Abstract
Pseudomonas aeruginosa is an opportunistic pathogen and is associated with nosocomial infections. Its ability to thrive in a broad range of environments is due to a large and diverse genome of which its accessory genome is part. The objective of this study was to characterize P. aeruginosa strains isolated from children who developed bacteremia, using pulse-field gel electrophoresis, and in terms of its genomic islands, virulence genes, multilocus sequence type, and antimicrobial susceptibility. Our results showed that P. aeruginosa strains presented the seven virulence genes: toxA, lasB, lecA, algR, plcH, phzA1, and toxR, a type IV pilin alleles (TFP) group I or II. Additionally, we detected a novel pilin and accessory gene, expanding the number of TFP alleles to group VI. All strains presented the PAPI-2 Island and the majority were exoU+ and exoS+ genotype. Ten percent of the strains were multi-drug resistant phenotype, 18% extensively drug-resistant, 68% moderately resistant and only 3% were susceptible to all the antimicrobial tested. The most prevalent acquired β-Lactamase was KPC. We identified a group of ST309 strains, as a potential high risk clone. Our finding also showed that the strains isolated from patients with bacteremia have important virulence factors involved in colonization and dissemination as: a TFP group I or II; the presence of the exoU gene within the PAPI-2 island and the presence of the exoS gene.
Highlights
Pseudomonas aeruginosa is a Gram-negative bacterium, which is categorized as an opportunistic pathogen due to its ability to cause infections mainly in immunocompromised patients
A 30% of the general population carries P. aeruginosa on their skin and in their mucosa and intestine (Thuong et al, 2003; Agodi et al, 2007). This bacterium is associated with chronic recurrent infections in patients with cystic fibrosis and it represents a high mortality in children with underlying conditions such as hemato-oncology diseases, cardiovascular surgeries, extended hospitalization in the Intensive Care Units (ICU), gastrointestinal malformations, and prematurity (Fergie et al, 1994; Zhang et al, 2012)
Genetic and phenotypic characterization of 60 isolates of P. aeruginosa associated with blood infections in children admitted to a highly specialized hospital in Mexico, showed that the infections were caused by strains with great diversity in their accessory genome
Summary
Pseudomonas aeruginosa is a Gram-negative bacterium, which is categorized as an opportunistic pathogen due to its ability to cause infections mainly in immunocompromised patients. An important virulent characteristic is the formation of Pseudomonas aeruginosa Strains Associated with Bacteremia biofilms and its natural multiresistance to a wide range of antibiotics and disinfectants (Drenkard and Ausubel, 2002; Wolska and Szweda, 2009; Poole, 2011; Rybtke et al, 2015) This microorganism has been associated with nosocomial infections and outbreaks in Intensive Care Units (ICU) for adults, children and neonates (Thuong et al, 2003; Agodi et al, 2007; Zhang et al, 2012). P. aeruginosa causes infections, such as ear infections or skin infections in healthy people exposed to poorly chlorinated water in swimming pools or tubs for hydromassage (Mena and Gerba, 2009; Rybtke et al, 2015)
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