High Rates of Aminoglycoside Methyltransferases Associated with Metallo-Beta-Lactamases in Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa Clinical Isolates from a Tertiary Care Hospital in Egypt

El-Far, Amira; Samir, Safia; El-Gebaly, Eman; Omar, Maysa; Dahroug, Heba; El‐Shenawy, A. I.; Soliman, Noha S.; Gamal, Doaa

doi:10.2147/idr.s335582

Cited by 20 publications

(15 citation statements)

References 37 publications

(69 reference statements)

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“…Moreover, the tested P. aeruginosa isolates exhibited high resistance to β-lactams because of β-lactamase production, especially the AmpC β-lactamase, efflux pump expression, permeability changes, and changes in the target site [5,68]. Besides, the P. aeruginosa isolates revealed high resistance to gentamicin, which agreed with a previous study that showed high aminoglycoside resistance among MDR and extensively drug-resistant (XDR) P. aeruginosa clinical isolates in Egypt [69]. Another study showed that the primary mechanism of resistance against aminoglycoside is methyltransferases responsible for changing the drug-binding sites [70].…”

Section: Discussionsupporting

confidence: 88%

Bacteriophage as a potential therapy to control antibiotic-resistant Pseudomonas aeruginosa infection through topical application onto a full-thickness wound in a rat model

Rezk

Abdelsattar

Elzoghby

et al. 2022

Journal of Genetic Engineering and Biotechnology

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Background Antibiotic-resistant Pseudomonas aeruginosa (P. aeruginosa) is one of the most critical pathogens in wound infections, causing high mortality and morbidity in severe cases. However, bacteriophage therapy is a potential alternative to antibiotics against P. aeruginosa. Therefore, this study aimed to isolate a novel phage targeting P. aeruginosa and examine its efficacy in vitro and in vivo. Results The morphometric and genomic analyses revealed that ZCPA1 belongs to the Siphoviridae family and could infect 58% of the tested antibiotic-resistant P. aeruginosa clinical isolates. The phage ZCPA1 exhibited thermal stability at 37 °C, and then, it decreased gradually at 50 °C and 60 °C. At the same time, it dropped significantly at 70 °C, and the phage was undetectable at 80 °C. Moreover, the phage ZCPA1 exhibited no significant titer reduction at a wide range of pH values (4–10) with maximum activity at pH 7. In addition, it was stable for 45 min under UV light with one log reduction after 1 h. Also, it displayed significant lytic activity and biofilm elimination against P. aeruginosa by inhibiting bacterial growth in vitro in a dose-dependent pattern with a complete reduction of the bacterial growth at a multiplicity of infection (MOI) of 100. In addition, P. aeruginosa-infected wounds treated with phages displayed 100% wound closure with a high quality of regenerated skin compared to the untreated and gentamicin-treated groups due to the complete elimination of bacterial infection. Conclusion The phage ZCPA1 exhibited high lytic activity against MDR P. aeruginosa planktonic and biofilms. In addition, phage ZCPA1 showed complete wound healing in the rat model. Hence, this research demonstrates the potential of phage therapy as a promising alternative in treating MDR P. aeruginosa.

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Section: Discussionsupporting

confidence: 88%

Bacteriophage as a potential therapy to control antibiotic-resistant Pseudomonas aeruginosa infection through topical application onto a full-thickness wound in a rat model

Rezk

Abdelsattar

Elzoghby

et al. 2022

Journal of Genetic Engineering and Biotechnology

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“…Susceptibility testing revealed that 10.7% of our P. aeruginosa isolates were MDR, comparable to a prior study from Iraq (12.4%) 26 . On the other side, current data from Egypt demonstrated a relatively higher rate up to 42.4% 27 .…”

Section: Discussionmentioning

confidence: 86%

Multidrug-Resistant Gram-Negative ESKAPE Pathogens from a Tertiary-Care Hospital: Prevalence and Risk Factors

El-Kady

Karoma

Atrouni

2022

Egyptian Journal of Medical Microbiology

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Antibiotic-resistant ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) are commonly implicated in health-care associated infections (HAIs). Objectives: The purpose of this study is to assess the antimicrobial susceptibility profile of Gram-negative ESKAPE pathogens, with prime emphasis on the prevalence and risk factors for infections by multidrug-resistant (MDR) strains. Methodology: In this retrospective cohort study, we reviewed the electronic medical and laboratory records of our tertiary health-care facility throughout the period from January 2019 to December 2020. Adult patients identified with infections by any of the Gram-negative ESKAPE bacteria were eligible for our study. The risk factors associated with acquisition of MDR organisms were analyzed using univariate and multivariate models. Results: During the period of interest, a total of 614 Gram-negative ESKAPE isolates were identified, of which 121 were found to be MDR (19.7%). A. baumannii was the leading MDR organism (43.1%), whereas MDR P. aeruginosa was the least common (10.7%). The independent risk factors associated with acquisition of MDR infections included long hospital stays (P < 0.0001), undergoing surgical procedures (P= 0.001), ischemic heart disease (P= 0.005), mechanical ventilation (P= 0.005), and presence of indwelling urinary catheter (P= 0.03). Conclusions: Infections with MDR Gram-negative ESKAPE organisms have an alarming magnitude in our institution. Continued vigilance by the involved health-care workers, stringent compliance to the infection control guidelines, and effective implementation of the antimicrobial stewardship programs are critical measures to decrease the burden of this health problem.

