Abstract
Objectives:Pseudomonas aeruginosa is an opportunistic pathogen with remarkable adaptation ability to thrive in diverse environmental conditions. This study aimed at phenotypic and molecular analysis of metallo beta lactamases (blaIMP, blaVIM, blaNDM-1 and blaSPM-1) and genetic diversity analysis among imipenem resistant clinical isolates of Pseudomonas aeruginosa.Methods:This study was conducted from May 2017 to June 2018. The study included 187 Pseudomonas aeruginosa isolates collected from different clinical specimens from Peshawar, Pakistan. The isolates were analyzed for resistance to imipenem. Combined disc test (CDT) was then performed for phenotypic detection of metallo beta lactamases among imipenem resistant isolates of Pseudomonas aeruginosa. Molecular detection of metallo beta lactamases genes i.e. blaIMP, blaVIM, blaNDM-1 and blaSPM-1 was analyzed through polymerase chain reaction. Genetic diversity was determined through RAPD-PCR.Results:MBL production was observed in 76% (n=19) isolates. The occurrence of MBL genes blaIMP, blaNDM-1 and blaVIM was 68% (n=17), 48% (n=12), and 4% (n=1) respectively. The blaSPM-1 gene was not detected. High genetic diversity was observed in current study. Out of 182 isolates 171 isolates showed different RAPD profiles (93.95% polymorphism); 160 were unique RAPD strains and based on similarity coefficient ≥ 80%, 22 isolates were clustered into 11 distinct clones.Conclusion:A high prevalence of blaIMP and blaNDM-1 among imipenem resistant isolates of Pseudomonas aeruginosa is alarming that calls for proper control and prevention strategies. RAPD technique was found to be a good genotyping technique when limited resources are available.
Highlights
Extensive drug resistant strains of Pseudomonas aeruginosa have been reported from hospitals around the world.[1]
Imipenemase (IMP), Verona integron encoded metallo beta lactamase (VIM), New Delhi metallo beta lactamase (NDM), Sao Paulo metallo beta lactamase (SPM), Florence imipenemase (FIM) and Germany imipenemase (GIM) are various types of metallo beta lactamases that have been reported in carbapenem resistant isolates of Pseudomonas aeruginosa.[11]
Important to know about the epidemiology and resistance mechanisms of Pseudomonas aeruginosa in order to control and prevent multi drug resistant pathogenic strains to overcome possible health risks.[11]
Summary
Extensive drug resistant strains of Pseudomonas aeruginosa have been reported from hospitals around the world.[1]. Pak J Med Sci November - December 2021 Vol 37 No 7 www.pjms.org.pk 1865 effective against Gram negative and Gram-positive bacteria demonstrating broad range antibacterial activity.[7] Resistant to carbapenems especially in Gram negative pathogens is global public health issue because of the spread of transferable carbapenemase encoding genes.[7] Highest resistance was reported by Farooq et al, against imipenem in multi drug resistant clinical isolates of Pseudomonas aeruginosa from tertiary care hospital Karachi, Pakistan.[8] Imipenem resistant pathogenic bacterial strains have been reported from Lahore and Quetta Pakistan.[9,10] Imipenemase (IMP), Verona integron encoded metallo beta lactamase (VIM), New Delhi metallo beta lactamase (NDM), Sao Paulo metallo beta lactamase (SPM), Florence imipenemase (FIM) and Germany imipenemase (GIM) are various types of metallo beta lactamases that have been reported in carbapenem resistant isolates of Pseudomonas aeruginosa.[11] Genes for MBLs are located on integrons, plasmids, transposons or on chromosomes.[11] These specific genetic elements carry carbapenem and other antibiotics resistant determinants and confer multi drug resistance to Pseudomonas aeruginosa These antibiotic resistant elements could be transferred to other Gram-negative bacterial strains and contribute towards spread of antimicrobial resistance rate making the treatment of infected patients complex.[11] It is important to know about the epidemiology and resistance mechanisms of Pseudomonas aeruginosa in order to control and prevent multi drug resistant pathogenic strains to overcome possible health risks.[11]
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