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Edward EA, El Shehawy MR, Abouelfetouh A, Aboulmagd E. Phenotypic and molecular characterization of extended spectrum- and metallo- beta lactamase producing Pseudomonas aeruginosa clinical isolates from Egypt. Infection 2024:10.1007/s15010-024-02297-8. [PMID: 38824475 DOI: 10.1007/s15010-024-02297-8] [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: 03/05/2024] [Accepted: 05/13/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Antimicrobial resistance among Pseudomonas aeruginosa (P. aeruginosa), a leading cause of nosocomial infections worldwide, is escalating. This study investigated the prevalence of extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) among 104 P. aeruginosa clinical isolates from Alexandria Main University Hospital, Alexandria, Egypt. METHODS Antimicrobial susceptibility testing was performed using agar dilution technique, or broth microdilution method in case of colistin. ESBL and MBL prevalence was assessed phenotypically and genotypically using polymerase chain reaction (PCR). The role of plasmids in mediating resistance to extended-spectrum β-lactams was studied via transformation technique using plasmids isolated from ceftazidime-resistant isolates. RESULTS Antimicrobial susceptibility testing revealed alarming resistance rates to carbapenems, cephalosporins, and fluoroquinolones. Using PCR as the gold standard, phenotypic methods underestimated ESBL production while overestimating MBL production. Eighty-five isolates (81.7%) possessed only ESBL encoding genes, among which 69 isolates harbored a single ESBL gene [blaOXA-10 (n = 67) and blaPER (n = 2)]. Four ESBL-genotype combinations were detected: blaPER + blaOXA-10 (n = 8), blaVEB-1 + blaOXA-10 (n = 6), blaPSE + blaOXA-10 (n = 1), and blaPER + blaVEB-1 + blaOXA-10 (n = 1). Three isolates (2.9%) possessed only the MBL encoding gene blaVIM. Three ESBL + MBL- genotype combinations: blaOXA-10 + blaAIM, blaOXA-10 + blaVIM, and blaPER + blaOXA-10 + blaAIM were detected in 2, 1 and 1 isolate(s), respectively. Five plasmid preparations harboring blaVEB-1 and blaOXA-10 were successfully transformed into chemically competent Escherichia coli DH5α with transformation efficiencies ranging between 6.8 × 10 3 and 3.7 × 10 4 CFU/μg DNA plasmid. Selected tested transformants were ceftazidime-resistant and harbored plasmids carrying blaOXA-10. CONCLUSIONS The study highlights the importance of the expeditious characterization of ESBLs and MBLs using genotypic methods among P. aeruginosa clinical isolates to hinder the development and dissemination of multidrug resistant strains.
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Affiliation(s)
- Eva A Edward
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, El-Khartoom Square, Azarita, Alexandria, Egypt.
| | - Marwa R El Shehawy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, El-Khartoom Square, Azarita, Alexandria, Egypt
| | - Alaa Abouelfetouh
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, El-Khartoom Square, Azarita, Alexandria, Egypt
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alamein International University, Alamein, Egypt
| | - Elsayed Aboulmagd
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, El-Khartoom Square, Azarita, Alexandria, Egypt
- College of Pharmacy, Arab Academy for Science, Technology and Maritime, Alamein Branch, Alamein, Egypt
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2
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Gervasoni LF, Peixoto IC, Imperador AC, De Oliveira LB, Correia LF, de Oliveira Vieira KC, Saeki EK, da Silva Lima PE, Mareco EA, Pereira VC, Winkelströter Eller LK. "Relationship between antibiotic resistance, biofilm formation, virulence factors and source of origin of Pseudomonas aeruginosa environmental isolates with regard to the presence of metallo-β-lactamase-encoding genes". Microb Pathog 2023; 182:106223. [PMID: 37423498 DOI: 10.1016/j.micpath.2023.106223] [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: 05/02/2023] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
A total of 557 water samples were evaluated and of these, 23 were positive for the presence of Pseudomonas aeruginosa. Approximately 91.7% of them were weak biofilm formers. Only 4 isolates showed antimicrobial resistance. All isolates presented Twitching motility, a positive result for the production of pyocyanin, alkaline protease, and hemolysins. The genotypic tests showed: lasA, (95.6%) lasB (95.6%), exoS (95.6%), exoT (91.3%), toxA (91.3%), akgO (91.3%), plcN (91.3%) aprA (86.9%), phzM (78.3%), and pvdA (60.9%). For genes encoding metallo-beta-lactamase, it was found: blaVIM (56.6%), blaSPM (4.3%), and blaSIM (47.8%). A strong association was found between the metallo-beta-lactamase producing genes, nine genes of virulence factors and the motility (r = 0.6231). The very close clonal profile suggests a probable similarity between the isolates from different cities. Thus, P. aeruginosa can be present in water supplies with variable virulence capacities and can generate a huge concern for human, animal, and environmental health.
