Articles

Class 1 integron and Imipenem Resistance in Clinical Isolates of Pseudomonas aeruginosa: Prevalence and Antibiotic Susceptibility

Abstract

Background and Objectives: Pseudomonas aeruginosa is one of the most important causative agents of nosocomial infections especially in ICU and burn units. P. aeruginosa infections are normally difficult to eradicate due to acquired resistance to many antibiotics. Recent appearance of carbapenem resistant P. aeruginosa isolates is considered a major healthcare problem. The present study was conducted to detect class 1 integron and antibiotic susceptibility profiles of imipenem-sensitive and resistant clinical isolates of P. aeruginosa.
Materials and Methods: Antibiotic susceptibility profiles and minimum inhibitory concentration against imipenem was studied in 160 clinical isolates of P. aeruginosa by disk agar diffusion method and Etest, respectively. Detection of class 1 integron was performed by the PCR method. Demographic and microbiological data were compared between imipenem susceptible and non-susceptible isolates by the SPSS software.
Results: PCR results showed that 90 (56.3%) of P. aeruginosa isolates carried class 1 integron. Antibiotic susceptibility results revealed that 93 (58.1%) were susceptible and 67 (41.9%) were non-susceptible to imipenem. Comparison of antibiotic susceptibility patterns showed high level of drug resistance among imipenem non-susceptible isolates. We found that MDR phenotype, presence of class 1 integron and hospitalization in ICU and burn units were significantly associated with imipenem non-susceptible isolates.
Conclusion: The high frequency of imipenem resistance was seen among our P. aeruginosa isolates. Since carbapenems are considered as the last drugs used for treatment of P. aeruginosa infections, it is crucial to screen imipenem non-susceptible isolates in infection control and optimal therapy.

Orrett FA. Antimicrobial susceptibility survey of Pseudomonas aeruginosa strains isolated from clinical sources. J Natl Med Assoc 2004; 96: 1065-1069.

Kipnis E, Sawa T, Wiener-Kronish J. Targeting mechanism of Pseudomonas aeruginosa patho- genesis. Med Mal Infect 2006; 36: 78-91.

Driscoll JA, Brody SL, Kollef MH. The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections. Drugs 2007; 67: 351-368.

Siegel RE. Emerging Gram-negative antibiotic resistance: Daunting challenges, declining sensitivities and dire consequences. Respir Care 2008; 53: 471-479.

Sevillano E, Valderrey C, Canduela MJ, Umaran A, Calvo F, Gallego L. Resistance to antibiotics in clinical isolates of Pseudomonas aeruginosa. Pathol Biol (Paris) 2006; 54 (8-9): 493-497.

Falagas ME, Koletsi PK, Bliziotis IA. The diversity of definitions of multidrug-resistant (MDR) and pandrug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa. J Med Microbiol 2006; 55:1619-1629.

Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant Gram-negative bacilli. Antimicrob Agents Chemother 2008; 52: 813-821.

Fonseca EL, Vieira VV, Cipriano R, Vicente AC.Class 1 integrons in Pseudomonas aeruginosa isolates from clinical settings in Amazon region, Brazil. FEMS Immunol Med Microbiol 2005; 44: 303-309.

Carattoli A. Importance of integrons in the diffusion of resistance. Vet Res 2001; 32: 243-259.

Weldhagen GF. Integrons and β-lactamases-a novel perspective on resistance. Int J Antinicrob Agents 2004; 23: 556-562.

Severino P, Magalhães VD. The role of integrons in the dissemination of antibiotic resistance among clinical isolates of Pseudomonas aeruginosa from an intensive care unit in Brazil. Res Microbiol 2002; 153: 221-226.

Liu SY, Lin JY, Chu C, Su LH, Lin TY, Chiu CH.Integron-associated imipenem resistance in Acinetobacter baumanii isolated from a regional hospital in Taiwan. Int J Antimicrob Agents 2006; 27: 81-84.

Chen J, Su Z, Liu Y, Wang S, Dai X, Li Y, et al.

S, Carmeli Y.Multidrug-resistant Pseudomonas aeruginosa: risk factors and clinical impact. Antimicrob Agents Chemother 2006; 50: 43-48.

