Intestinal colonization of infants with multidrug resistant Pseudomonas aeruginos in tertiary care center in Jordan

A. Shehabi, Noor Issam Shishtawi, Manar Al-lawama
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Abstract

Background: Pseudomonas.aeruginosa is among the most common opportunistic hospital pathogens, which exhibit an innate resistance and has developed increasing resistance to many useful antimicrobial agents over the last decades. This study investigated the occurrence of important types of ESBLs and MBLs in association with potential important virulence factors among P. aeruginosa isolates from feces of Jordanian infants.   Methods: A total of 302 feces samples were obtained randamely from neonates and infants admitted to Pediatric Clinic and the Neonate Intensive Care Unit (NICU)/Jordan University Hospital (JUH), over a  9-months period(2016- 2017). Fecal samples were cultured for P.aeruginosa and their growth was identified and tested using microbiological and antibiotic susceptibility methods. Additionly,  virulence factors, antimicrobial resistance genes and genotypes were detected using Polymerase Chain Reaction (PCR). Results: A total of 16/302 (5.3%) of P. aeruginosa isolates were recovered from feces samples. Antimicrobial susceptibility of the isolates ranged between the lowest 18.75% to meropenem and highest of 87.5% to azetreonam among 9 tested drugs. The percentage of specific genes of ESBLs and MBLs in 16 P.aeruginosa isolates were the following: blaOXA-50, blaTEM, blaCTX-M , blaVIM ,blaKPC , blaSHV ,blaGES, and blaVEB were detected at the rate of  13(81.2%), 13(81.2%), 12(75%), 12(75%), 11(68.7%), 10(62.5%), 2(12.5),1(6.2%), respectively. The percentage of the potential virulence genes in the same isolates were detected as follow:  lasB, algD , toxA, exo S and exo U at the rate of 100%, 87.5% , 81.2%, 81.2%,31.2, respectively. All P.aeruginosa isolates observed to develop beta-hemolysis on both human and sheep blood agar, and to produce either pyoverdin ((56.3%) or pyocyanin (43.7%).  Conclusions: The present study demonstrates high occurrence of multidrug resistant P.aeruginosa isolates in infant feces which carried high rates of important genes of ESBLs and MBLs and potential virulence factors.    
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约旦三级保健中心耐多药铜绿假单胞菌婴儿肠道定植
背景:假单胞菌。铜绿菌是最常见的机会性医院病原体之一,它表现出先天耐药性,并在过去几十年中对许多有用的抗微生物药物产生了越来越多的耐药性。本研究调查了约旦婴儿粪便中铜绿假单胞菌分离株中重要类型的ESBLs和MBLs的发生与潜在的重要毒力因素的关系。方法:在2016- 2017年9个月的时间里,随机抽取约旦大学医院儿科门诊和新生儿重症监护病房(NICU)的新生儿和婴儿302份粪便样本。对粪便样品进行铜绿假单胞菌培养,并采用微生物学和抗生素敏感性方法对其生长进行鉴定和检测。采用聚合酶链式反应(PCR)检测毒力因子、耐药基因及基因型。结果:从粪便中检出铜绿假单胞菌16株(5.3%);9种药物中,分离菌对美罗培南的敏感性最低(18.75%),对阿西曲南的敏感性最高(87.5%)。16株铜绿假单胞菌ESBLs和MBLs特异性基因检出率分别为:blaOXA-50、blablem、blaCTX-M、blaVIM、blaKPC、blaSHV、blaGES和blaVEB,检出率分别为13(81.2%)、13(81.2%)、12(75%)、12(75%)、11(68.7%)、10(62.5%)、2(12.5)、1(6.2%)。在同一菌株中检测到的潜在毒力基因比例分别为:lasB、algD、toxA、exo S和exo U,分别为100%、87.5%、81.2%、81.2%和31.2。所有铜绿假单胞菌分离株在人血琼脂和羊血琼脂上均发生β溶血,并产生pyoverdin(56.3%)或pyocyanin(43.7%)。结论:多重耐药铜绿假单胞菌分离株在婴幼儿粪便中高发,携带ESBLs和MBLs重要基因及潜在毒力因子的比例较高。
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