Infection and Drug Resistance (Apr 2021)
Screening of Antimicrobial Resistance Genes and Epidemiological Features in Hospital and Community-Associated Carbapenem-Resistant Pseudomonas aeruginosa Infections
Abstract
Ayşegül Çopur Çiçek,1 Ayşe Ertürk,2 Nebahat Ejder,1 Erva Rakici,1 Uğur Kostakoğlu,2 İlknur Esen Yıldız,2 Songül Özyurt,3 Emine Sönmez2 1Recep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Microbiology, Rize, Turkey; 2Recep Tayyip Erdogan University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Rize, Turkey; 3Recep Tayyip Erdogan University, Faculty of Medicine, Department of Chest Diseases, Rize, TurkeyCorrespondence: Ayşegül Çopur ÇiçekRecep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Microbiology, Rize, 53100, TurkeyEmail [email protected]: Researching carbapenem-resistant isolates enables the identification of carbapenemase-producing bacteria and prevents their spread.Methods: P. aeruginosa isolates were recovered from Medicine Faculty of Recep Tayyip Erdoğan University and identified by conventional methods and the automated Vitek 2 Compact system. Antimicrobial susceptibility experiments were performed in accordance with CLSI criteria and the automated Vitek 2 Compact system. The PCR method was investigated for the presence of β-lactamase resistance genes. PFGE typing was performed to show clonal relation among samples.Results: Seventy P. aeruginosa isolates were isolated from seventy patients. Of the patients, 67.1% had contact with the health service in the last 90 days and 75.7% of the patients had received antimicrobial therapy in the previous 90 days. Twenty-four isolates were carbapenem resistant, 2 isolates were multidrug-resistant except colistin, and none of the samples had colistin resistance. The gene encoding β-lactamase or metallo-β-lactamase was found in a total of 36 isolates. The blaVEB and blaPER genes were identified in 1 and 5 isolates alone or 17 and 13 isolates in combination with other resistance genes, respectively. The blaNDM was the most detected metallo-β-lactamase encoding gene (n=18), followed by blaKPC (n=12). blaIMP and blaVIM were detected in 5 and 1 isolates, respectively. Also, the association of blaVEB-blaPER and blaVEB-blaKPC-blaNDM was found to be very high. Much more resistance genes and co-occurrence were detected in hospital-acquired samples than community-acquired samples. No difference was found between the community and hospital-associated isolates according to PFGE results. Simultaneously from 6 patients, other microorganisms were also isolated and 5 of them died.Conclusion: The average length of stay (days) was found to be significantly higher in HAI group than CAI group. The death of 5 patients with fewer or no resistance genes showed that the co-existence of other microorganisms in addition to resistance genes was important on death.Keywords: Pseudomonas aeruginosa, antibiotic resistance genes, epidemiology, PFGE
