Year-end Sale % OFF 
Abstract
The multidrug- or extensively drug-resistant (MDR/XDR) Pseudomonas aeruginosa carrying some virulence genes has become a global public health threat. However, in Nepal, there is no existing report showing the prevalence of oprL and toxA virulence genes among the clinical isolates of P. aeruginosa. Therefore, this study was conducted for the first time in the country to detect the virulence genes (oprL and toxA) and antibiotic susceptibility pattern of P. aeruginosa. A total of 7,898 clinical specimens were investigated following the standard microbiological procedures. The antibiotic susceptibility testing was examined by the modified disc diffusion method, and virulence genes oprL and toxA of P. aeruginosa were assessed using multiplex PCR. Among the analyzed specimens, 87 isolates were identified to be P. aeruginosa of which 38 (43.68%) isolates were reported as MDR. A higher ratio of P. aeruginosa was detected from urine samples 40 (45.98%), outpatients' specimens 63 (72.4%), and in patients of the age group of 60–79 years 36 (41.37%). P. aeruginosa was more prevalent in males 56 (64.36%) than in female patients 31 (35.63%). Polymyxin (83.90%) was the most effective antibiotic. P. aeruginosa (100%) isolates harboured the oprL gene, while 95.4% of isolates were positive for the toxA gene. Identification of virulence genes such as oprL and toxA carrying isolates along with the multidrug resistance warrants the need for strategic interventions to prevent the emergence and spread of antimicrobial resistance (AMR). The findings could assist in increasing awareness about antibiotic resistance and suggest the judicious prescription of antibiotics to treat the patients in clinical settings of Nepal.
Highlights
Pseudomonas aeruginosa is known as one of the most widely spread opportunistic human pathogens causing 18 to 63% of infections worldwide [1, 2]
Antibiotic Susceptibility Testing. e antibiotic susceptibility testing was performed on Muller Hinton agar (MHA) by the modified disc diffusion method according to the criteria set by the Clinical and Laboratory Standards Institute (CLSI), 2018 [30, 31]. e antibiotics disks used in this study were procured from HiMedia Laboratories, India, and include ceftazidime (30 μg), ciprofloxacin (5 μg), imipenem (10 μg), tobramycin (10 μg), piperacillin (100 μg), piperacillin-tazobactam (100/10 μg), nitrofurantoin (300 μg), gentamicin (10 μg), norfloxacin (10 μg), aztreonam (30 μg), cefixime (5 μg), carbenicillin (100 μg), and polymyxin (300 μg)
A substantial number (36 (41.37%)) of P. aeruginosa were isolated from the age group 60–75. e highest percentage of P. aeruginosa was isolated from urine samples 40 (45.98%) followed by sputum 24 (27.59%). e occurrence of multidrug resistant (MDR) P. aeruginosa was higher in females, inpatients, and 40–59 years age group patients (P > 0.05)
Summary
Pseudomonas aeruginosa is known as one of the most widely spread opportunistic human pathogens causing 18 to 63% of infections worldwide [1, 2]. E pathogenesis of P. aeruginosa is linked with the extracellular and cellmediated virulence factors such as toxA, exoS, exoY, exoU, oprL, oprI, lasA, lasB, oprD, plcH, plcN, and nan which can cause host tissue destruction, invasion, and spread in the host body [16]. Virulence genes such as oprL, oprI, and oprD are the major constituents of outer membrane lipoproteins of P. aeruginosa which are used as markers for the identification of P. aeruginosa-associated infections [17]. The toxA gene is one of the virulence genes, which encodes exotoxin A produced by P. aeruginosa and inhibits protein biosynthesis by stopping the elongation of polypeptide chains [17,18,19]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
