埃及一家三级医院中引起伤口感染的耐碳青霉烯类铜绿假单胞菌的分子研究。

Molecular study of carbapenem-resistant Pseudomonas aeruginosa causing wound infection in an Egyptian tertiary hospital.

作者信息

El Menofy Nagwan Galal, Tawfick Mahmoud M, Badawy Mona Shaban E M

机构信息

Department of Microbiology and Immunology, Faculty of Pharmacy (For Girls), Al-Azhar University, Cairo 11751, Egypt.

Department of Microbiology and Immunology, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt.

出版信息

J Infect Dev Ctries. 2025 Jul 28;19(7):997-1006. doi: 10.3855/jidc.19953.

DOI:10.3855/jidc.19953

PMID:40720456

Abstract

INTRODUCTION

Pseudomonas aeruginosa is a bacterial pathogen that causes various acute and chronic human infections, including wound and burn infections, with serious consequences. This study aimed to determine the antimicrobial resistance profile of P. aeruginosa isolated from wound infections and investigate the molecular mechanism of carbapenem resistance.

METHODOLOGY

Forty-nine P. aeruginosa wound infection isolates were collected from a tertiary care hospital in Cairo, Egypt, from September 2022 to September 2023. The resistance profile of P. aeruginosa isolates was determined by the disc diffusion method, minimum inhibitory concentration (MIC) of meropenem susceptibility, and detection of metallo‑β-lactamase (MBL) production by imipenem-EDTA combined disc test. Polymerase chain reaction (PCR) was utilized to identify the carbapenem resistance genes, blaKPC, blaNDM-1, and blaOXA-48 among carbapenem-resistant P. aeruginosa (CRPA) isolates. The ERIC-PCR was used to assess the genetic diversity and relatedness among CRPA isolates. The results were presented as descriptive statistics in percentages and relative frequencies.

RESULTS

The findings revealed that 44.9% (22/49) of P. aeruginosa isolates were multidrug-resistant (MDR), meropenem resistant, and MBL producers. PCR assays showed that out of 22 CRPA isolates, six isolates (6/22, 27.3%) harbored the blaNDM-1 gene, and three (3/22, 13.6%) carried the blaOXA-48 gene, while none of the isolates had the blaKPC. ERIC-PCR-based genotyping demonstrated a significant molecular heterogeneity, indicated by 16 ERIC-based patterns or fingerprints among 22 CRPA isolates.

CONCLUSIONS

The resistance profile demonstrated by P. aeruginosa in wound infections suggests the need for effective hospital infection control and antibiotic policies in developing countries. The CRPA isolates were polyclonal, highlighted by their substantial genetic heterogeneity.

摘要

引言

铜绿假单胞菌是一种细菌病原体，可引发各种急慢性人类感染，包括伤口和烧伤感染，后果严重。本研究旨在确定从伤口感染中分离出的铜绿假单胞菌的抗菌药物耐药谱，并研究碳青霉烯类耐药的分子机制。

方法

2022年9月至2023年9月期间，从埃及开罗的一家三级护理医院收集了49株铜绿假单胞菌伤口感染分离株。通过纸片扩散法、美罗培南药敏最低抑菌浓度（MIC）以及亚胺培南-EDTA联合纸片试验检测金属β-内酰胺酶（MBL）的产生来确定铜绿假单胞菌分离株的耐药谱。利用聚合酶链反应（PCR）鉴定耐碳青霉烯类铜绿假单胞菌（CRPA）分离株中的碳青霉烯类耐药基因blaKPC、blaNDM-1和blaOXA-48。ERIC-PCR用于评估CRPA分离株之间的遗传多样性和相关性。结果以百分比和相对频率的描述性统计数据呈现。

结果

研究结果显示，44.9%（22/49）的铜绿假单胞菌分离株具有多重耐药性（MDR）、对美罗培南耐药且产MBL。PCR检测表明，在22株CRPA分离株中，6株（6/22，27.3%）携带blaNDM-1基因，3株（3/22，13.6%）携带blaOXA-48基因，而所有分离株均未携带blaKPC。基于ERIC-PCR的基因分型显示出显著的分子异质性，22株CRPA分离株中有16种基于ERIC的模式或指纹图谱。