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对在埃及米尼亚医院收集的、处于新冠疫情期间的铜绿假单胞菌中氟喹诺酮类和氨基糖苷类耐药性的表型和基因型评估

Phenotypic and genotypic assessment of fluoroquinolones and aminoglycosides resistances in Pseudomonas aeruginosa collected from Minia hospitals, Egypt during COVID-19 pandemic.

作者信息

Boushra Maria Refaat, Gad Gamal Fadl Mahmoud, Hassuna Noha Anwar, Waly Nancy Gamil Fawzy, Ibrahem Reham Ali

机构信息

Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia, Egypt.

Department of Medical Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, Egypt.

出版信息

BMC Infect Dis. 2024 Jul 31;24(1):763. doi: 10.1186/s12879-024-09605-5.

Abstract

BACKGROUND

One of the most prevalent bacteria that cause nosocomial infections is Pseudomonas aeruginosa. Fluoroquinolones (FQ) and aminoglycosides are vital antipseudomonal drugs, but resistance is increasingly prevalent. The study sought to investigate the diverse mechanisms underlying FQ and aminoglycoside resistance in various P. aeruginosa strains particularly during the COVID-19 crisis.

METHODS

From various clinical and environmental samples, 110 P. aeruginosa isolates were identified and their susceptibility to several antibiotic classes was evaluated. Molecular techniques were used to track target gene mutations, the presence of genes encoding for quinolone resistance, modifying enzymes for aminoglycosides and resistance methyltransferase (RMT). Efflux pump role was assessed phenotypically and genotypically. Random amplified polymorphic DNA (RAPD) analysis was used to measure clonal diversity.

RESULTS

QnrS was the most frequently encountered quinolone resistance gene (37.5%) followed by qnrA (31.2%) and qnrD (25%). Among aminoglycoside resistant isolates, 94.1% harbored modifying enzymes genes, while RMT genes were found in 55.9% of isolates. The aac(6')-Ib and rmtB were the most prevalent genes (79.4% and 32.3%, respectively). Most FQ resistant isolates overexpressed mexA (87.5%). RAPD fingerprinting showed 63.2% polymorphism.

CONCLUSIONS

Aminoglycosides and FQ resistance observed in this study was attributed to several mechanisms with the potential for cross-contamination existence so, strict infection control practices are crucial.

摘要

背景

铜绿假单胞菌是引起医院感染最常见的细菌之一。氟喹诺酮类(FQ)和氨基糖苷类是重要的抗铜绿假单胞菌药物,但耐药性日益普遍。该研究旨在调查不同铜绿假单胞菌菌株中FQ和氨基糖苷类耐药的多种机制,特别是在新冠疫情期间。

方法

从各种临床和环境样本中鉴定出110株铜绿假单胞菌分离株,并评估它们对几种抗生素类别的敏感性。采用分子技术追踪靶基因突变、喹诺酮耐药编码基因、氨基糖苷修饰酶和耐药甲基转移酶(RMT)的存在情况。从表型和基因型方面评估外排泵的作用。采用随机扩增多态性DNA(RAPD)分析来测量克隆多样性。

结果

QnrS是最常遇到的喹诺酮耐药基因(37.5%),其次是qnrA(31.2%)和qnrD(25%)。在氨基糖苷类耐药分离株中,94.1%携带修饰酶基因,而55.9%的分离株中发现了RMT基因。aac(6')-Ib和rmtB是最普遍的基因(分别为79.4%和32.3%)。大多数FQ耐药分离株mexA过表达(87.5%)。RAPD指纹图谱显示63.2%的多态性。

结论

本研究中观察到的氨基糖苷类和FQ耐药归因于多种机制,存在交叉污染的可能性,因此严格的感染控制措施至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5361/11292888/71b7adb7c5be/12879_2024_9605_Fig1_HTML.jpg

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