临床样本中生物膜形成基因 blaexoU 与耐金属和扩展谱β-内酰胺酶生产的多药耐药铜绿假单胞菌之间的关联。

Association Between Biofilm Formation Gene Bla exoU and Metallo and Extend Spectrum Beta-lactamase Production of Multidrug Resistance Pseudomonas aeruginosa in Clinical Samples.

机构信息

Department of Medical Microbiology, College of Health Sciences, Hawler Medical University, Iraq.

出版信息

Comb Chem High Throughput Screen. 2022;25(7):1207-1218. doi: 10.2174/1386207324666210419112210.

DOI:10.2174/1386207324666210419112210

PMID:33874869

Abstract

BACKGROUND

The presence of biofilm formation exoU gene is a 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 June 2018 to March 2019 and were 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, Lincomycin, Piperacillin and Chloramphenicol and Rifampicin (100 %), whereas Imipenem (5%) was found to be the most effective antimicrobial drug. Of all P. aeruginosa isolates, 30 (75% %) were identified as MDR, approximately 9 (22.5%) 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 was recorded in 52.5% of the isolates. Altogether 40 isolates were processed for the 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.

摘要

背景

生物膜形成 exoU 基因的存在对医院感染控制管理构成重大挑战，铜绿假单胞菌的暴露可能导致进一步传播和抗菌药物耐药性的发展。

方法

在 2018 年 6 月至 2019 年 3 月期间，从伊拉克埃尔比勒市的 Rizgary、教学医院、实验室中心、Raparin 和 Nanakaly 医院的患者中采集了 40 株临床分离的铜绿假单胞菌作为 227 个样本，通过标准细菌学程序和抗菌药物敏感性试验对其进行了全面鉴定，并通过 Vitek 2 compact 系统进行了 ESBL 检测。所有分离株均通过 16S rDNA 鉴定为铜绿假单胞菌，产物大小为（956bp）。

结果

青霉素、林可霉素、哌拉西林和氯霉素以及利福平（100%）的耐药率较高，而亚胺培南（5%）是最有效的抗菌药物。所有铜绿假单胞菌分离株中，30 株（75%）被鉴定为 MDR，约 9 株（22.5%）在烧伤样本中对 9 种药物有耐药性。使用刚果红法进行定量生物膜测定显示，28 株（70%）产生生物膜，而 MDR 铜绿假单胞菌分离株的生物膜产量明显更高，同时记录到 52.5%的分离株同时产生扩展谱β-内酰胺酶（ESBL）和金属β-内酰胺酶（MBL）ESBLs。总共对 40 株分离株进行了 PCR 分析，结果显示 26 株（70%）铜绿假单胞菌分离株携带编码基因 exoU，产物大小（204）pb 更常见于烧伤分离株。此外，exoU 基因与更高的 MDR（80%）显著相关，8 株（76.9%）分离株携带 ESBL 和（65%）MBL，而 MDR（80.8%）在烧伤样本中也同样如此。