Diversity and Distribution of Resistance Markers in Pseudomonas aeruginosa International High-Risk Clones.

Béla Kocsis,Dániel Gulyás,Dóra Szabó

doi:10.3390/microorganisms9020359

Abstract

Pseudomonas aeruginosa high-risk clones are disseminated worldwide and they are common causative agents of hospital-acquired infections. In this review, we will summarize available data of high-risk P. aeruginosa clones from confirmed outbreaks and based on whole-genome sequence data. Common feature of high-risk clones is the production of beta-lactamases and among metallo-beta-lactamases NDM, VIM and IMP types are widely disseminated in different sequence types (STs), by contrast FIM type has been reported in ST235 in Italy, whereas GIM type in ST111 in Germany. In the case of ST277, it is most frequently detected in Brazil and it carries a resistome linked to blaSPM. Colistin resistance develops among P. aeruginosa clones in a lesser extent compared to other resistance mechanisms, as ST235 strains remain mainly susceptible to colistin however, some reports described mcr positive P. aeurigonsa ST235. Transferable quinolone resistance determinants are detected in P. aeruginosa high-risk clones and aac(6′)-Ib-cr variant is the most frequently reported as this determinant is incorporated in integrons. Additionally, qnrVC1 was recently detected in ST773 in Hungary and in ST175 in Spain. Continuous monitoring and surveillance programs are mandatory to track high-risk clones and to analyze emergence of novel clones as well as novel resistance determinants.

Highlights

Pseudomonas aeruginosa is a Gram-negative ubiquitous rod-shaped bacterium and one of the most common opportunistic human pathogens with the ability of causing a wide range of severe infections, including ventilator-associated pneumonia, otitis externa, burn wound infection, contact lense-related keratitis, and bloodstream infection [1,2,3,4]
Various antibiotic resistance mechanisms can occur in P. aeruginosa that enable it to develop multiresistance, it can cause difficult to treat infections
Infections caused by ESKAPE pathogens are usually associated with significantly high morbidity and mortality rates as limited number of effective antimicrobial agents are available against these pathogens [6,7,8,9]

Summary

Introduction

Pseudomonas aeruginosa is a Gram-negative ubiquitous rod-shaped bacterium and one of the most common opportunistic human pathogens with the ability of causing a wide range of severe infections, including ventilator-associated pneumonia, otitis externa, burn wound infection, contact lense-related keratitis, and bloodstream infection [1,2,3,4]. Persistence of MDR P. aeruginosa empowers these strains for hospital outbreaks worldwide These MDR P. aeruginosa are referred as international high-risk clones, such as the most frequently reported ST 111, 175, 233, 235, 277, 357, 654, and 773 [12,20,37,38]. BlaNDM-1 carrier P. aeruginosa strains were isolated from a patient with acute pyelonephritis in France in 2012, and from a stem cell transplant recipient in Italy in 2013 Both patients were hospitalized previously in Serbia [11,60]. A comprehensive study conducted in Madrid, revealed that MDR P. aeuginosa ST235 causes high mortality rate in patients in invasive infections, especially in patients with chronic respiratory tract infections [62] This international successful clone is responsible for numerous MDR P. aeruginosa cases around the world [63]. Archive with accession number PRJEB4573 [63] (Table 1)

Accession Number

Discussion

Resistance to Colistin