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“…This variability might be attributed to lower sample size in such studies. On the other hand, global data showed that CRPA prevalence variations based on different geographic locations such as European and Mediterranean countries (ranging from 10.9% in Sweden to 70.5% in Poland) [20], China (89.4%) [12], Egypt (64.2%) [73], Turkey (20%) [74], India (33%) [75] and Nigeria (40%) [76]. Similarly, a multicenter study in 10 different countries reported 22% [77] and the SENTRY surveillance program 23.9% [78].…”

Section: Discussionmentioning

confidence: 99%

Molecular Analysis of Carbapenem and Aminoglycoside Resistance Genes in Carbapenem-Resistant Pseudomonas aeruginosa Clinical Strains: A Challenge for Tertiary Care Hospitals

Gondal,

Choudhry,

Niaz

et al. 2024

Antibiotics

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Carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) strains have become a global threat due to their remarkable capability to survive and disseminate successfully by the acquisition of resistance genes. As a result, the treatment strategies have been severely compromised. Due to the insufficient available data regarding P. aeruginosa resistance from Pakistan, we aimed to investigate the resistance mechanisms of 249 P. aeruginosa strains by antimicrobial susceptibility testing, polymerase chain reaction for the detection of carbapenemases, aminoglycoside resistance genes, extended-spectrum beta-lactamases (ESBLs), sequence typing and plasmid typing. Furthermore, we tested silver nanoparticles (AgNPs) to evaluate their in vitro sensitivity against antimicrobial-resistant P. aeruginosa strains. We observed higher resistance against antimicrobials in the general surgery ward, general medicine ward and wound samples. Phenotypic carbapenemase-producer strains comprised 80.7% (201/249) with 89.0% (179/201) demonstrating genes encoding carbapenemases: blaNDM-1 (32.96%), blaOXA48 (37.43%), blaIMP (7.26%), blaVIM (5.03%), blaKPC-2 (1.12%), blaNDM-1/blaOXA48 (13.97%), blaOXA-48/blaVIM (1.68%) and blaVIM/blaIMP (0.56%). Aminoglycoside-modifying enzyme genes and 16S rRNA methylase variants were detected in 43.8% (109/249) strains: aac(6′)-lb (12.8%), aac(3)-lla (12.0%), rmtB (21.1%), rmtC (11.0%), armA (12.8%), rmtD (4.6%), rmtF (6.4%), rmtB/aac(3)-lla (8.2%), rmtB/aac(6′)-lla (7.3%) and rmtB/armA (3.6%). In total, 43.0% (77/179) of the strains coharbored carbapenemases and aminoglycoside resistance genes with 83.1% resistant to at least 1 agent in 3 or more classes and 16.9% resistant to every class of antimicrobials tested. Thirteen sequence types (STs) were identified: ST235, ST277, ST234, ST170, ST381, ST175, ST1455, ST1963, ST313, ST207, ST664, ST357 and ST348. Plasmid replicon types IncFI, IncFII, IncA/C, IncL/M, IncN, IncX, IncR and IncFIIK and MOB types F11, F12, H121, P131 and P3 were detected. Meropenem/AgNPs and Amikacin/AgNPs showed enhanced antibacterial activity. We reported the coexistence of carbapenemases and aminoglycoside resistance genes among carbapenem-resistant P. aeruginosa with diverse clonal lineages from Pakistan. Furthermore, we highlighted AgNP’s potential role in handling future antimicrobial resistance concerns.

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High Rates of Aminoglycoside Methyltransferases Associated with Metallo-Beta-Lactamases in Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa Clinical Isolates from a Tertiary Care Hospital in Egypt

Cited by 20 publications

References 37 publications

Bacteriophage as a potential therapy to control antibiotic-resistant Pseudomonas aeruginosa infection through topical application onto a full-thickness wound in a rat model

Bacteriophage as a potential therapy to control antibiotic-resistant Pseudomonas aeruginosa infection through topical application onto a full-thickness wound in a rat model

Multidrug-Resistant Gram-Negative ESKAPE Pathogens from a Tertiary-Care Hospital: Prevalence and Risk Factors

Molecular Analysis of Carbapenem and Aminoglycoside Resistance Genes in Carbapenem-Resistant Pseudomonas aeruginosa Clinical Strains: A Challenge for Tertiary Care Hospitals

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