42/71) from females, and 76.06% (54/71) of the isolates were multidrug resistant. They exhibited higher resistance against Piperacillin with resistance rates of 98.59%. Among the ESBL-producing isolates tested, blaOXA-10 was found in 59.26% (32), blaPER-1 was found in 44.44% (24), and blaSHV was found in 11.11% (6). All isolates must undergo antimicrobial susceptibility testing because only a few numbers of the available antibiotics are effective for the treatment of this bacterium. This will prevent the development of resistance in burn units and aids in the management of the treatment plan.
Collapse
Affiliation(s)
- Reem F Polse
- Department of Biology, Faculty of Science, University of Zakho, Kurdistan Region, Zakho, 42002, Iraq.
| | - Haval M Khalid
- Department of Biology, Faculty of Science, University of Zakho, Kurdistan Region, Zakho, 42002, Iraq
| | - Wijdan M S Mero
- Department of Biology, Faculty of Science, University of Zakho, Kurdistan Region, Zakho, 42002, Iraq
- College of Science, Nawroz University, Kurdistan Region, Duhok, 42001, Iraq
| |
Collapse
|
3
|
Coșeriu RL, Mare AD, Toma F, Vintilă C, Ciurea CN, Togănel RO, Cighir A, Simion A, Man A. Uncovering the Resistance Mechanisms in Extended-Drug-Resistant Pseudomonas aeruginosa Clinical Isolates: Insights from Gene Expression and Phenotypic Tests. Microorganisms 2023; 11:2211. [PMID: 37764055 PMCID: PMC10535578 DOI: 10.3390/microorganisms11092211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The purpose of the study was to describe the activity of mex efflux pumps in Multidrug-Resistant (MDR) clinical isolates of Pseudomonas aeruginosa and to compare the carbapenem-resistance identification tests with PCR; (2) Methods: Sixty MDR P. aeruginosa were analyzed for detection of carbapenemase by disk diffusion inhibitory method, carbapenem inactivation method and Modified Hodge Test. Endpoint PCR was used to detect 7 carbapenemase genes (blaKPC, blaOXA48-like, blaNDM, blaGES-2, blaSPM, blaIMP, blaVIM) and mcr-1 for colistin resistance. The expression of mexA, mexB, mexC, mexE and mexX genes corresponding to the four main efflux pumps was also evaluated; (3) Results: From the tested strains, 71.66% presented at least one carbapenemase gene, with blaGES-2 as the most occurring gene (63.3%). Compared with the PCR, the accuracy of phenotypic tests did not exceed 25% for P. aeruginosa. The efflux pump genes were present in all strains except one. In 85% of the isolates, an overactivity of mexA, mexB and mostly mexC was detected. Previous treatment with ceftriaxone increased the activity of mexC by more than 160 times; (4) Conclusions: In our MDR P. aeruginosa clinical isolates, the carbapenem resistance is not accurately detected by phenotypic tests, due to the overexpression of mex efflux pumps and in a lesser amount, due to carbapenemase production.
Collapse
Affiliation(s)
- Răzvan Lucian Coșeriu
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania
| | - Anca Delia Mare
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
| | - Felicia Toma
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
| | - Camelia Vintilă
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania
| | - Cristina Nicoleta Ciurea
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
| | - Radu Ovidiu Togănel
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania
| | - Anca Cighir
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania
| | - Anastasia Simion
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania
| | - Adrian Man
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology Târgu Mureș, 540142 Târgu Mures, Romania; (R.L.C.); (F.T.); (C.V.); (C.N.C.); (R.O.T.); (A.C.); (A.S.); (A.M.)