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Affiliation(s)
- Letícia Franco Gervasoni
- Faculty of Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Inaiá Calegari Peixoto
- Faculty of Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Anna Cardoso Imperador
- Faculty of Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Lívia Batista De Oliveira
- Faculty of Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Lucimeire Fernandes Correia
- Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Karolinny Cristiny de Oliveira Vieira
- Program of Animal Science, University of Western São Paulo, - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Erika Kushikawa Saeki
- Regional Laboratory of Presidente Prudente, Adolfo Lutz Institute - Avenida Coronel José Soares Marcondes, 2357 - Vila Maristela, CEP: 19020-120. Presidente Prudente, SP/Brazil
| | - Paula Esteves da Silva Lima
- Regional Laboratory of Presidente Prudente, Adolfo Lutz Institute - Avenida Coronel José Soares Marcondes, 2357 - Vila Maristela, CEP: 19020-120. Presidente Prudente, SP/Brazil
| | - Edson Assunção Mareco
- Environment and Regional Development Graduate Program, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Valéria Cataneli Pereira
- Faculty of Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil; Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil
| | - Lizziane Kretli Winkelströter Eller
- Faculty of Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil; Health Science, University of Western São Paulo - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil; Program of Animal Science, University of Western São Paulo, - Rua José Bongiovani, 700 - Cidade Universitária, CEP: 19050-920. Presidente Prudente, SP/Brazil.
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3
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Alqarni MS, Attar M, Alshammari S, Ambon B, Al Zhrani AA, Alghamdi A, Naebulharam A, Al-Amri A, Altayib H. Common Resistance Patterns in the Burn Unit of a Tertiary Care Center: A Retrospective Observational Study. Cureus 2023; 15:e43896. [PMID: 37746476 PMCID: PMC10511942 DOI: 10.7759/cureus.43896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Background Nosocomial bacterial infections have been one of the major concerns in the healthcare system. Burn patients, specifically severe cases, are at a high risk of developing bacterial infections compared to others. The most frequent cultures among burn patients are Staphylococcus aureus, Pseudomonas aeruginosa,and Acinetobacter baumannii. There is a scarcity of local data showing the most common infections in burn patients. This research aimed to determine the most common organisms that cause infections in burn unit patients and the antibiotic sensitivity and resistance patterns in King Abdulaziz Medical City (KAMC) in Jeddah. Methodology In this cross-sectional study, data were collected from patients' files into a data collection sheet. All patients in the burn unit with a positive culture were included in the study using a convenient sampling technique from Best-Care, KAMC electronic medical records. Burn patients with negative culture results and patients who were admitted to the plastic surgery ward for reasons other than burns were excluded. For sample size calculation, convenience sampling of 109 patient medical charts, over the study period from June 2016 to November 2021, was selected for data extraction, analysis, and reporting. Results Pseudomonas aeruginosa was the leading cause of infection in burn patients comprising 33.9% of the cases. Enterobacter cloacae was the second most frequent cause of infection among burn patients (27.5%). Klebsiella pneumoniae was the third most frequent cause of infection (26.6%) while Acinetobacter baumannii was the fourth most frequent cause of infection in burn patients (22.9%). Conclusions Understanding the local epidemiology of bacterial infections will be crucial for the development of treatment guidelines designed to standardize initial antibiotic use, reduce hospital-acquired infections, and reduce drug resistance. More attention should be paid to gram-negative bacteria, specifically Pseudomonas aeruginosa and Enterobacter Cloacae.
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Affiliation(s)
- Mohammed S Alqarni
- Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Meshari Attar
- Research Office, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Salem Alshammari
- Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
- Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Badr Ambon
- Emergency, Ministry of Health, Mikhwah General Hospital, Al-Baha, SAU
| | | | - Abdullah Alghamdi
- Radiology, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
- Radiology, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Ahmad Naebulharam
- Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
- Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Abdulfattah Al-Amri
- Pathology and Laboratory Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Pathology and Laboratory Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Hadeel Altayib
- Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
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Worldwide Prevalence of Carbapenem Resistance in Acinetobacter baumannii. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023. [DOI: 10.1097/ipc.0000000000001236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Aminoglycoside-Modifying Enzymes Are Sufficient to Make Pseudomonas aeruginosa Clinically Resistant to Key Antibiotics. Antibiotics (Basel) 2022; 11:antibiotics11070884. [PMID: 35884138 PMCID: PMC9312099 DOI: 10.3390/antibiotics11070884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 02/06/2023] Open
Abstract
Aminoglycosides are widely used to treat infections of Pseudomonas aeruginosa. Genes encoding aminoglycoside-modifying enzymes (AMEs), acquired by horizontal gene transfer, are commonly associated with aminoglycoside resistance, but their effects have not been quantified. The aim of this research was to determine the extent to which AMEs increase the antibiotic tolerance of P. aeruginosa. Bioinformatics analysis identified AME-encoding genes in 48 out of 619 clinical isolates of P. aeruginosa, with ant(2′)-Ia and aac(6′)-Ib3, which are associated with tobramcyin and gentamicin resistance, being the most common. These genes and aph(3′)-VIa (amikacin resistance) were deleted from antibiotic-resistant strains. Antibiotic minimum inhibitory concentrations (MICs) were reduced by up to 64-fold, making the mutated bacteria antibiotic-sensitive in several cases. Introduction of the same genes into four antibiotic-susceptible P. aeruginosa strains increased the MIC by up to 128-fold, making the bacteria antibiotic-resistant in all cases. The cloned genes also increased the MIC in mutants lacking the MexXY-OprM efflux pump, which is an important contributor to aminoglycoside resistance, demonstrating that AMEs and this efflux pump act independently in determining levels of aminoglycoside tolerance. Quantification of the effects of AMEs on antibiotic susceptibility demonstrates the large effect that these enzymes have on antibiotic resistance.
