Abstract
This study aimed to correlate the pattern of antimicrobial susceptibility, phenotypic production of virulence factors, the occurrence of virulence factors genes and the clonal profile of clinical isolates of Pseudomonas aeruginosa of a tertiary hospital in Recife-PE. The 30 clinical isolates (15 multidrug-sensitive (MDS) and 15 multidrug-resistant (MDR)) were analyzed using phenotypic methods to detect virulence factors (alkaline protease, hemolysin, phospholipase C, lipase, and pigments). The detection of the aprA, lasA, lasB, plcH, and toxA genes was performed through specific PCRs, and the clonal profile was assessed using ERIC-PCR. The results revealed cephalosporins being the class eliciting the highest percentage of resistance; the MDR isolates were all resistant. Among the MDS isolates, all were sensitive to carbapenems and quinolones. The MDR isolates produced less virulence factors such as pyocyanin and lipase, and exhibited lower expression of toxA and lasA genes, whereas the MDS isolates produced less hemolysin and phospholipase C. There was no difference between the groups for alkaline protease production and aprA gene expression. All the isolates produced pyocyanin and expressed lasB and plcH genes. A great genetic diversity was found, and it was possible to observe 28 genetic profiles. Clones were present among the MDR isolates. The occurrence of virulence factors in almost all the isolates studied suggests their high level of pathogenicity, demonstrating that this pathogen is capable of accumulating numerous virulence factors, and in some cases, is associated with multidrug resistance, which makes it difficult to treat these infections.
Highlights
Pseudomonas aeruginosa, one of the main pathogens involved in hospital infections of immunocompromised patients, causes the most frequent healthcare-related infections associated with drug-resistant bacteria
Adding to the lack of perspectives for the introduction of new drugs that could be used against this pathogen, such evolutions provided the need for investigations on its physiology, mainly with regard to its diverse virulence factors that contribute to the pathogenic potential of the infectious process, since they favor infection by increasing tissue damage and protecting P. aeruginosa against recognition by the immune system and the action of antimicrobials (Todar, 2020)
The isolates were seeded on cetrimide agar, which is selective for the isolation of P. aeruginosa, and were cultivated on nutrient agar to conserve them in stock
Summary
Pseudomonas aeruginosa, one of the main pathogens involved in hospital infections of immunocompromised patients, causes the most frequent healthcare-related infections associated with drug-resistant bacteria. This bacterium is considered an opportunistic infectious agent and exhibits several pathogenic mechanisms as well as resistance to various antimicrobials Its mechanisms of resistance to antimicrobials can be intrinsic or acquired, and are related to therapeutic failure for infections related to it (Silva Júnior et al, 2017). Combinations of these resistance mechanisms have given rise to multidrugresistant (MDR) isolates (Magiorakos et al, 2012). Adding to the lack of perspectives for the introduction of new drugs that could be used against this pathogen, such evolutions provided the need for investigations on its physiology, mainly with regard to its diverse virulence factors that contribute to the pathogenic potential of the infectious process, since they favor infection by increasing tissue damage and protecting P. aeruginosa against recognition by the immune system and the action of antimicrobials (Todar, 2020)
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