Antibiotic Susceptibility Patterns and Molecular Epidemiology of Metallo-β-Lactamase Producing Pseudomonas Aeruginosa Strains Isolated From Burn Patients

Background: Failure in the treatment of burn patients infected with Pseudomonas aeruginosa could happen as a result of the acquisition of antibiotic resistance, including carbapenems. Objectives: The aim of the present study was to investigate the phenotypic and genotypic characteristics of the Pseudomonas aeruginosa strains, isolated from burn patients. Patients and Methods: During a 12 month period, in this cross-sectional study, two hundred seventy strains of Pseudomonas aeruginosa were isolated from the burn patients in Ghotbeddin Burn Hospital, Shiraz, Iran. Screening for the carbapenem resistance in the isolates was carried out by the E test method. Sensitivity patterns of metallo-β-lactamase (MβLs) producing strains of pseudomonas to eleven antibiotics were determined by the mentioned method. The epidemiological associations of these strains were determined by Pulsed-field gel electrophoresis (PFGE). Results: Of the 270 strains, 60 (22.2%) were resistant to imipenem and meropenem, classified as MβLs producing. MβLs producing strains of pseudomonas were completely resistant to five tested antibiotics while their sensitivities to the three most effective antibiotics including ceftazidime, amikacin and ciprofloxacin were 23.4%, 6.7 % and 1.7%, respectively. In PFGE, 37 patterns from the genome of Pseudomonas aeruginosa were observed. Majority of the strains (43; 71.6%) exhibited more than 80% similarity, based on the drawn dendrogram. Conclusions: According to the results, none of the tested antibiotics is safe to prescribe. As PFGE revealed, a limited number of Pseudomonas aeruginosa types are predominant in the hospitals which infect the burn patients.

[1]  Mirzaee Somaye,et al.  STREAMFLOW SIMULATION AND ASSESSING THE LAND USE CHANGES IMPACTS ON IT (CASE STUDY: GOL GOL CATCHMENT IN THE PROVINCE OF ILAM, IRAN) , 2016 .

[2]  R. Ranjbar,et al.  Genotypic Analysis of E. coli Strains Isolated from Patients with Cystitis and Pyelonephritis , 2012, Iranian Red Crescent medical journal.

[3]  R. Ranjbar,et al.  Integron and genotype patterns of quinolones-resistant uropathogenic Escherichia coli , 2011 .

[4]  N. Alam,et al.  Comments on "the increasing trend in alcohol-related burns: it's impact on a Tertiary burn centre". , 2011, Burns : journal of the International Society for Burn Injuries.

[5]  R. Alaghehbandan,et al.  A prospective population-based study of suicidal behavior by burns in the province of Ilam, Iran , 2011, European Psychiatry.

[6]  A. Zandieh,et al.  Factors associated with mortality in adult hospitalized burn patients in Tehran. , 2011, Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES.

[7]  Cristianne Kayoko Matsumoto,et al.  Diversity of Pulsed-Field Gel Electrophoresis Patterns of Mycobacterium abscessus Type 2 Clinical Isolates , 2010, Journal of Clinical Microbiology.

[8]  H. Sadeghi-Bazargani,et al.  Epidemiology of minor and moderate burns in rural Ardabil, Iran. , 2010, Burns : journal of the International Society for Burn Injuries.

[9]  P. Owlia,et al.  Molecular Epidemiology and Drug Susceptibility of Pseudomonas aeruginosa Strains Isolated From Burn Patients , 2010 .

[10]  P. Hold,et al.  The increasing trend in alcohol-related burns: it's impact on a tertiary burn centre. , 2010, Burns : journal of the International Society for Burn Injuries.

[11]  D. Hospenthal,et al.  Prevalence of multidrug-resistant organisms recovered at a military burn center. , 2010, Burns : journal of the International Society for Burn Injuries.

[12]  F. Shahcheraghi,et al.  Identification and genetic characterization of metallo-beta-lactamase-producing strains of Pseudomonas aeruginosa in Tehran, Iran. , 2010, The new microbiologica.

[13]  P. Mariotte,et al.  Nationwide Investigation of Extended-Spectrum β-Lactamases, Metallo-β-Lactamases, and Extended-Spectrum Oxacillinases Produced by Ceftazidime-Resistant Pseudomonas aeruginosa Strains in France , 2010, Antimicrobial Agents and Chemotherapy.

[14]  A. Viale,et al.  Emergence of Pseudomonas aeruginosa strains producing metallo-beta-lactamases of the IMP-15 and VIM-2 types in Mexico. , 2010, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[15]  A. Mazzariol,et al.  VIM-2 β-lactamase in Pseudomonas aeruginosa isolates from Zagreb, Croatia , 2010, Scandinavian journal of infectious diseases.

[16]  E. Kalantar,et al.  Epidemiology of hospitalized burn patients in Taleghani Hospital during 2003-2007. , 2010, Bratislavske lekarske listy.

[17]  C. Maurer,et al.  Cologne burn centre experience with assault burn injuries. , 2009, Burns : journal of the International Society for Burn Injuries.

[18]  A. Guttormsen,et al.  The epidemiology of patients with burn injuries admitted to Norwegian hospitals in 2007. , 2009, Burns.

[19]  D. Herndon,et al.  Emerging infections in burns. , 2009, Surgical infections.

[20]  P. Hsueh,et al.  Dissemination of transposon Tn6001 in carbapenem-non-susceptible and extensively drug-resistant Pseudomonas aeruginosa in Taiwan , 2009, The Journal of antimicrobial chemotherapy.