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6
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Bueno TS, Loiko MR, Vidaletti MR, Oliveira JA, Fetzner T, Cerva C, Moraes LB, De Carli S, Siqueira FM, Rodrigues RO, Menezes Coppola M, Callegari‐Jacques SM, Mayer FQ. Multidrug‐resistant
Escherichia coli
from free‐living pigeons (
Columba livia
): Insights into antibiotic environmental contamination and detection of resistance genes. Zoonoses Public Health 2022; 69:682-693. [DOI: 10.1111/zph.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 04/11/2022] [Accepted: 04/24/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Thaís Silveira Bueno
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Márcia Regina Loiko
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
- Universidade Feevale Novo Hamburgo Brazil
| | - Marina Roth Vidaletti
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Júlia Alves Oliveira
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Tiago Fetzner
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Cristine Cerva
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Lucas Brunelli Moraes
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Silvia De Carli
- Laboratório de Bacteriologia Veterinária, Departamento de Patologia Clínica Veterinária, Faculdade de Veterinária Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | - Franciele Maboni Siqueira
- Laboratório de Bacteriologia Veterinária, Departamento de Patologia Clínica Veterinária, Faculdade de Veterinária Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | - Rogério Oliveira Rodrigues
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | - Mario Menezes Coppola
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
| | | | - Fabiana Quoos Mayer
- Centro de Pesquisa em Saúde Animal, Departamento de Diagnóstico e Pesquisa Agropecuária, Instituto de Pesquisas Veterinárias DesidérioFinamor Secretaria de Agricultura, Pecuária e Desenvolvimento Rural Eldorado do Sul Brazil
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Geographic Patterns of Carbapenem-resistant Pseudomonas aeruginosa in the Asia-Pacific Region: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2015-2019. Antimicrob Agents Chemother 2021; 66:e0200021. [PMID: 34807753 DOI: 10.1128/aac.02000-21] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pseudomonas aeruginosa is a common pathogen that is associated with multidrug-resistant (MDR) and carbapenem-resistant (CR) phenotypes; therefore, we investigated its resistance patterns and mechanisms by using data from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program in the Asia-Pacific region during 2015-2019. MICs were determined using the broth microdilution method. Genes encoding major extended-spectrum β-lactamases and carbapenemases were investigated by multiplex PCR assays. Susceptibility was interpreted using the Clinical and Laboratory Standards Institute (CLSI) breakpoints. A total of 6,349 P. aeruginosa isolates were collected in the ATLAS program between 2015 and 2019 from 14 countries. According to the CLSI definitions, the numbers (and rates) of CR and MDR P. aeruginosa were 1,198 (18.9%) and 1,303 (20.5%), respectively. For 747 of the CR P. aeruginosa strains that were available for gene screening, 253 β-lactamases genes were detected in 245 (32.8%) isolates. The most common gene was blaVIM (29.0, 71/245), followed by blaNDM (24.9%, 61/245) and blaVEB (20.8%, 51/245). The resistance patterns and associated genes varied significantly between the countries in the Asia-Pacific region. India had the highest rates of carbapenem resistance (29.3%, 154/525) and gene detection (17.7%, 93/525). Compared to those harboring either class A or B β-lactamase genes, the CR P. aeruginosa without detected β-lactamase genes had lower MICs for most of the antimicrobial agents, including ceftazidime/avibactam and ceftolozane/tazobactam. In conclusion, MDR and CR P. aeruginosa infections pose a major threat, particularly those with detected carbapenemase genes. Continuous surveillance is important for improving antimicrobial stewardship and antibiotic prescriptions.
