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.
Ann Clin Microbiol Antimicrob. 2024 Jan 13;23(1):5. doi: 10.1186/s12941-024-00668-5.
Hospital-acquired infections caused by multidrug-resistant Pseudomonas aeruginosa incline hospital stay and costs of treatment that resulted in an increased mortality rate. The frequency of P. aeruginosa high-risk clones producing carbapenemases was investigated in our clinical samples.
In this cross-sectional study, 155 non-repetitive P. aeruginosa isolates were included from different medical centers of Iran. Antibiotic susceptibility testing was determined, and the presence of β-lactamases were sought by phenotypic and genotypic methods. The clonal relationship of all isolates was investigated, and multi-locus sequence typing (MLST) was used for finding the sequence types of carbapenemase-producers.
The agent with highest percent susceptibility rate was recorded for colistin (94.9%). MOX and FOX were found both as low as 1.95% (3/155). The most frequent narrow spectrum β-lactamase was SHV with 7.7% (12/155) followed by PER, OXA-1, and TEM with the frequency of 7.1% (11/155), 3.2% (5/155), and 1.3% (2/155), respectively. Carbapenemases were detected in 28 isolates (18%). The most frequent carbapenemase was IMP with 9% (14/155) followed by NDM, 8.4% (13/155). OXA-48 and VIM were also detected both per one isolate (0.65%). MLST of carbapenem resistant P. aeruginosa isolates revealed that ST244, ST664, ST235, and ST357 were spread in subjected clinical settings. REP-PCR uncovered high genomic diversity in our clinical setting.
Clonal proliferation of ST235 strain plays a key role in the propagation of MDR pattern in P. aeruginosa. Our data showed that high-risk clones has distributed in Iran, and programs are required to limit spreading of these clones.
多药耐药铜绿假单胞菌引起的医院获得性感染会延长住院时间和治疗费用，导致死亡率上升。本研究调查了我院临床标本中产碳青霉烯酶的铜绿假单胞菌高危克隆的频率。
在这项横断面研究中，共纳入了来自伊朗不同医疗中心的 155 株非重复铜绿假单胞菌。采用表型和基因型方法检测抗生素敏感性，并寻找β-内酰胺酶的存在。对所有分离株的克隆关系进行了研究，并采用多位点序列分型（MLST）确定了产碳青霉烯酶株的序列类型。
对多粘菌素的敏感性最高，为 94.9%。MOX 和 FOX 的敏感性均为 1.95%（3/155）。最常见的窄谱β-内酰胺酶为 SHV，占 7.7%（12/155），其次为 PER、OXA-1 和 TEM，频率分别为 7.1%（11/155）、3.2%（5/155）和 1.3%（2/155）。共检测到 28 株（18%）产碳青霉烯酶。最常见的碳青霉烯酶是 IMP，占 9%（14/155），其次是 NDM，占 8.4%（13/155）。OXA-48 和 VIM 各有 1 株（0.65%）。碳青霉烯类耐药铜绿假单胞菌分离株的 MLST 显示，ST244、ST664、ST235 和 ST357 在受试临床环境中传播。REP-PCR 显示，我们的临床环境中存在高基因组多样性。
ST235 菌株的克隆增殖在铜绿假单胞菌 MDR 模式的传播中起着关键作用。我们的数据表明，高危克隆已在伊朗传播，需要制定计划限制这些克隆的传播。
