Molecular characterization of multidrug-resistant (MDR) Pseudomonas aeruginosa isolated in a burn center

Silva, Keila de Cássia Ferreira de Almeida; Calomino, Mariana Alcântara; Deutsch, Gabriela; Castilho, Selma Rodrigues de; Paula, Geraldo Renato de; Esper, Luciana Maria Ramires; Teixeira, Lenise Arneiro

doi:10.1016/j.burns.2016.07.002

Cited by 45 publications

(36 citation statements)

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“…10 Exoenzymes S, Y, T, and U are encoded by the genes exoS, exoY exoT, and exoU, respectively, with exoS being the most predominant. 11 While former studies have shown that the existence of exoS is related to increased virulence in burn wounds and lung infections, 12 ExoU is 100 times more cytotoxic than ExoS. 5,13 LasB elastase, a zinc metalloprotease encoded by the lasB gene, attacks eukaryotic proteins such as elastin and collagen.…”

Section: Introductionmentioning

confidence: 99%

Virulence Constitution of Multi-Drug-Resistant Pseudomonas aeruginosa in Upper Egypt

Hassuna¹,

Mandour²,

Mohamed³

2020

IDR

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Ventilator-associated pneumonia caused by Pseudomonas aeruginosa (P. aeruginosa) is a major health-care problem. In this study, we explored the epidemiology of virulence determinants among multi-drug-resistant (MDR) clinical P. aeruginosa isolates from hospitalized patients with ventilator-associated pneumonia in intensive care units in Upper Egypt. Patients and Methods: MDR P. aeruginosa isolates were screened for the presence of eight virulence factors and typed by ERIC-PCR. Results: A total of 39 clinical MDR isolates were selected out of 173 isolated P. aeruginosa showing a combination of adhesion and cytotoxicity virulence patterns, with the detection of aprA, exoU, exoS, lasB, algD, toxA in 74.3%, 58.9%, 46.1%, 41.2%, 30.7%, 20.5% of the isolates, respectively. The MDR isolates were grouped into 13 different virulence profiles according to the pattern of virulence gene distribution. exoU genotype was more predominant among the P. aeruginosa isolates with more than 48% of the isolates harboring this gene alone, 7% harboring both exoU and exoS and 43.5% harboring exoS gene. An intermediate degree of diversity was detected by ERIC-PCR typing where the isolates were clustered in 7 major groups, indicating possible cross-infection within the hospital. Conclusion: Our results highlight the increased frequency of virulent P. aeruginosa isolates with a shift to the more virulent cytotoxic exoU genotype. Further hospital infection-control measures are mandatory to control the hospital cross-transmission of these highly virulent isolates. This study could vastly be a help to develop efficient treatment policies against P. aeruginosa induced ventilator-associated pneumonia.

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Section: Introductionmentioning

confidence: 99%

Virulence Constitution of Multi-Drug-Resistant Pseudomonas aeruginosa in Upper Egypt

Hassuna¹,

Mandour²,

Mohamed³

2020

IDR

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“…Up to two-thirds of ocular isolates of P . aeruginosa possess the exoU gene [ 22 ], which is a much higher rate than the isolates from other infections [ 6 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Association between possession of ExoU and antibiotic resistance in Pseudomonas aeruginosa

et al. 2018

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Virulent strains of Pseudomonas aeruginosa are often associated with an acquired cytotoxic protein, exoenzyme U (ExoU) that rapidly destroys the cell membranes of host cells by its phospholipase activity. Strains possessing the exoU gene are predominant in eye infections and are more resistant to antibiotics. Thus, it is essential to understand treatment options for these strains. Here, we have investigated the resistance profiles and genes associated with resistance for fluoroquinolone and beta-lactams. A total of 22 strains of P. aeruginosa from anterior eye infections, microbial keratitis (MK), and the lungs of cystic fibrosis (CF) patients were used. Based on whole genome sequencing, the prevalence of the exoU gene was 61.5% in MK isolates whereas none of the CF isolates possessed this gene. Overall, higher antibiotic resistance was observed in the isolates possessing exoU. Of the exoU strains, all except one were resistant to fluoroquinolones, 100% were resistant to beta-lactams. 75% had mutations in quinolone resistance determining regions (T81I gyrA and/or S87L parC) which correlated with fluoroquinolone resistance. In addition, exoU strains had mutations at K76Q, A110T, and V126E in ampC, Q155I and V356I in ampR and E114A, G283E, and M288R in mexR genes that are associated with higher beta-lactamase and efflux pump activities. In contrast, such mutations were not observed in the strains lacking exoU. The expression of the ampC gene increased by up to nine-fold in all eight exoU strains and the ampR was upregulated in seven exoU strains compared to PAO1. The expression of mexR gene was 1.4 to 3.6 fold lower in 75% of exoU strains. This study highlights the association between virulence traits and antibiotic resistance in pathogenic P. aeruginosa.

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“…This virulence factor is associated with bacterial enzyme production of elastase that degrades immunoglobulin and complement factor (12). In Brazil, the gene exo U was described in CRPA belonging to ST2237 in burn patients instead of ST277 (17).…”

Section: Introductionmentioning

confidence: 99%

Carbapenem-resistant Pseudomonas aeruginosa bloodstream infection: in vitro synergy, virulence and clinical outcome

Rizek

et al. 2018

Preprint

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34 Página2In the current study carbapanem-resistant P. aeruginosa bloodstream 35 infection (CRPA-BSI) was associated with high 14-day mortality. Although, 36 highly resistant to meropenem, half of the isolates achieved in vitro synergy 37 with the combination of meropenem with colistin, and the patients that 38 received this combination therapy showed a tendency towards lower mortality. 39Our strains did not carry exoU gene, on the other hand, patients with CRPA-40 BSI caused by strains harboring gene lasB evolved more frequent to death. 41 42

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Molecular characterization of multidrug-resistant (MDR) Pseudomonas aeruginosa isolated in a burn center

Cited by 45 publications

References 46 publications

<p>Virulence Constitution of Multi-Drug-Resistant <em>Pseudomonas aeruginosa</em> in Upper Egypt</p>

<p>Virulence Constitution of Multi-Drug-Resistant <em>Pseudomonas aeruginosa</em> in Upper Egypt</p>

Association between possession of ExoU and antibiotic resistance in Pseudomonas aeruginosa

Carbapenem-resistant Pseudomonas aeruginosa bloodstream infection: in vitro synergy, virulence and clinical outcome

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