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8
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Yoon EJ, Jeong SH. Mobile Carbapenemase Genes in Pseudomonas aeruginosa. Front Microbiol 2021; 12:614058. [PMID: 33679638 PMCID: PMC7930500 DOI: 10.3389/fmicb.2021.614058] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Carbapenem-resistant Pseudomonas aeruginosa is one of the major concerns in clinical settings impelling a great challenge to antimicrobial therapy for patients with infections caused by the pathogen. While membrane permeability, together with derepression of the intrinsic beta-lactamase gene, is the global prevailing mechanism of carbapenem resistance in P. aeruginosa, the acquired genes for carbapenemases need special attention because horizontal gene transfer through mobile genetic elements, such as integrons, transposons, plasmids, and integrative and conjugative elements, could accelerate the dissemination of the carbapenem-resistant P. aeruginosa. This review aimed to illustrate epidemiologically the carbapenem resistance in P. aeruginosa, including the resistance rates worldwide and the carbapenemase-encoding genes along with the mobile genetic elements responsible for the horizontal dissemination of the drug resistance determinants. Moreover, the modular mobile elements including the carbapenemase-encoding gene, also known as the P. aeruginosa resistance islands, are scrutinized mostly for their structures.
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Affiliation(s)
- Eun-Jeong Yoon
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
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9
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Carbapenemases as factors of Resistance to Antibacterial Drugs. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2020-5.6.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Musavi SH, Davoodi B. Risk assessment for hazardous lubricants in machining industry. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:625-634. [PMID: 32816181 DOI: 10.1007/s11356-020-10472-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
Knowing that over two-thirds of lubricant disposals return to the environment with no purification process, adequate strategies are demanded to reduce their risks. For this reason, the main focus of the present study is to describe an environment-friendly approach. In the first part, two widely used lubricants (mineral-based and vegetable-based) were introduced, and the reasons for their hazards were investigated. The composition of mineral-based lubricant was characterized by x-ray fluorescence elemental analysis. The result showed the presence of phosphorus, chlorine, and zinc dialkyl dithiophosphate in its composition that many scholars considered them to be the leading risk factor in the chemical composition of mineral-based lubricants. It has been focused on the potential risks of vegetable-based lubricants, which many researchers have identified as a safe lubricant. The Pseudomonas microbe was cultivated in the vegetable-based sample, and the result showed that although vegetable-based lubricants are compatible with humans, bacteria colony can quickly grow there without making any apparent changes that lead to harm to operators in a mysterious way. In the present work, the hypothesis of the safety of unreinforced vegetable-based lubricants has been rejected, and a new window on the environmental issues of vegetable-based lubricants has been presented. In the final, to eliminate environment-human risks and to reduce consumption of lubricant and natural resources to green manufacturing, a comprehensive study on the possibility of completely removing lubricant was performed. The results showed that the machining without lubricant could be replaced with the traditional method.
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Affiliation(s)
- Seyed Hasan Musavi
- Sustainable Manufacturing Systems Research Laboratory (SMSRL), School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran
- Department of Mechanical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Behnam Davoodi
- Sustainable Manufacturing Systems Research Laboratory (SMSRL), School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran.
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11
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Antipseudomonal β-Lactams Resistance in Iran. Int J Microbiol 2020; 2020:8818315. [PMID: 33488724 PMCID: PMC7803146 DOI: 10.1155/2020/8818315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/07/2020] [Indexed: 11/17/2022] Open
Abstract
Over the last years, the mortality rate of Pseudomonas aeruginosa, which is one of the major reasons for severe infections, has been significantly increasing. This bacterium is highly resistant to many antibiotics, especially carbapenems, thanks to its complicated mechanism by which it can acquire exogenous genes. The purpose of this research is to have a review of empirical studies surveying the P. aeruginosa resistance to beta-lactams in Iran in order to investigate the most reliable methods by which the incidence of P. aeruginosa infections can be decreased and controlled. We performed a systematic review of all articles published from 2008 until 2018. Studies which did not address P. aeruginosa resistance to beta-lactams were excluded from the analysis. Studies with less than 10 cases were also excluded. Studies with more than ten cases, which did not have repetitive information, were taken into account for the final selection; 133 out of 893 articles were chosen. The resistance rate of P. aeruginosa among the articles was as follows: more than 72% of studies revealed >50% level of resistance to cefepime, followed by aztreonam (53.2%), ceftazidime (61%), piperacillin/tazobactam (54.5%), meropenem (48.3%), and imipenem (42.4%). The selection of empiric antipseudomonal antibiotics is absolutely uncertain and hazardous, and the risk of clinical failure may be more among cephalosporins and piperacillin-tazobactam as well as aztreonam. The results of this study illustrate that the methods enabling clinics to identify the bacterium resistance pattern and its genetic basis and to have the opportunity of empiric therapies through access to updated local data of antimicrobial susceptibility pattern are the most effective methods. However, the widespread usage of these approaches undoubtedly needs reliable molecular and nucleic acid-based devices, which are both affordable and available.
