Prevalence Of Carbapenem Resistant Pseudomonas Aeruginosa Isolated from Wound Infection and The Genes Responsible for Carbapenemase Production in Najaf Hospitals
Keywords:
Pseudomonas aeruginosa, Carbapenem Resistant genes, ESBLAbstract
Background: Pseudomonas aeruginosa is one of the most prevalent opportunistic human pathogens among Gram-negative bacteria, it is linked to nosocomial infections such as burn and wound infections. The rise of carbapenem-resistant P. aeruginosa (CRPA) is a major therapeutic challenge. The objective of the current study is to specify the frequency carbapenem resistant P. aeruginosa and the associated carbapenemase genes in P. aeruginosa isolated from wound infection
Methods: During the study period, 300 swabs were collected from patients who had wound infections. P. aeruginosa were identified using standard bacteriological and biochemical methods. The Kirby-Bauer disk diffusion method was utilized to investigate the antibiotic susceptibility of using 17 antimicrobial drugs. Multi-druge resistance(MDR) and Extensive-druge resistance (XDR) were identified using international guideline. Extended-spectrum-beta-lactamase (ESBL) production were screened using ceftazidime, ceftriaxone, cefotaxime and aztreonam antibiotics by disk diffusion method. Carbapenem resistance isolates were characterized using imipenem and/or meropenem antibiotics resistance and the double disk diffusion test was used to confirm its production. PCR analysis was conducted to identify ESBL and carbapenem resistance genes (blaCTX-M, blaTEM, blaSHV, blaOXA, blaKPC, blaIMP, bla VIM, blaSIM, bla NDM, bla GIM, bla SPM, bla OXA-48).
Results: from 300 swabs specimen P. aeruginosa isolates were identified in 40 (13.3%) specimens. Antibiotic susceptibility test revealed 13(32.5%) isolates were carbapenem resistant P. aeruginosa, and the highest resistant was to β-lactam class and cephalosporin antibiotics. The results showed 17(42.5%) of isolates were MDR and 23(57.5%) were XDR. PCR assay revealed that blaCTX-M was found in 22(55%) and blaOXA was noticed in 27 (67.5%) of P. aeruginosa isolates. Among 13 CRPA isolates, 1(7.6%) isolate had blaOXA-48, 2(15.3%) isolates had blaIMP, blaSIM and blaVIM for each, 3(23%) carry blaGIM, and 4 (30.7%) had blaNDM. While blaSPM and blaKPC were not found in any isolate.
Conclusion: wound infections showed high rate of XDR and CRPA driven by diverse carbapenem resistance genes, indicating dangerous public health concern
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