High Prevalence of GES-5 Variant and Co-Expression of VIM-2 and GES-45 among Clinical <i>Pseudomonas aeruginosa</i> Strains in Tunisia

• Main Authors: Meha Fethi (Author), Beatriz Rojo-Bezares (Author), Ameni Arfaoui (Author), Raoudha Dziri (Author), Gabriela Chichón (Author), Farouk Barguellil (Author), María López (Author), Mohamed Selim El Asli (Author), Paula Toledano (Author), Hadda-Imen Ouzari (Author), Yolanda Sáenz (Author), Naouel Klibi (Author)
• Format: Book
• Published: MDPI AG, 2023-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Carbapenem-resistant <i>Pseudomonas aeruginosa</i> (CRPA) are a global health concern. The antimicrobial resistance, virulence, and molecular typing of 57 CRPA isolated from 43 patients who attended a specific Tunisian hospital from September 2018 to July 2019 were analyzed. All but one were multidrug-resistant CRPA, and 77% were difficult-to-treat-resistant (DTR) isolates. The <i>bla</i>_VIM-2 gene was detected in four strains (6.9%), and among the 36 <i>bla</i>_GES-positive CRPA (62%), the <i>bla</i>_GES-5 gene was the predominant variant (86%). Three strains co-harbored the <i>bla</i>_VIM-2 and <i>bla</i>_GES-45 genes, and seven CRPA carried the <i>bla</i>_SHV-2a gene (14%). OprD alterations, including truncations by insertion sequences, were observed in 18 strains. Regarding the 46 class 1 integron-positive CRPA (81%), the <i>bla</i>_GES-5 gene was located in integron In717, while the <i>bla</i>_GES-29 and <i>bla</i>_GES-45 genes were found in two new integrons (In2122 and In4879), and the <i>bla</i>_VIM-2 gene was found in In1183 and the new integron In2142. Twenty-four PFGE patterns and thirteen sequence types (three new ones) were identified. The predominant serotype O:11 and <i>exoU</i> (81%) were mostly associated with ST235 and the new ST3385 clones. The seven <i>bla</i>_SHV-2a-CRPA from different patients belonged to ST3385 and the same PFGE pattern. The <i>bla</i>_GES-5- and <i>bla</i>_VIM-2 + <i>bla</i>_GES-45-positive CRPA recovered mostly from ICU patients belonged to the high-risk clone ST235. Our results highlight the alarming prevalence of <i>bla</i>_GES-5- and ST235-CRPA, the co-existence of <i>bla</i>_GES-45 and <i>bla</i>_VIM-2, and their location within integrons favoring their dissemination.

Item Description

10.3390/antibiotics12091394
2079-6382