| |
Collapse
|
4
|
Phan S, Feng CH, Huang R, Lee ZX, Moua Y, Phung OJ, Lenhard JR. Relative Abundance and Detection of Pseudomonas aeruginosa from Chronic Wound Infections Globally. Microorganisms 2023; 11:1210. [PMID: 37317184 DOI: 10.3390/microorganisms11051210] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 06/16/2023] Open
Abstract
Pseudomonas aeruginosa is a difficult-to-treat pathogen that is frequently involved with chronic wound infections. Here, we conducted a literature search of world-wide studies published between 2005 and 2022 that described the microbiological profiles of chronic wound infections. For each continent, a hierarchy of pathogens was created to define the organisms that were most frequently isolated in each region. Except for South America, P. aeruginosa was the second most common organism in each major continent, with Staphylococcus aureus being the most abundant pathogen overall. When individual countries were evaluated, P. aeruginosa was the most frequently isolated organism in several Southeast Asia nations including India and Malaysia. P. aeruginosa was less commonly isolated from diabetic foot infections in North America, Europe, and Africa in comparison to other types of chronic wound infections. Additionally, the Levine wound swab technique may be a quick and painless way to isolate P. aeruginosa from wound infections, but the isolation of P. aeruginosa does not seem to be an informative predictor of the patient's clinical course. A multivariate risk assessment that accounts for the regional frequency of P. aeruginosa isolation may be an appropriate way to guide empiric management of chronic wound infections.
Collapse
Affiliation(s)
- Sang Phan
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| | - Cafrey He Feng
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| | - Raymond Huang
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| | - Zeng X Lee
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| | - Yer Moua
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| | - Olivia J Phung
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| | - Justin R Lenhard
- College of Pharmacy, California Northstate University, Elk Grove, CA 95757, USA
| |
Collapse
|
5
|
Investigation of mobile colistin resistance (mcr) genes among carbapenem resistance Pseudomonas aeruginosa isolates from bovine mastitis in Mashhad, Iran. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
6
|
Detection of blaOXA-145, blaOXA-224, blaOXA-539, and blaOXA-675 Genes and Carbapenem-Hydrolyzing Class D β-Lactamases (CHDLs) in Clinical Isolates of Pseudomonas aeruginosa Collected from West of Iran, Hamadan. Int J Microbiol 2022; 2022:3841161. [PMID: 36032180 PMCID: PMC9411009 DOI: 10.1155/2022/3841161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
Carbapenem-hydrolyzing class D β-lactamases (CHDLs) are on the rise and are a major public health problem worldwide. Pseudomonas aeruginosa is resistant to carbapenem; currently, the most effective treatment option is being increasingly reported. This study aimed to identify blaOXA-145, blaOXA-224, blaOXA-539, and blaOXA-675 genes in CHDL strains. Samples were collected from clinical specimens admitted to the hospital. Antibiotic susceptibility was determined using the disk diffusion methods. CHDL strains were detected using a phenotypic method (disk diffusion). The PCR method was used to identify blaOXA-145, blaOXA-224, blaOXA-539, and blaOXA-675 genes. Piperacillin-resistant strains (n = 9, 17.4%) had the lowest frequency, and cefoxitin-resistant strains (n = 100, 91.7%) had the highest distribution in P. aeruginosa isolates. Also, 29.35%, 12.8%, and 8.2% were multidrug-resistant, extensively drug-resistant, and pan drug-resistant, respectively. MBL-producing P. aeruginosa and KPC-producing P. aeruginosa were detected, respectively, in 47.7% and 37.6% of isolates. Biofilm formation was observed in 63.3% of P. aeruginosa isolates. The frequency of OXA genes was as follows: blaOXA-145 gene in 30 isolates (27.5%), blaOXA-224 in 24 isolates (22.0%), blaOXA-539 in 22 isolates (20.1%), and blaOXA-675 in 13 isolates (11.9%). However, 19 (17.4%) isolates carry all blaOXA-145, blaOXA-224, blaOXA-539, and blaOXA-675 genes. The antimicrobial resistance and OXA genes among biofilm former strains were significantly higher than those of nonbiofilm former strains (
). The emergence of carbapenem-resistant isolates of P. aeruginosa has posed serious threats to the community because they exhibit multiple drug resistance, thus limiting the therapeutic options for clinicians.