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12
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Heidarzadeh S, Enayati Kaliji Y, Pourpaknia R, Mohammadzadeh A, Ghazali-Bina M, Saburi E, Vazini H, Khaledi A. A Meta-Analysis of the Prevalence of Class 1 Integron and Correlation with Antibiotic Resistance in Pseudomonas aeruginosa Recovered from Iranian Burn Patients. J Burn Care Res 2020; 40:972-978. [PMID: 31326983 DOI: 10.1093/jbcr/irz135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The role of integrons has been highlighted in antibiotic resistance among Pseudomonas aeruginosa isolates. Therefore, we here reviewed the prevalence of class 1 integrons and their correlations with antibiotic resistance of P. aeruginosa isolated from Iranian burn patients. This review was conducted according to the guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Cross-sectional and cohort studies published from January 1, 2000 until December 31, 2018 were enrolled. Meta-analysis was performed by Comprehensive Meta-Analysis (CMA) software using the random effects model, Cochran's Q, and I2 tests. Publication bias was estimated by Funnel plot and Egger's linear regression test. Nine out of 819 studies met the eligibility criteria. The overall combined prevalence of class 1 integrons in P. aeruginosa isolates was 69% (95% confidence interval [CI]: 50.5-83%). The highest combined resistance was reported against Cloxacillin (87.7%), followed by Carbenicillin (79.1%) and Ceftriaxone (77.3%). The combined prevalence of multidrug-resistant (MDR) isolates was 79.3% (95% CI: 31.1-97%). Also, a significant correlation was noted between the presence of class 1 integrons and antibiotic resistance in 55.5% of the included studies (P < .05). The results showed high prevalence of class 1 integrons, antibiotic resistance, and MDR strains in P. aeruginosa isolated from Iranian burn patients. Also, most of the included studies showed a significant correlation between the presence of class 1 integrons and antibiotic resistance.
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Affiliation(s)
- Siamak Heidarzadeh
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Reza Pourpaknia
- Department of Medical Genetics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Mohammadzadeh
- Department of Microbiology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mehran Ghazali-Bina
- Department of Microbiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Saburi
- Immunogenetic and Cell Culture Department, Immunology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Vazini
- Nursing Department Basic Sciences Faculty, Hamedan Branch, Islamic Azad University, Hamadan, Iran
| | - Azad Khaledi
- Infectious Diseases Research Center, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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13
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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]
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14
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Ding J, Gao X, Gui H, Ding X, Lu Y, An S, Liu Q. Proteomic Analysis of Proteins Associated with Inhibition of Pseudomonas aeruginosa Resistance to Imipenem Mediated by the Chinese Herbal Medicine Qi Gui Yin. Microb Drug Resist 2020; 27:462-470. [PMID: 32924788 DOI: 10.1089/mdr.2020.0110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Antibiotic resistance of Pseudomonas aeruginosa (PA) that lowers the effectiveness of current treatments for pneumonia is a growing problem. Qi Gui Yin is a Chinese herbal medicine that has been used to improve the efficacy of antibiotic therapy against antibiotic-resistant bacteria. This study aimed to elucidate the mechanism by which Qi Gui Yin inhibits antibiotic resistance of PA. Methods: Active components of Qi Gui Yin were analyzed by chromatography. Isobaric Tags for Relative and Absolute Quantification (iTRAQ) technology was used to compare protein expression profiles of PA strains cultured in serum from rats that were and were not treated with Qi Gui Yin. Quantitative polymerase chain reaction (qPCR) analysis was performed to detect gene expression changes. Results: Proteomic analysis identified 76 differentially expressed proteins between PA strains cultured in serum from rats that were or were not treated with Qi Gui Yin. Bioinformatics analysis revealed that the largest number of differentially expressed proteins were associated with resistance mechanisms such as quorum sensing, bacterial biofilm formation, and active pumping. In addition, qPCR analysis confirmed that downregulation of iscU and arcA gene expression was associated with Qi Gui Yin treatment. Conclusions: Serum from Qi Gui Yin-treated rats could effectively inhibit antibiotic resistance of PA. Chlorogenic acid and astragaloside IV are the main components of Qi Gui Yin, which may mediate inhibition of antibiotic resistance. Our findings provide new insights into strategies involving Chinese herbal medicine that can be used to treat pneumonia caused by antibiotic-resistant bacteria.
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Affiliation(s)
- Junying Ding
- Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
| | - Xiang Gao
- Department of Clinical Laboratory, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Hong Gui
- Department of Clinical Laboratory, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Xuefei Ding
- Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
| | - Youran Lu
- Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
| | - Shidong An
- Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
| | - Qingquan Liu
- Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
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15
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Wang W, Wang X. Prevalence of metallo-β-lactamase genes among Pseudomonas aeruginosa isolated from various clinical samples in China. J LAB MED 2020. [DOI: 10.1515/labmed-2019-0162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Pseudomonas aeruginosa is an opportunistic pathogen which is associated with nosocomial infections and causes various diseases including urinary tract infection, pneumonia, soft-tissue infection and sepsis. The emergence of P. aeruginosa-acquired metallo-β-lactamase (MBL) is most worrisome and poses a serious threat during treatment and infection control. The objective of this study was to identify antibiotic susceptibility, phenotypic detection of MBL production and to determine the prevalence of MBL genes in carbapenem-resistant P. aeruginosa isolated from different clinical samples.
