Abstract
Abstract Background: Pseudomonas aeruginosa is an opportunistic human pathogen and are reported to cause acute and chronic infectious diseases. Due to its high ability to acquire resistance to many antibiotics, it has become a global public health threat. It consists of some virulence genes that may lead to its pathogenicity. The main objective of this cross-sectional study was to detect the virulence genes and antibiotic susceptibility pattern of P. aeruginosa isolated from clinical specimens collected from governmental hospital of Nepal.Methods: A total of 7898 clinical specimens were analyzed for the period of six months from November 2018 to April 2019. The specimens were cultured on Nutrient agar, Blood agar, MacConkey agar, Chocolate agar, Cysteine-Lactose, Electrolyte Deficient agar plates and were incubated at 37°C for 24 hours. All the isolates were identified by standard biochemical tests and further confirmed by growth on Cetrimide agar plate. The antibiotic susceptibility testing was performed by modified Kirby-Bauer disc diffusion method following CLSI guideline. Multiplex-PCR was done to detect the virulence genes oprL and toxA. Statistical analysis was carried out using IBM SPSS Statistic ver. 25 and the p-value was calculated at significance level (0.05%) by using Chi square.Results: Out of these specimens investigated, 87 isolates were tentatively identified to be P. aeruginosa in which 20 (22.98 %) were found to be multidrug resistant. Comparatively, most of the P. aeruginosa were isolated from outpatients 63 (72.41 %) than inpatients 24 (27.58 %), from male 56 (64.36 %) than female 31 (35.63 %) and in age group 60-79 years (41.37 %). AST result showed the highest resistance of 100% with cefixime whereas susceptibilities of 83.9% and 81.6% with polymixin B and tobramycin were noticed respectively. The PCR results showed that all P. aeruginosa isolates carried oprL 87 (100%) and 83 (95.4 %) isolates showed toxA genes. Conclusion: The studies revealed that almost all P. aeruginosa harbors both oprL and toxA genes.
Highlights
Pseudomonas aeruginosa is an opportunistic human pathogen and are reported to cause acute and chronic infectious diseases
Most of the P. aeruginosa were isolated from outpatients 63 (72.41 %) than inpatients 24 (27.58 %), from male 56 (64.36 %) than female 31 (35.63 %) and in age group 60-79 years (41.37 %)
The polymerase chain reaction (PCR) results showed that all P. aeruginosa isolates carried oprL 87 (100%) and 83 (95.4 %) isolates showed toxA genes
Summary
Pseudomonas aeruginosa is an opportunistic human pathogen and are reported to cause acute and chronic infectious diseases. It consists of some virulence genes that may lead to its pathogenicity. The main objective of this cross-sectional study was to detect the virulence genes and antibiotic susceptibility pattern of P. aeruginosa isolated from clinical specimens collected from governmental hospital of Nepal. Pseudomonas aeruginosa is known as one of the most-widely spread opportunistic human pathogen causing 18 to 63% infection worldwide [1, 2]. There are several extracellular and cell associated virulence factors that may lead to its pathogenicity. The colonization of these factors can cause blood stream invasive, extensive tissue damage and dissemination. Normally encode and participate in the virulence factors are, toxA, exoS, exoY, exoU, oprL, oprI, lasA, lasB, oprD, plcH, plcN and nan etc. [9]
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