Collapse
|
7
|
Uçkay I, Lebowitz D, Kressmann B, von Dach E, Lipsky BA, Gariani K. Pseudomonal Diabetic Foot Infections: Vive la Différence? Mayo Clin Proc Innov Qual Outcomes 2022; 6:250-256. [PMID: 35634135 PMCID: PMC9130228 DOI: 10.1016/j.mayocpiqo.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the outcomes of diabetic foot infections (DFIs) due to Pseudomonas aeruginosa. Patients and Methods From April 24, 2013 to July 31, 2016, we analyzed data from patients prospectively enrolled in our clinical pathway of DFIs, comparing those with infection due to Pseudomonas with those without infection due to Pseudomonas. Results Overall, we assessed 1018 cases of DFIs: 392 with osteomyelitis and 626 with only soft tissue infections. The prevalence of P aeruginosa in deep wound cultures was 10% (104/1018); of the 1018 cultures, 22 were monomicrobial, 82 were polymicrobial, and 46 were with osteomyelitis. Overall, the patients were treated with a median of 1 surgical debridement and a total of 20 days of antibiotic therapy. In a comparison of crude groups, the proportion of clinical failures was significantly higher with Pseudomonas than with other pathogens (36/104 [35%] vs 218/914 [24%], respectively; P=.02). A multivariate analysis showed that pseudomonal DFIs did not recur more often than nonpseudomonal DFIs (hazard ratio, 1.0; 95% confidence interval, 0.6-1.7). Among the 104 cases of pseudomonal DFIs, there was no association between failure of treatment and the total duration of antibiotic therapy, duration of intravenous therapy, duration of combined antibiotic therapy with more than 1 agent, or duration of oral (fluoroquinolone) therapy. Among 15 cases of pseudomonal recurrence, 2 (13%) developed resistance to the antibiotic agent used for the index episode. Conclusion For DFIs caused by P aeruginosa, other than choosing an antibiotic agent that is active against the organism, it does not appear necessary to treat with a different therapeutic regimen compared with the treatment of nonpseudomonal DFIs. There is no difference!
Collapse
Affiliation(s)
- Ilker Uçkay
- Clinical Pathway for Diabetic Foot Infections, Geneva University Hospitals, Geneva, Switzerland
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
- Infectiology, Balgrist University Hospital, Zurich, Switzerland
- Correspondence: Address to Ilker Uçkay, MD, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland.
| | - Dan Lebowitz
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
| | - Benjamin Kressmann
- Clinical Pathway for Diabetic Foot Infections, Geneva University Hospitals, Geneva, Switzerland
| | - Elodie von Dach
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
| | - Benjamin A. Lipsky
- Clinical Pathway for Diabetic Foot Infections, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, University of Washington, Seattle, WA
| | - Karim Gariani
- Clinical Pathway for Diabetic Foot Infections, Geneva University Hospitals, Geneva, Switzerland
- Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
8
|
Zamani K, Allah-Bakhshi N, Akhavan F, Yousefi M, Golmoradi R, Ramezani M, Bach H, Razavi S, Irajian GR, Gerami M, Pakdin-Parizi A, Tafrihi M, Ramezani F. Antibacterial effect of cerium oxide nanoparticle against Pseudomonas aeruginosa. BMC Biotechnol 2021; 21:68. [PMID: 34876083 PMCID: PMC8650514 DOI: 10.1186/s12896-021-00727-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/24/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Antibiotics have been widely used for the treatment of bacterial infections for decades. However, the rapid emergence of antibiotic-resistant bacteria has created many problems with a heavy burden for the medical community. Therefore, the use of nanoparticles as an alternative for antibacterial activity has been explored. In this context, metal nanoparticles have demonstrated broad-spectrum antimicrobial activity. This study investigated the antimicrobial activity of naked cerium oxide nanoparticles dispersed in aqueous solution (CNPs) and surface-stabilized using Pseudomonas aeruginosa as a bacterial model. METHODS Gelatin-polycaprolactone nanofibers containing CNPs (Scaffold@CNPs) were synthesized, and their effect on P. aeruginosa was investigated. The minimum inhibitory and bactericidal concentrations of the nanoparticls were determined in an ATCC reference strain and a clinical isolate strain. To determine whether the exposure to the nanocomposites might change the expression of antibiotic resistance, the expression of the genes shv, kpc, and imp was also investigated. Moreover, the cytotoxicity of the CNPs was assessed on fibroblast using flow cytometry. RESULTS Minimum bactericidal concentrations for the ATCC and the clinical isolate of 50 µg/mL and 200 µg/mL were measured, respectively, when the CNPs were used. In the case of the Scaffold@CNPs, the bactericidal effect was 50 µg/mL and 100 µg/mL for the ATCC and clinical isolate, respectively. Interestingly, the exposure to the Scaffold@CNPs significantly decreased the expression of the genes shv, kpc, and imp. CONCLUSIONS A concentration of CNPs and scaffold@CNPs higher than 50 μg/mL can be used to inhibit the growth of P. aeruginosa. The fact that the scaffold@CNPs significantly reduced the expression of resistance genes, it has the potential to be used for medical applications such as wound dressings.
