Molecular and Cell Biology Research Centre, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Medical Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Farah Abad Blv, Khazar Square, Sari, Mazandaran, Iran.
Curr Microbiol. 2023 May 21;80(7):221. doi: 10.1007/s00284-023-03330-z.
Increasing antimicrobial resistance and the development of multi-drug resistant (MDR) Pseudomonas aeruginosa is dependent on the expression of efflux pumps. This study aimed to investigate the role of overexpression of MexCD-OprJ and MexEF-OprN efflux pumps in reduced susceptibility to antimicrobial agents among P. aeruginosa strains. Totally, 100 clinical isolates of P. aeruginosa were collected from patients and the strains were identified by standard diagnostic tests. The MDR isolates were detected using the disk agar diffusion method. The expression levels of MexCD-OprJ and MexEF-OprN efflux pumps were evaluated by the real-time PCR. Forty-one isolates showed MDR phenotype, while piperacillin-tazobactam and levofloxacin were the most- and least-effective antibiotics, respectively. Also, all 41 MDR isolates showed a more than tenfold increase in the expression of mexD and mexF genes. In this study, a significant relationship was observed between the rate of antibiotic resistance, the emergence of MDR strains, and increasing the expression levels of MexEF-OprN and MexCD-OprJ efflux pumps (P < 0.05). Efflux systems mediated resistance was a noteworthy mechanism causative to multidrug resistance in P. aeruginosa clinical isolates. The study results demonstrated mexE and mexF overexpression as the primary mechanism conferring in the emergence of MDR phenotypes among P. aeruginosa strains. In addition, we also show that piperacillin/tazobactam exhibited a stronger ability in the management of infections caused by MDR P. aeruginosa in this area.
抗微生物药物耐药性的增加和多药耐药（MDR）铜绿假单胞菌的发展依赖于外排泵的表达。本研究旨在探讨 MexCD-OprJ 和 MexEF-OprN 外排泵的过度表达在铜绿假单胞菌菌株对抗菌药物敏感性降低中的作用。总共从患者中收集了 100 株临床分离的铜绿假单胞菌，并用标准诊断试验鉴定了这些菌株。使用纸片琼脂扩散法检测 MDR 分离株。通过实时 PCR 评估 MexCD-OprJ 和 MexEF-OprN 外排泵的表达水平。41 株分离株表现出 MDR 表型，而哌拉西林-他唑巴坦和左氧氟沙星分别是最有效的和最无效的抗生素。此外，所有 41 株 MDR 分离株的 mexD 和 mexF 基因表达均增加了 10 倍以上。在这项研究中，观察到抗生素耐药率、MDR 菌株的出现以及 MexEF-OprN 和 MexCD-OprJ 外排泵表达水平的增加之间存在显著的相关性（P<0.05）。外排系统介导的耐药性是铜绿假单胞菌临床分离株多药耐药的一个重要机制。研究结果表明，mexE 和 mexF 的过度表达是导致铜绿假单胞菌菌株出现 MDR 表型的主要机制。此外，我们还表明，哌拉西林/他唑巴坦在该地区管理 MDR 铜绿假单胞菌引起的感染方面具有更强的能力。