Methods
A total of 329 non-duplicate P. aeruginosa isolated from various clinical samples from two hospitals in China between September 2017 and March 2019 were included in this study. Phenotypic detection of MBL was performed by the combined detection method using imipenem and imipenem-ethylenediaminetetraacetic acid (EDTA) discs. MBL-encoding genes including bla
VIM-1
, bla
VIM-2
, bla
IMP-1
, bla
IMP-2
, bla
SPM-1
, bla
SIM
, bla
NDM-1
and bla
GIM
were detected by polymerase chain reaction (PCR).
Results
Of the 329 P. aeruginosa, majority of the isolates were resistant to imipenem (77.5%) followed by meropenem (64.7%). Of the 270 P. aeruginosa isolates tested, 149 (55.2%) isolates were found to be positive for MBL detection. Of the different samples, 57.8% (n = 26) of P. aeruginosa isolated from blood were found to be positive for MBL production. Of the various MBL genes, bla
IMP-1
(28.2%) was the most predominant gene detected followed by bla
VIM-2
(18.8%), bla
VIM-1
(16.1%), bla
NDM-1
(9.4%), bla
IMP-2
(6.7%), bla
SIM
(6.0%), bla
SPM-1
(4.0%) and bla
GIM
(1.3%) genes.
Conclusions
The high resistance of P. aeruginosa toward imipenem and meropenem and the high prevalence of bla
IMP-1
and bla
VIM-2
set the alarm on the increasing, perhaps the increased, carbapenem resistance. In addition to routine antibiotic susceptibility testings, our results emphasize the importance of both the phenotypic and genotypic MBL detection methods in routine practice for early detection of carbapenem resistance and to prevent further dissemination of this resistant pathogen.
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Affiliation(s)
- Wei Wang
- Department of Laboratory Medicine, Beijing Friendship Hospital , Capital Medical University , Beijing 100050 , P.R. China
| | - Xiaoya Wang
- Department of Neurosurgery, Nanchong Central Hospital , The Second Clinical Medical College, North Sichuan Medical College , Nanchon, Sichuan , P.R. China
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16
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Fodor A, Abate BA, Deák P, Fodor L, Gyenge E, Klein MG, Koncz Z, Muvevi J, Ötvös L, Székely G, Vozik D, Makrai L. Multidrug Resistance (MDR) and Collateral Sensitivity in Bacteria, with Special Attention to Genetic and Evolutionary Aspects and to the Perspectives of Antimicrobial Peptides-A Review. Pathogens 2020; 9:pathogens9070522. [PMID: 32610480 PMCID: PMC7399985 DOI: 10.3390/pathogens9070522] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022] Open
Abstract
Antibiotic poly-resistance (multidrug-, extreme-, and pan-drug resistance) is controlled by adaptive evolution. Darwinian and Lamarckian interpretations of resistance evolution are discussed. Arguments for, and against, pessimistic forecasts on a fatal “post-antibiotic era” are evaluated. In commensal niches, the appearance of a new antibiotic resistance often reduces fitness, but compensatory mutations may counteract this tendency. The appearance of new antibiotic resistance is frequently accompanied by a collateral sensitivity to other resistances. Organisms with an expanding open pan-genome, such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae, can withstand an increased number of resistances by exploiting their evolutionary plasticity and disseminating clonally or poly-clonally. Multidrug-resistant pathogen clones can become predominant under antibiotic stress conditions but, under the influence of negative frequency-dependent selection, are prevented from rising to dominance in a population in a commensal niche. Antimicrobial peptides have a great potential to combat multidrug resistance, since antibiotic-resistant bacteria have shown a high frequency of collateral sensitivity to antimicrobial peptides. In addition, the mobility patterns of antibiotic resistance, and antimicrobial peptide resistance, genes are completely different. The integron trade in commensal niches is fortunately limited by the species-specificity of resistance genes. Hence, we theorize that the suggested post-antibiotic era has not yet come, and indeed might never come.