Collapse
Affiliation(s)
- Khosro Zamani
- 1. Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Faezeh Akhavan
- Department of Biology, Sana Institute of Higher education, Sari, Iran
| | - Mahdieh Yousefi
- Department of Biology, Sana Institute of Higher education, Sari, Iran
| | - Rezvan Golmoradi
- 1. Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Horacio Bach
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Shabnam Razavi
- 1. Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam-Reza Irajian
- 1. Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahyar Gerami
- Department of Biology, Sana Institute of Higher education, Sari, Iran.
| | - Ali Pakdin-Parizi
- Sari Agricultural Sciences and Natural Resources University, Sari, Iran
| | - Majid Tafrihi
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Mazandaran, Iran
| | - Fatemeh Ramezani
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
Al-Orphaly M, Hadi HA, Eltayeb FK, Al-Hail H, Samuel BG, Sultan AA, Skariah S. Epidemiology of Multidrug-Resistant Pseudomonas aeruginosa in the Middle East and North Africa Region. mSphere 2021; 6:e00202-21. [PMID: 34011686 PMCID: PMC8265635 DOI: 10.1128/msphere.00202-21] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Over the last decades, there has been a dramatic global increase in multidrug-resistant (MDR) pathogens particularly among Gram-negative bacteria (GNB). Pseudomonas aeruginosa is responsible for various health care-associated infections, while MDR P. aeruginosa causes significant morbidity and mortality. Middle East and North Africa (MENA) represent an unexplored geographical region for the study of drug resistance since many of these countries are at crossroads of high volume of travel, diverse expatriate populations, as well as high antibiotic consumption despite attempts to implement antimicrobial stewardship programs. This minireview analyzes epidemiology, microbiological, and genomic characteristics of MDR P. aeruginosa in the MENA region. Published data on MDR P. aeruginosa prevalence, antimicrobial resistance patterns, and genetic profiles from studies published during the past 10 years from 19 MENA countries have been included in this minireview. There is wide variation in the epidemiology of MDR P. aeruginosa in the MENA region in terms of prevalence, antimicrobial characteristics, as well as genetic profiles. Overall, there is high prevalence of MDR P. aeruginosa seen in the majority of the countries in the MENA region with similarities between neighboring countries, which might reflect comparable population and antibiotic-prescribing cultures. Isolates from critical care units are significantly resistant particularly from certain countries such as Saudi Arabia, Egypt, Libya, Syria, and Lebanon with high-level resistance to cephalosporins, carbapenems, and aminoglycosides. Colistin susceptibility patterns remains high apart from countries with high-level antibiotic resistance such as Saudi Arabia, Syria, and Egypt.
