van Burgh Sebastian, Maghdid Delshad M, Ganjo Aryann R, Mansoor Isam Y, Kok Dik J, Fatah Mohammed H, Alnakshabandi Abdulkadir A, Asad Dlnya, Hammerum Anette M, Ng Kim, Klaassen Corné, Goessens Wil H F
1 Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center Rotterdam , Rotterdam, the Netherlands .
2 College of Pharmacy, Hawler Medical University , Erbil, Iraq .
Microb Drug Resist. 2019 Jan/Feb;25(1):32-38. doi: 10.1089/mdr.2018.0036. Epub 2018 Aug 1.
Nosocomial infections occur worldwide and also in the Kurdistan region. Frequently patients colonized with multiresistant Pseudomonas aeruginosa isolates are encountered in many hospitals. As information is lacking with respect to the mechanisms of resistance responsible for the multiresistant character of the P. aeruginosa isolates and their genetic relationship, isolates were prospectively collected and characterized with respect to their mechanism of resistance. During 2012 and 2013, 81 P. aeruginosa isolates were collected from three teaching hospitals in the city of Erbil, Iraq. Susceptibility testing was performed using the VITEK-2 system. Isolates were screened for the presence of extended-spectrum β-lactamases (ESBLs) and for the presence of metallo β-lactamases (MBLs). The presence of serine carbapenemases was detected by PCR. The genetic relationship of the isolates was demonstrated by amplified fragment length polymorphism (AFLP). Susceptibility results revealed high rates of resistance against all classes of antibiotics except polymyxins. Genetic characterization demonstrated the presence of ESBL-genes, that is, bla (30%) and bla (17%), also ESBL bla was detected in four isolates. AFLP typing revealed clonal spread of bla, bla, and three clusters of bla-positive isolates. Only one isolate was MBL (bla) positive. Of a selected number of isolates (n = 11), whole-genome sequencing analysis revealed that these isolates belonged to "high-risk" MLSTs ST244, ST235, ST308, and ST654. This study reveals the presence and clonal spread of widely resistant high-risk clones of P. aeruginosa in Iraqi Kurdistan. As far as we are aware, this is the first report of multiple, polyclonal, PME producing P. aeruginosa outside the Arabian Peninsula.
医院感染在全球范围内以及库尔德地区均有发生。许多医院经常会遇到携带多重耐药铜绿假单胞菌分离株的患者。由于缺乏关于导致铜绿假单胞菌分离株多重耐药特性的耐药机制及其遗传关系的信息，因此前瞻性地收集了分离株，并对其耐药机制进行了表征。在2012年至2013年期间，从伊拉克埃尔比勒市的三家教学医院收集了81株铜绿假单胞菌分离株。使用VITEK-2系统进行药敏试验。对分离株进行超广谱β-内酰胺酶（ESBLs）和金属β-内酰胺酶（MBLs）的筛选。通过PCR检测丝氨酸碳青霉烯酶的存在。通过扩增片段长度多态性（AFLP）证明分离株的遗传关系。药敏结果显示，除多粘菌素外，对所有类别的抗生素耐药率都很高。遗传特征表明存在ESBL基因，即bla（30%）和bla（17%），在四株分离株中也检测到ESBL bla。AFLP分型显示bla、bla的克隆传播以及三株bla阳性分离株的簇。只有一株分离株为MBL（bla）阳性。对选定数量的分离株（n = 11）进行全基因组测序分析，结果显示这些分离株属于“高危”多位点序列分型（MLST）ST244、ST235、ST308和ST654。本研究揭示了伊拉克库尔德地区广泛耐药的高危铜绿假单胞菌克隆的存在和克隆传播。据我们所知，这是阿拉伯半岛以外首次关于多重、多克隆、产PME铜绿假单胞菌的报告。