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Affiliation(s)
- András Fodor
- Department of Genetics, University of Szeged, H-6726 Szeged, Hungary;
- Correspondence: or (A.F.); (L.M.); Tel.: +36-(30)-490-9294 (A.F.); +36-(30)-271-2513 (L.M.)
| | - Birhan Addisie Abate
- Ethiopian Biotechnology Institute, Agricultural Biotechnology Directorate, Addis Ababa 5954, Ethiopia;
| | - Péter Deák
- Department of Genetics, University of Szeged, H-6726 Szeged, Hungary;
- Institute of Biochemistry, Biological Research Centre, H-6726 Szeged, Hungary
| | - László Fodor
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, P.O. Box 22, H-1581 Budapest, Hungary;
| | - Ervin Gyenge
- Hungarian Department of Biology and Ecology, Faculty of Biology and Geology, Babeș-Bolyai University, 5-7 Clinicilor St., 400006 Cluj-Napoca, Romania; (E.G.); (G.S.)
- Institute for Research-Development-Innovation in Applied Natural Sciences, Babeș-Bolyai University, 30 Fântânele St., 400294 Cluj-Napoca, Romania
| | - Michael G. Klein
- Department of Entomology, The Ohio State University, 1680 Madison Ave., Wooster, OH 44691, USA;
| | - Zsuzsanna Koncz
- Max-Planck Institut für Pflanzenzüchtungsforschung, Carl-von-Linné-Weg 10, D-50829 Köln, Germany;
| | | | - László Ötvös
- OLPE, LLC, Audubon, PA 19403-1965, USA;
- Institute of Medical Microbiology, Semmelweis University, H-1085 Budapest, Hungary
- Arrevus, Inc., Raleigh, NC 27612, USA
| | - Gyöngyi Székely
- Hungarian Department of Biology and Ecology, Faculty of Biology and Geology, Babeș-Bolyai University, 5-7 Clinicilor St., 400006 Cluj-Napoca, Romania; (E.G.); (G.S.)
- Institute for Research-Development-Innovation in Applied Natural Sciences, Babeș-Bolyai University, 30 Fântânele St., 400294 Cluj-Napoca, Romania
- Centre for Systems Biology, Biodiversity and Bioresources, Babeș-Bolyai University, 5-7 Clinicilor St., 400006 Cluj-Napoca, Romania
| | - Dávid Vozik
- Research Institute on Bioengineering, Membrane Technology and Energetics, Faculty of Engineering, University of Veszprem, H-8200 Veszprém, Hungary; or or
| | - László Makrai
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, P.O. Box 22, H-1581 Budapest, Hungary;
- Correspondence: or (A.F.); (L.M.); Tel.: +36-(30)-490-9294 (A.F.); +36-(30)-271-2513 (L.M.)
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17
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Xu Y, Niu H, Hu T, Zhang L, Su S, He H, Wang H, Zhang D. High Expression of Metallo-β-Lactamase Contributed to the Resistance to Carbapenem in Clinical Isolates of Pseudomonas aeruginosa from Baotou, China. Infect Drug Resist 2020; 13:35-43. [PMID: 32021318 PMCID: PMC6954094 DOI: 10.2147/idr.s233987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
Background Bacterial resistance to antibiotics has become a major public health concern. This study aimed to determine the resistance mechanisms to carbapenem in clinical isolates of Pseudomonas aeruginosa. Methods A total of 62 clinical isolates of carbapenem-resistant P. aeruginosa (CRPA) were collected from 2015 to 2017. Imipenem (IPM)–EDTA disk synergy test was used to screen strains that produced metallo-β-lactamase. In addition, the genes for outer membrane protein OprD2, metallo-β-lactamase and mexR gene were amplified and sequenced. Expression of mexA was detected by real-time PCR. Results Disk synergy test showed that 51.6% (32/62) of the strains were positive for metallo-β-lactamase. PCR showed that 84.4% of the strains were SIM-positive (27/32), 15.6% of the strains were IMP-positive (5/32), and 12.5% of the strains were VIM-positive (4/32). SPM-positive and GIM-positive strains were not detected. In addition, 5 of the 62 strains had small deletions and/or point mutations in OprD2. Three strains had a high expression of mexA, while eight strains were positive for the regulatory gene mexR with no mutations detected by DNA sequencing. Conclusion Expression of metallo-β-lactamase is the main resistance mechanism of P. aeruginosa to carbapenem. Mutations in OprD2 and/or the overexpression of efflux pump MexAB-OprM may contribute to P. aeruginosa resistance to carbapenem.
