Canadian recommendations for laboratory interpretation of multiple or extensive drug resistance in clinical isolates of Enterobacteriaceae, Acinetobacter species and Pseudomonas aeruginosa

Background: Drug resistance and virulence genes are two key factors for the colonization of Pseudomonas aeruginosa in settings with high antibiotic pressure, such as hospitals, and the development of hospital-acquired infections. Objectives: The objective of this study was to investigate the prevalence of drug resistance and virulence gene profiles in clinical isolates of P. aeruginosa in Ardabil, Iran. Methods: A total of 84 P. aeruginosa isolates were collected from clinical specimens of Ardabil hospitals and confirmed using laboratory standard tests. The disk diffusion method was used for antibiotic susceptibility testing and polymerase chain reaction (PCR) for the identification of P. aeruginosa virulence genes. Results: The highest and the lowest antibiotic resistance rates of P. aeruginosa strains were against ticarcillin-clavulanate (94%) and doripenem (33.3%), respectively. In addition, the frequency of multidrug-resistant (MDR) P. aeruginosa was 55.9%. The prevalence of virulence factor genes was as follows: algD 84.5%, lasB 86.9%, plcH 86.9%, plcN 86.9%, exoU 56%, exoS 51.2%, toxA 81%, nan1 13.1%, and pilB 33.3%. A significant association was observed between resistance to some antibiotics and the prevalence of virulence genes in P. aeruginosa. Conclusions: Our results revealed a high prevalence of antibiotic resistance, especially MDR, and virulence-associated genes in clinical isolates of P. aeruginosa in Ardabil hospitals. Owing to the low resistance rates against doripenem, gentamicin, and tobramycin, these antibiotics are recommended for the treatment of infections caused by highly resistant and virulent P. aeruginosa strains.

Download Full-text

Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt

Infection and Drug Resistance ◽

10.2147/idr.s189341 ◽

2019 ◽

Vol Volume 12 ◽

pp. 1113-1125 ◽

Cited By ~ 4

Author(s):

Heba Shehta Said ◽

Eman Salama Abdelmegeed

Keyword(s):

Drug Resistance ◽

Multidrug Resistance ◽

Clinical Isolates ◽

Extensive Drug Resistance

Download Full-text

Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v21i2.25109 ◽

2019 ◽

Vol 21 (2) ◽

pp. 110-116

Author(s):

Rajani Shrestha ◽

N. Nayak ◽

D.R. Bhatta ◽

D. Hamal ◽

S.H. Subramanya ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Drug Resistance ◽

Biofilm Formation ◽

Tertiary Care ◽

Clinical Problem ◽

Multidrug Resistant ◽

Clinical Isolates ◽

Diffusion Method ◽

Care Hospital ◽

Microbiological Methods

Clinical isolates of Pseudomonas aeruginosa often exhibit multidrug resistance due to their inherent ability to form biofilms. Drug resistance in Ps. aeruginosa is a major clinical problem, especially in the management of patients with nosocomial infections and those admitted to ICUs with indwelling medical devices. To evaluate the biofilm forming abilities of the clinical isolates of Ps. aeruginosa and to correlate biofilm formation with antibiotic resistance. A total of 90 consecutive isolates of Ps. aeruginosa obtained from various specimens collected from patients visiting the Manipal Teaching Hospital, Pokhara, Nepal between January 2018 - October 2018 were studied. Isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. All the isolates were tested for their biofilm forming abilities by employing the tissue culture plate assay. Of the 90 Ps. aeruginosa isolates, maximum i.e 42 (46.6%) were from patients in the age group of > 50 years. Majority (30; 33.3%) of the isolates were obtained from sputum samples. However, percentage isolation from other specimens like urine, endotracheal tube (ETT), pus, eye specimens and blood were 18.9%, 16.7%, 16.7%, 7.8% and 6.7% respectively. All the isolates were sensitive to polymixin B and colistin, 91.1% of the organisms were sensitive to imipenem, and more than 80% to aminoglycosides (80% to gentamicin, 83.3% to amikacin). A total of 29 (32.2%) organisms were biofilm producers. Maximum numbers of biofilm producing strains were obtained from ETT (8 of 15; 53.3%), pus (8 of 15; 53.3%) and blood (2 of 6; 33.3%) i.e from all invasive sites. None of the isolates from noninvasive specimens such as conjunctival swabs were biofilm positive. Significantly higher numbers of biofilm producers (23 of 29; 79.3%) were found to be multidrug resistant as compared to non-biofilm (6 of 61; 9.8%) producers (p=0.000). Ps. aeruginosa colonization leading to biofilm formation in deep seated tissues and on indwelling devices is a therapeutic challenge as majority of the isolates would be recalcitrant to commonly used antipseudomonal drugs. Effective monitoring of drug resistance patterns in all Pseudomonas clinical isolates should be a prerequisite for successful patient management.

Download Full-text

Characterization of mutations in multi- and extensive drug resistance among strains of Mycobacterium tuberculosis clinical isolates in Republic of Korea

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2013.02.035 ◽

2013 ◽

Vol 76 (2) ◽

pp. 187-196 ◽

Cited By ~ 45

Author(s):

Hum Nath Jnawali ◽

Sung Chul Hwang ◽

Young Kil Park ◽

Hyejin Kim ◽

Yeong Seon Lee ◽

...

Keyword(s):

Drug Resistance ◽

Mycobacterium Tuberculosis ◽

Clinical Isolates ◽

Republic Of Korea ◽

Extensive Drug Resistance

Download Full-text

Draft Genome Sequences ofEscherichia coliIsolates from Wounded Military Personnel: TABLE 1

Genome Announcements ◽

10.1128/genomea.00828-16 ◽

2016 ◽

Vol 4 (4) ◽

Author(s):

Brock A. Arivett ◽

Dave C. Ream ◽

Steven E. Fiester ◽

Destaalem Kidane ◽

Luis A. Actis

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Drug Resistance ◽

Klebsiella Pneumoniae ◽

Military Personnel ◽

Draft Genome ◽

Genome Sequences ◽

E Coli ◽

Extensive Drug Resistance

Members of theEscherichia colibacterial family have been grouped as ESKAPE (Enterococcus faecium,Staphylococcus aureus,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa, andEnterobacterspecies) pathogens because of their extensive drug resistance phenotypes and increasing threat to human health. The genomes of six extended-spectrum β-lactamase (ESBL)-producingE. colistrains isolated from wounded military personnel were sequenced and annotated.

Download Full-text