Collapse
Affiliation(s)
- Mahmood Al-Orphaly
- Department of Medical Education, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Hamad Abdel Hadi
- Department of Infectious Diseases, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | | | - Hissa Al-Hail
- Department of Medical Education, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Bincy Gladson Samuel
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Sini Skariah
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| |
Collapse
|
10
|
Ali FA. Association between biofilm formation gene bla exoU and metallo and extend spectrum beta-lactamase production of multidrug resistance Pseudomonas aeruginosa in clinical samples. Comb Chem High Throughput Screen 2021; 25:1207-1218. [PMID: 33874869 DOI: 10.2174/1386207324666210419112210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The presence of biofilm formation exoU gene is significant challenge to infection control management in hospitals and exposure by Pseudomonas aeruginosa may lead to further spread and development of antimicrobial resistance. METHODS Out of 227 samples 40 clinical isolates of P. aeruginosa were collected from patients attending public hospitals ( Rizgary, Teaching hospital, Laboratory center, Raparin, Nanakaly hospitals)in Erbil city/Iraq over a period during 2018 to march 2019 and fully characterized by standard bacteriological procedures and antimicrobial susceptibility test and ESBL has been carried out by Vitek 2 compact system and. by Vitek 2 compact system. The identification has been verified by all isolates as P. aeruginosa by using 16S rDNA with product size (956pb). RESULTS A high rate of resistance was seen against Penicillin and lincomycin and Piperacillin and chloramphenicol and rifampicin (100 %), whereas Imipenem (5%) were found to be the most effective antimicrobial drugs. Of all P. aeruginosa isolates, 30 (75% %) were identified as MDR, approximately 9(22.5%) of isolates were resistant to 9 drugs in burn samples. Quantitative biofilm determination using the Congo red method revealed that 28 isolates (70%) produced biofilm, biofilm production was significantly higher among MDR P. aeruginosa isolates while coproduction of Extended Spectrum β-lactamase (ESBL) together with Metallo β-lactamase (MBL) ESBLs MBLs recorded in (52.5%) of the isolates. Altogether 40 isolates were processed for analysis by PCR assays and showed that 26(70%) of P. aeruginosa isolates harboured the exoU encoding gene with product size (204) pb was more commonly seen in isolates obtained from burn isolates. In addition, exo U gene was significantly associated with the higher MDR (80%), 8 isolates (76.9%)had exoU gene with ESBL and( 65%) had MBL and the same for MDR (80.8%) in samples for burning. CONCLUSION Our results showed surveillance of P. aeruginosa resistance against antimicrobial and ESBL and MBL is fundamental to monitor trends in susceptibility patterns and appropriately guide clinicians in choosing empirical or directed therapy.
Collapse
Affiliation(s)
- Fattma Abodi Ali
- Department of Medical microbiology, College of Health Sciences, Hawler Medical University. Iraq
| |
Collapse
|
11
|
Interplay between ESKAPE Pathogens and Immunity in Skin Infections: An Overview of the Major Determinants of Virulence and Antibiotic Resistance. Pathogens 2021; 10:pathogens10020148. [PMID: 33540588 PMCID: PMC7912840 DOI: 10.3390/pathogens10020148] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
The skin is the largest organ in the human body, acting as a physical and immunological barrier against pathogenic microorganisms. The cutaneous lesions constitute a gateway for microbial contamination that can lead to chronic wounds and other invasive infections. Chronic wounds are considered as serious public health problems due the related social, psychological and economic consequences. The group of bacteria known as ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter sp.) are among the most prevalent bacteria in cutaneous infections. These pathogens have a high level of incidence in hospital environments and several strains present phenotypes of multidrug resistance. In this review, we discuss some important aspects of skin immunology and the involvement of ESKAPE in wound infections. First, we introduce some fundamental aspects of skin physiology and immunology related to cutaneous infections. Following this, the major virulence factors involved in colonization and tissue damage are highlighted, as well as the most frequently detected antimicrobial resistance genes. ESKAPE pathogens express several virulence determinants that overcome the skin's physical and immunological barriers, enabling them to cause severe wound infections. The high ability these bacteria to acquire resistance is alarming, particularly in the hospital settings where immunocompromised individuals are exposed to these pathogens. Knowledge about the virulence and resistance markers of these species is important in order to develop new strategies to detect and treat their associated infections.
Collapse
|
12
|
Prevalence and molecular typing of Metallo-β-lactamase-producing Pseudomonas aeruginosa with adhesion factors: A descriptive analysis of burn wounds isolates from Iran. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
13
|
Genome Sequence of Clinical Strain Pseudomonas aeruginosa NRD619. Microbiol Resour Announc 2020; 9:9/44/e01013-20. [PMID: 33122414 PMCID: PMC7595950 DOI: 10.1128/mra.01013-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Here, we report the complete genome sequence of the multidrug-resistant (MDR) strain Pseudomonas aeruginosa NRD619, assembled via long- and short-read hybrid assembly. P. aeruginosa is a Gram-negative bacterial pathogen that is a significant public health burden. NRD619 was isolated from a left ventricular assist device (LVAD) draining sinus tract. Here, we report the complete genome sequence of the multidrug-resistant (MDR) strain Pseudomonas aeruginosa NRD619, assembled via long- and short-read hybrid assembly. P. aeruginosa is a Gram-negative bacterial pathogen that is a significant public health burden. NRD619 was isolated from a left ventricular assist device (LVAD) draining sinus tract.
Collapse
|