Phenotypic and genotypic detection of antibiotic resistance of Pseudomonas aeruginosa isolated from urinary tract infections.

Amira M El-Ganiny,Hisham A Abbas,Hend A Kamel

doi:10.4314/ahs.v18i1.3

Abstract

Pseudomonas aeruginosa is a major nosocomial uropathogen. It can tolerate a wide variety of physical conditions and many antibiotics by different resistance mechanisms. This study aimed to investigate the mechanisms of antibiotics resistance in uropathogenic P. aeruginosa clinical isolates. Two hundred sixty six urine samples were collected from Zagazig University Hospitals, Zagazig, Egypt. P. aeruginosa isolates were identified using standard microbiological tests. The sensitivity to different antibiotics was determined by disc diffusion method. Anti-microbial resistance mechanisms were investigated using phenotypic methods and confirmed by PCR. Fifty P. aeruginosa isolates were recovered. All isolates were MDR and were resistant to amoxicillin/clavulinic, sulphamethaxzole/trimethoprim, doxycycline and ceftazidime. Phenotypic detection of resistance mechanisms revealed that all strains have efflux mechanism, outer membrane porins, and AmpC β-lactamase; none of the strains showed ESBL activity and two of the imipenem resistant strains showed MβL activity. PCR analysis showed that all strains have MexAB-R, OprD and AmpC genes, 42 strains had PSE gene, while VEB and VIM genes were not detected. The resistance rates in P. aeruginosa were higher than global values; this resistance was attributed to several mechanisms. This high resistance is alarming and necessitates applying strict antibiotic prescription policies.

Highlights

Pseudomonas aeruginosa is one of the most ecologically significant species among the genus Pseudomonas
This study aimed to investigate the mechanisms of antibiotics resistance in uropathogenic P. aeruginosa clinical isolates
50 P. aeruginosa isolates were recovered from urine samples, all the isolates were multidrug resistance (MDR) (100%), this MDR rate was higher than rates reported previously in Egypt which ranged from 34% 56%31-33; this may reflect higher resistance rate in case of urinary tract infections

Summary

Introduction

Pseudomonas aeruginosa is one of the most ecologically significant species among the genus Pseudomonas. P. aeruginosa is of extreme importance because of the widespread distribution of its strains in nature, its high intrinsic anti-bacterial resistance and its virulence[1]. P. aeruginosa is an opportunistic, hospital-acquired pathogen that causes severe diseases in immuno-compromised individuals including urinary tract infection. Urinary tract infections (UTIs) are some of the most frequent bacterial infections, affecting 150 million people annually worldwide[2]. P. aeruginosa is the third most common pathogen associated with nosoomial catheter-associated UTIs3. Despite advances in anti-microbial therapy, the mortality and morbidity associated with P. aeruginosa induced UTIs remain significantly high[4]. One key reason for therapy failure is the increased level of antibiotic resistance among clinical P. aeruginosa isolates[5]. Many antibiotic resistance mechanisms have been reported in P. aeruginosa including: 1) Reduced expression or loss

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