Abstract
Pseudomonas aeruginosa is a major opportunistic human pathogen, responsible for nosocomial infections and infections in patients with impaired immune systems. Little data exist about the faecal colonisation by P. aeruginosa isolates in healthy humans. The occurrence, antimicrobial resistance phenotype, virulence genotype, and genetic lineages of P. aeruginosa from faecal samples of children from two different Spanish regions were characterised. Seventy-two P. aeruginosa were isolated from 1,443 faecal samples. Low antimicrobial resistance levels were detected: ceftazidime (8%), cefepime (7%), aztreonam (7%), gentamicin (3%), ciprofloxacin (1%), and imipenem (1%); susceptibility to meropenem, amikacin, tobramycin, levofloxacin, and colistin. Four multidrug-resistant strains were found. Important differences were detected between both geographical regions. Forty-one sequence types were detected among the 48 tested strains. Virulence and quorum sensing genes were analysed and 13 virulotypes were detected, being 26 exoU-positive strains. Alteration in protein OprD showed eight different patterns. The unique imipenem-resistant strain showed a premature stop codon in OprD. Intestinal colonisation by P. aeruginosa, mainly by international clones (as ST244, ST253, and ST274), is an important factor for the systemic infections development and the environmental dissemination. Periodic active surveillance is useful to identify these community human reservoirs and to control the evolution of antibiotic resistance and virulence activity.
Highlights
Pseudomonas aeruginosa is a ubiquitous Gram-negative bacteria present in many diverse environmental settings, including different living sources, such as animals and humans
A total of 72 P. aeruginosa were isolated from 1,443 faecal samples of children (5%): 42 isolates were obtained in Hospital Clınico Universitario Lozano Blesa (HLB) (4.3%) and the 30 remaining ones in Hospital San Pedro (HSP) (6.3%)
The occurrence of P. aeruginosa isolates in this study (5%) (HSP 6.3% and HLB 4.3%) was in the range detected in other studies (2.6-24%) [3, 7]
Summary
Pseudomonas aeruginosa is a ubiquitous Gram-negative bacteria present in many diverse environmental settings, including different living sources, such as animals and humans. The ability of P. aeruginosa to survive on minimal nutritional requirements and to tolerate a variety of physical conditions has allowed this organism to persist in both community and hospital settings [1]. This species is a major opportunistic human pathogen, responsible for worldwide nosocomial infections with increasing medical and veterinary importance [1] and causing infections mostly in patients with impaired immune systems [2]. The increasing prevalence of multidrug-resistant (MDR) P. aeruginosa isolates is a global health problem, because of the limitation in clinical treatment options [5, 6] This microorganism is seldom a member of the normal microbiota in humans.
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