[21]  B. Aracil,et al.  Susceptibility of 228 Non-fermenting Gram-Negative Rods to Tigecycline and Six Other Antimicrobial Drugs , 2009, Journal of chemotherapy.

[22]  R. Alaghehbandan,et al.  Suicidal behavior by burns in the province of Fars, Iran. , 2009, Crisis.

[23]  S. Gharavi,et al.  Pulsed field gel electrophoresis & plasmid profile of Pseudomonas aeruginosa at two hospitals in Tehran, Iran. , 2007, The Indian journal of medical research.

[24]  M. Kalani,et al.  Comparison of arbitrarily primed-polymerase chain reaction and plasmid profiles typing of Pseudomonas aeruginosa strains from burn patients and hospital environment. , 2007, Saudi Medical Journal.

[25]  R. Sheridan,et al.  Intravenous Colistin for the Treatment of Multi-Drug Resistant, Gram-Negative Infection in the Pediatric Burn Population , 2007, Journal of burn care & research : official publication of the American Burn Association.

[26]  R. Gamelli,et al.  A Novel Antibacterial Gene Transfer Treatment for Multidrug-Resistant Acinetobacter Baumannii-Induced Burn Sepsis , 2007, Journal of burn care & research : official publication of the American Burn Association.

[27]  D. Sandvang,et al.  Pulsed-Field Gel Electrophoresis Typing of Escherichia coli Strains from Samples Collected before and after Pivmecillinam or Placebo Treatment of Uncomplicated Community-Acquired Urinary Tract Infection in Women , 2006, Journal of Clinical Microbiology.

[28]  M. Kalani,et al.  Susceptibility patterns and cross-resistance of antibiotics against Pseudomonas aeruginosa isolated from burn patients in the South of Iran. , 2006, Burns : journal of the International Society for Burn Injuries.

[29]  D. Church,et al.  Burn Wound Infections , 2006, Clinical Microbiology Reviews.

[30]  A. Zavascki,et al.  Outbreak of carbapenem-resistant Pseudomonas aeruginosa producing SPM-1 metallo-{beta}-lactamase in a teaching hospital in southern Brazil. , 2005, The Journal of antimicrobial chemotherapy.

[31]  M. Akçay,et al.  The risk factors for acquisition of imipenem-resistant Pseudomonas aeruginosa in the burn unit. , 2005, Burns : journal of the International Society for Burn Injuries.

[32]  R. Juste,et al.  Technical note: molecular typing of Corynebacterium bovis isolates by pulsed-field gel electrophoresis. , 2005, Journal of Dairy Science.

[33]  M. Kılıç,et al.  Distribution of conjugates of alkylphenols in milk from different ruminant species. , 2005, Journal of dairy science.

[34]  P. Petersen The burden of oral disease: challenges to improving oral health in the 21st century. , 2005, Bulletin of the World Health Organization.

[35]  Ronald N. Jones,et al.  First Isolation of blaVIM-2 in Latin America: Report from the SENTRY Antimicrobial Surveillance Program , 2004, Antimicrobial Agents and Chemotherapy.

[36]  S. Lewis,et al.  Colistin interactions with the mammalian urothelium. , 2004, American journal of physiology. Cell physiology.

[37]  Ronald N. Jones,et al.  Pseudomonas aeruginosa strains harbouring an unusual blaVIM-4 gene cassette isolated from hospitalized children in Poland (1998-2001). , 2004, The Journal of antimicrobial chemotherapy.

[38]  F. Baquero,et al.  High Genetic Diversity among Stenotrophomonas maltophilia Strains Despite Their Originating at a Single Hospital , 2004, Journal of Clinical Microbiology.

[39]  Ronald N. Jones,et al.  bla VIM-7, an Evolutionarily Distinct Metallo-β-Lactamase Gene in a Pseudomonas aeruginosa Isolate from the United States , 2004, Antimicrobial Agents and Chemotherapy.

[40]  V. Miriagou,et al.  VIM-1 Metallo-β-Lactamase-Producing Klebsiella pneumoniae Strains in Greek Hospitals , 2003, Journal of Clinical Microbiology.

[41]  Ronald N. Jones,et al.  Evolution of an integron carrying blaVIM-2 in Eastern Europe: report from the SENTRY Antimicrobial Surveillance Program. , 2003, The Journal of antimicrobial chemotherapy.

[42]  Y. Chong,et al.  VIM- and IMP-Type Metallo-β-lactamase–Producing Pseudomonas spp. and Acinetobacter spp. in Korean Hospitals , 2003, Emerging infectious diseases.

[43]  P. Francioli,et al.  Sulfa Resistance and Dihydropteroate Synthase Mutants in Recurrent Pneumocystis carinii Pneumonia , 2003, Emerging infectious diseases.

[44]  L. Peixe,et al.  Metallo-beta-lactamase VIM-2 in clinical isolates of Pseudomonas aeruginosa from Portugal. , 2002, Microbial drug resistance.

[45]  M. Ferraro Performance standards for antimicrobial susceptibility testing , 2001 .

[46]  Paul Milligan,et al.  Bulletin of the World Health Organization , 2017 .

[47]  E. Livingston,et al.  Percentage of burned body surface area determination in obese and nonobese patients. , 2000, The Journal of surgical research.

[48]  M. Kaufmann,et al.  Pulsed-field gel electrophoresis. , 1998, Methods in molecular medicine.

[49]  Neu Hc Trends in the development of beta-lactam antibiotics. , 1984 .

[50]  E. Bruck,et al.  National Committee for Clinical Laboratory Standards. , 1980, Pediatrics.