Molecular detection of carbapenemase-producing Pseudomonas aeruginosa isolated from intensive care units of surgical specialty hospital in Erbil city

Background: The emergence and spread of carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a serious cause of nosocomial infections in critically ill patients. Objectives: The aim of this study was to determine the prevalence of CRPA and carriage of class B Metallo-β-lactamase resistant genes in...

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Bibliographic Details
Main Author: Soza Tharwat Baban
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Medical Journal of Babylon
Subjects:
Online Access:http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2020;volume=17;issue=2;spage=185;epage=193;aulast=Baban
Description
Summary:Background: The emergence and spread of carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a serious cause of nosocomial infections in critically ill patients. Objectives: The aim of this study was to determine the prevalence of CRPA and carriage of class B Metallo-β-lactamase resistant genes in intensive care units (ICUs) from patients with surgical-site infection or ventilator-associated pneumonia at a Surgical Specialty Hospital in Erbil city. Materials and Methods: During 6 months' study, a total of 80 clinical samples were collected from ICUs. The identification of P. aeruginosa in clinical specimens was confirmed by polymerase chain reaction (PCR) amplification of a molecular marker–oprL gene. Antimicrobial susceptibility was performed using Vitek-identification system. Screening of carbapenemase-producer isolates was confirmed using Rapidec Carba NP test. CRPA isolates were tested for the presence of metallo-β-lactamase (MBL)-encoding genes, including: blaVIM, blaIMP, and blaNDMby using PCR. Results: A total of 50 (62.5%) P. aeruginosa isolates were identified with antibiotic resistance profile (4% pan drug resistant [PDR], 20% extensively drug resistant [XDR] and 76% multidrug resistant). Twelve (24%) isolates were CRPA positive, in which the most prevalent MBL-encoding gene was blaVIM (58.3%), blaNDM (41.7%), and blaIMP (33.3%). Conclusions: Alarmingly, high prevalence of CRPA with predominance of MBL-encoding genes was detected. The XDR and PDR resistance phenotypes have become highly prevalent for this nosocomial pathogen in ICU patients that may cause a therapeutic impasse. The MBL-encoding genes were predominant among clinical isolates of P. aeruginosa. These findings emphasize on adherence to infection prevention and control standard precautions, early detection of CRPA isolates and development of to effectively reduce the burden of carbapenem resistance.
ISSN:1812-156X
2312-6760