Nikbin VS, Abdi-Ali A, Feizabadi MM, Gharavi S. Pulsed field gel electrophoresis & plasmid profile of Pseudomonas aeruginosa at two hospitals in Tehran, Iran. Indian J Med Res 2007; 126: 146-151.

Bahar MA, Jamali S, Samadikuchaksaraei A. Imipenem-resistant Pseudomonas aeruginosa strains carry Identification and characterization of class 1 integrons among Pseudomonas aeruginosa isolates from patients metallo-β-lactamase gene bla burn hospital. Burns; 2010; VIM in a level I Iranian in Zhenjiang, China. Int J Infect Dis 2009; 13: 717-721.

Hall GS. Nonfermenting and miscellaneous Gram- negative bacilli. In: Mahon CR, Lehman DC, Manuselis G: Textbook of diagnostic microbiology, 3th ed. Ohio: Saunders – Elsevier 2007 p. 564-584.

Clinical and Laboratory Standards Institute.Performance standards for antimicrobial testing. 16th Informational Supplement. M100- S16, Wayne, PA: CLSI; 2006.

Ohara M, Kouda S, Ondera M, Fujiue Y, Sasaki M, Kohara T. Molecular characterization of imipenem- resistant Pseudomonas aeruginosa in Hiroshima, Japan. Microbiol Immunol 2007; 51: 271-277.

Jung R, Fish DN, Obritsch MD, Maclaren R.Surveillance of multi-drug resistant Pseudomonas aeruginosa in an urban tertiary-care teaching hospital. J Hosp Infect 2004; 57: 105-111.

Fraenkel CJ, Ullberg M, Bernander S, Ericson E, Larsson P, Rydberg J, et al. In vitro activities of three carbapenems against recent bacterial isolates from severely ill patients at Swedish hospitals. Scand J Infect Dis 2006; 38: 853-859.

Aloush V, Navon-Venezia S, Seigman-Igra Y, CabiliS, Carmeli Y.Multidrug-resistant Pseudomonas aeruginosa: risk factors and clinical impact. Antimicrob Agents Chemother 2006; 50: 43-48.

Nikbin VS, Abdi-Ali A, Feizabadi MM, Gharavi S.Pulsed field gel electrophoresis & plasmid profile of Pseudomonas aeruginosa at two hospitals in Tehran, Iran. Indian J Med Res 2007; 126: 146-151.

Bahar MA, Jamali S, Samadikuchaksaraei A. Imipenem-resistant Pseudomonas aeruginosa strains carry metallo-β-lactamase gene bla burn hospital. Burns; 2010;VIM in a level I Iranian 826-830.

Saderi H, Karimi Z, Owlia P, Bahar MA, Akhavi Rad SMB. Phenotypic detection of metallo-β-lactamases producing Pseudomonas aeruginosa strains isolated from burned patients. Iranian Journal of Pathology 2008; 3: 20-24.

Khosravi AD, Mihani F. Detection of metallo-β- lactamase-producing Pseudomonas aeruginosa strains isolated from burn patients in Ahwaz, Iran. Diagn Microbiol Infect Dis 2008; 60: 125-128.

Japoni A, Alborzi A, Kalani M, Nasiri J, Hayati M, Farshad S. Susceptibility patterns and cross-resistance of antibiotics against Pseudomonas aeruginosa isolated from burn patients in the South of Iran. Burns.2006; 32: 343-347.

Harris AD, Smith D, Johnson JA, Bradham DD, Roghmann MC. Risk factors for imipenem-resistant Pseudomonas aeruginosa among hospitalized patients. Clin Infect Dis 2002; 34: 340-345.

Onguru P, Erbay A, Bodur H, Baran G, Akinci E, Balaban N, et al. Imipenem-resistant Pseudomonas aeruginosa: risk factors for nosocomial infections. J Korean Med Sci 2008; 23: 982-987.

Files
IssueVol 2 No 3 (2010) QRcode
SectionArticles
Keywords
Carbapenem drug resistance Pseudomonas aeruginosa class 1 integron

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Yousefi S, Nahaei M, Farajnia S, Ghojazadeh M, Akhi M, Sharifi Y, Milani M, Ghotaslou R. Class 1 integron and Imipenem Resistance in Clinical Isolates of Pseudomonas aeruginosa: Prevalence and Antibiotic Susceptibility. Iran J Microbiol. 1;2(3):113-119.