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Affiliation(s)
- Yanfeng Xu
- Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Haiying Niu
- Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Tongping Hu
- Department of Clinical Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Lixia Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Shanna Su
- Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Huijie He
- Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Huimin Wang
- Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
| | - Dong Zhang
- Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, People's Republic of China
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18
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Lima WG, Silva Alves GC, Sanches C, Antunes Fernandes SO, de Paiva MC. Carbapenem-resistant Acinetobacter baumannii in patients with burn injury: A systematic review and meta-analysis. Burns 2019; 45:1495-1508. [DOI: 10.1016/j.burns.2019.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/09/2019] [Accepted: 07/03/2019] [Indexed: 12/25/2022]
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19
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Beigverdi R, Sattari-Maraji A, Emaneini M, Jabalameli F. Status of carbapenem-resistant Acinetobacter baumannii harboring carbapenemase: First systematic review and meta-analysis from Iran. INFECTION GENETICS AND EVOLUTION 2019; 73:433-443. [DOI: 10.1016/j.meegid.2019.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 05/22/2019] [Accepted: 06/04/2019] [Indexed: 12/13/2022]
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20
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Beigverdi R, Jabalameli L, Jabalameli F, Emaneini M. Prevalence of extended-spectrum β-lactamase-producing Klebsiella pneumoniae: First systematic review and meta-analysis from Iran. J Glob Antimicrob Resist 2019; 18:12-21. [PMID: 30685458 DOI: 10.1016/j.jgar.2019.01.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 01/12/2019] [Accepted: 01/17/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) have emerged as an important pathogen causing severe infections worldwide. Infections due to ESBL-KP are associated with high morbidity and mortality, especially in developing countries such as Iran. The aim of this study was to assess the pooled prevalence of ESBL-KP with different gene variants in Iran. METHODS A literature search of Medline (via PubMed), Embase, Web of Science and Iranian Database was performed. A meta-analysis was conducted using Comprehensive Meta-Analysis Software (version 2.2, Biostat). A fixed- or random-effects model was used based on the heterogeneity test. Publication bias was determined using Begg's rank correlation and Egger's weighted regression methods. RESULTS Among 783 articles identified, 43 studies met the eligibility criteria. The pooled prevalence of ESBL-KP was 43.5% (95% CI 39.3-47.9%) among clinical K. pneumoniae isolates. Among genes encoding ESBLs during 2000-2009, SHV, CTX-M and TEM were found with prevalences of 23.3%, 15.2% and 12.3%, respectively, whilst the prevalences of SHV, CTX-M, TEM and VEB were 24%, 28.1%, 25.2% and 8.3%, respectively, during the period 2010-2018. CONCLUSION The prevalence of ESBL-KP has increased steadily in recent years among clinical K. pneumoniae isolates in Iran. Thus, initial identification of ESBL-KP according to Clinical and Laboratory Standards Institute (CLSI) guidelines, proper molecular approaches, and implementation of antimicrobial stewardship programmes in Iranian hospitals together with comprehensive infection control measures are urgently needed to control the dissemination of these strains.
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Affiliation(s)
- Reza Beigverdi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, 100 Poursina St., Keshavarz Blvd., Tehran, Iran
| | - Leila Jabalameli
- Department of Microbiology, Faculty of Science, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, 100 Poursina St., Keshavarz Blvd., Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, 100 Poursina St., Keshavarz Blvd., Tehran, Iran.
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21
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Rouhi S, Ramazanzadeh R. Phenotypic and Molecular Survey of Metallo-beta-lactamase-producing Pseudomonas aeruginosa Isolated from Patients with Nosocomial and Non- Nosocomial Infections. Infect Disord Drug Targets 2019; 20:56-64. [PMID: 30659550 DOI: 10.2174/1871526519666190119113328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/08/2018] [Accepted: 01/04/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Resistance to antimicrobial agents in Pseudomonas aeruginosa (P. aeruginosa) including carbapenems is a prominent problem in patients. The aim of this study is surveying Metallo-beta-lactamase (MBL)-producing P. aeruginosa isolated from patient specimens with nosocomial and non-nosocomial infections in Kurdistan province, Iran. METHODS In total, 146 Pseudomonas spp. were collected (December 2015 to August 2017). P. aeruginosa isolates were detected by phenotypic and polymerase chain reactions (PCR) of gyrB gene. Combination disk (CD) phenotypic test was used for the identification of MBL-producing strains and PCR was applied for identification of blaIMP and blaVIM genes in P. aeruginosa. Sensitivity and specificity of phenotypic tests were calculated as well. Fisher's exact test and logistic regression were used for data analysis (p≤0.05). RESULTS A total of 134 (91.78%) and 133 (91.09%) P. aeruginosa were detected using PCR and the phenotypic test, respectively. Fifty-six (41.79%) clinical isolates were isolated from patients with nosocomial infection. CD test proved that 67 out of 134 (50%) P. aeruginosa isolates were positive for MBL, of which 11 (8.20%) carried blaIMP gene. No significant relationship was found between MBL-producing P. aeruginosa and blaIMP genes; as well as between MBL-producing P. aeruginosa and blaIMP genes with age, sex, city of residence, inpatient/outpatient and specimen's type (p≥0.05). CONCLUSION Presence of MBL-producing P. aeruginosa strains and blaIMP genes were proved in this study; thus more precaution should be taken in the administration of carbapenem antibiotics to patients.
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Affiliation(s)
- Samaneh Rouhi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Rashid Ramazanzadeh
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Microbiology Department, Kurdistan University of Medical Sciences, Sanandaj, Iran
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