| Summary: | Carbapenem-resistant <i>Pseudomonas aeruginosa</i> (CRPA) are a global health concern. The antimicrobial resistance, virulence, and molecular typing of 57 CRPA isolated from 43 patients who attended a specific Tunisian hospital from September 2018 to July 2019 were analyzed. All but one were multidrug-resistant CRPA, and 77% were difficult-to-treat-resistant (DTR) isolates. The <i>bla</i><sub>VIM-2</sub> gene was detected in four strains (6.9%), and among the 36 <i>bla</i><sub>GES</sub>-positive CRPA (62%), the <i>bla</i><sub>GES-5</sub> gene was the predominant variant (86%). Three strains co-harbored the <i>bla</i><sub>VIM-2</sub> and <i>bla</i><sub>GES-45</sub> genes, and seven CRPA carried the <i>bla</i><sub>SHV-2a</sub> gene (14%). OprD alterations, including truncations by insertion sequences, were observed in 18 strains. Regarding the 46 class 1 integron-positive CRPA (81%), the <i>bla</i><sub>GES-5</sub> gene was located in integron In717, while the <i>bla</i><sub>GES-29</sub> and <i>bla</i><sub>GES-45</sub> genes were found in two new integrons (In2122 and In4879), and the <i>bla</i><sub>VIM-2</sub> gene was found in In1183 and the new integron In2142. Twenty-four PFGE patterns and thirteen sequence types (three new ones) were identified. The predominant serotype O:11 and <i>exoU</i> (81%) were mostly associated with ST235 and the new ST3385 clones. The seven <i>bla</i><sub>SHV-2a-</sub>CRPA from different patients belonged to ST3385 and the same PFGE pattern. The <i>bla</i><sub>GES-5</sub>- and <i>bla</i><sub>VIM-2</sub> + <i>bla</i><sub>GES-45</sub>-positive CRPA recovered mostly from ICU patients belonged to the high-risk clone ST235. Our results highlight the alarming prevalence of <i>bla</i><sub>GES-5-</sub> and ST235-CRPA, the co-existence of <i>bla</i><sub>GES-45</sub> and <i>bla</i><sub>VIM-2</sub>, and their location within integrons favoring their dissemination.
|
|---|