Abstract
ScopeThis study aimed to analyse the prevalence, antibiotic resistance and genetic relatedness of P. aeruginosa isolates obtained from potable and recreational water samples (n. 8,351) collected from different settings (swimming pools, n. 207; healthcare facilities, n 1,684; accommodation facilities, n. 1,518; municipal waterworks, n. 4,500; residential buildings, n. 235). Possible mechanisms underlying resistance to imipenem, with particular focus on those involving oprD-based uptake, were also explored.Methods and resultsIsolation and identification of Pseudomonas aeruginosa was performed according to the standardized procedure UNI EN ISO 16266:2008 followed by PCR confirmation. Antibiotic Susceptibility testing was conducted according to EUCAST standardized disk diffusion method. Genetic relatedness of strains was carried out by RAPD. The sequence of the oprD gene was analyzed by standard method. Fifty-three samples (0.63%) were positive for P. aeruginosa, of which 10/207 (4.83%) were from swimming pools. Five isolates (9.43%) were resistant to imipenem, one to Ticarcillin + Clavulanate, one to both Piperacillin and Ticarcillin + Clavulanate. The highest isolation rate of imipenem resistant P. aeruginosa was observed in swimming pool water. Identical RAPD profiles were found in isolates from the same location in the same year or even in different years.ConclusionsImipenem resistant strains were identified as carbapenemase-negative and resistance has been associated with inactivating mutations within the oprD gene, with a concomitant loss of porin. RAPD results proved that a water system can remain colonized by one strain for long periods and the contamination may be difficult to eradicate.This study has revealed the presence of P. aeruginosa in different water samples, including resistant strains, especially in swimming pools, and confirmed the role of porins as a contributing factor in carbapenem resistance in Gram-negative bacteria.
Highlights
Pseudomonas aeruginosa is an opportunistic human pathogen implicated in a variety of acute and chronic infections such as respiratory, urinary tract and gastrointestinal infections as well as bacteremia
RAPD results proved that a water system can remain colonized by one strain for long periods and the contamination may be difficult to eradicate
This study has revealed the presence of P. aeruginosa in different water samples, including resistant strains, especially in swimming pools, and confirmed the role of porins as a contributing factor in carbapenem resistance in Gram-negative bacteria
Summary
Pseudomonas aeruginosa is an opportunistic human pathogen implicated in a variety of acute and chronic infections such as respiratory, urinary tract and gastrointestinal infections as well as bacteremia. It is mainly found in subjects with compromised host defenses, e.g., cancer, HIV and cystic fibrosis (CF) patients [1], and is a significant cause of morbidity and mortality It is widespread in the environment, in a variety of water sources such as hospital [2] and municipal drinking water systems [3], healthcare facilities [2,4], accommodation facilities [5], as well as in swimming pools and hot tubs [6,7], where P. aeruginosa is a major cause of skin infections such as folliculitis and external otitis [8,9]. In Italy the quality of water intended for human consumption is ensured by Legislative Decree n.31/2001 [14] and its subsequent amendments, Legislative Decree n.27/2002 [15], while the microbiological criteria for swimming pool water are established by Italian Guidelines [16].
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