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Abstract
Today, one of the most important challenges for physicians is the adequate treatment of infections due to multidrug resistant organism (MDR). Pseudomonas aeruginosa is considered an opportunistic organism causing different types of healthcare associated infections (HAIs). We aimed to investigate the MDR and pandrug resistance (PDR) rate in P. aeruginosa in our region and detect efflux-pump mexAB genes and the proposed binding interactions of five different categories of antimicrobial agents with the mexB pump. A total of 180 non-duplicated P. aeruginosa strains were isolated from patients with HAIs in the Suez Canal University Hospital. Phenotypically, minimum inhibitory concentration (MIC) was done for all MDR and PDR strains before and after addition of efflux pump inhibitor carbonyl cyanide m-chlorophenyl hydrazone (CCCP). Molecular detection of mexA and mexB genes was done by using polymerase chain reaction (PCR). Most of the isolated strains (126 strains) were MDR (70%); only 10 samples (5.5%) were PDR. MexA and mexB genes were detected in 88.2% (120 strains) and 70.5% (96 strains) of stains, respectively. All PDR strains (10 stains) carried both mexA and mexB genes. Efflux mexAB genes were detected in all MDR and PDR strains (136 strains). Molecular modeling studies were performed to investigate the modes of intermolecular binding interactions between the antimicrobial agents and mexB key amino acids that resulted in MDR and PDR. The current study reported high prevalence of MDR and PDR P. aeruginosa in patients with HAIs in the Suez Canal University Hospitals.
Highlights
One of the important pathogens reported in community and healthcare-associated infections (HAIs) is P. aeruginosa [1,2]
The present study aimed to investigate P. aeruginosa multidrug resistant organism (MDR) and pandrug resistance (PDR) rate and to detect the efflux pump mexAB genes as a possible mechanism involved in resistance in our region
A total of 180 non-duplicated P. aeruginosa were isolated from patients with healthcare associated infections (HAIs) in the Suez
Summary
One of the important pathogens reported in community and healthcare-associated infections (HAIs) is P. aeruginosa [1,2]. Pathogens 2020, 9, 471; doi:10.3390/pathogens9060471 www.mdpi.com/journal/pathogens (MDR) in this organism is of considerable concern, as limited antimicrobial drugs are effective against these resistant strains [1,3]. This phenomenon can be explained by the intrinsic resistance to many antimicrobials due to the presence of efflux transporters with low outer membrane permeability [4,5]. The extrusion of toxic compounds from the cell are promoted through these membrane-associated active transporters. These extruded compounds include antibiotics [6,7,8]. MDR isolates display resistance to three categories of drugs used as anti-Pseudomonas, while all types of antibiotics show no effect in the treatment of PDR isolates [9]
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