Molecular Analysis of Carbapenem and Aminoglycoside Resistance Genes in Carbapenem-Resistant <i>Pseudomonas aeruginosa</i> Clinical Strains: A Challenge for Tertiary Care Hospitals
Carbapenem-resistant <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) strains have become a global threat due to their remarkable capability to survive and disseminate successfully by the acquisition of resistance genes. As a result, the treatment strategies have been sev...
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| Main Authors: | , , , |
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MDPI AG,
2024-02-01T00:00:00Z.
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| Summary: | Carbapenem-resistant <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) strains have become a global threat due to their remarkable capability to survive and disseminate successfully by the acquisition of resistance genes. As a result, the treatment strategies have been severely compromised. Due to the insufficient available data regarding <i>P. aeruginosa</i> resistance from Pakistan, we aimed to investigate the resistance mechanisms of 249 <i>P. aeruginosa</i> strains by antimicrobial susceptibility testing, polymerase chain reaction for the detection of carbapenemases, aminoglycoside resistance genes, extended-spectrum beta-lactamases (ESBLs), sequence typing and plasmid typing. Furthermore, we tested silver nanoparticles (AgNPs) to evaluate their in vitro sensitivity against antimicrobial-resistant <i>P. aeruginosa</i> strains. We observed higher resistance against antimicrobials in the general surgery ward, general medicine ward and wound samples. Phenotypic carbapenemase-producer strains comprised 80.7% (201/249) with 89.0% (179/201) demonstrating genes encoding carbapenemases: <i>bla</i><sub>NDM-1</sub> (32.96%), <i>bla</i><sub>OXA48</sub> (37.43%), <i>bla</i><sub>IMP</sub> (7.26%), <i>bla</i><sub>VIM</sub> (5.03%), <i>bla</i><sub>KPC-2</sub> (1.12%), <i>bla</i><sub>NDM-1</sub>/<i>bla</i><sub>OXA48</sub> (13.97%), <i>bla</i><sub>OXA-48</sub>/<i>bla</i><sub>VIM</sub> (1.68%) and <i>bla</i><sub>VIM</sub>/<i>bla</i><sub>IMP</sub> (0.56%). Aminoglycoside-modifying enzyme genes and 16S rRNA methylase variants were detected in 43.8% (109/249) strains: <i>aac(6')-lb</i> (12.8%), <i>aac(3)-lla</i> (12.0%), <i>rmtB</i> (21.1%), <i>rmtC</i> (11.0%), <i>armA</i> (12.8%), <i>rmtD</i> (4.6%), <i>rmtF</i> (6.4%), <i>rmtB</i>/<i>aac(3)-lla</i> (8.2%), <i>rmtB</i>/<i>aac(6')-lla</i> (7.3%) and <i>rmtB/armA</i> (3.6%). In total, 43.0% (77/179) of the strains coharbored carbapenemases and aminoglycoside resistance genes with 83.1% resistant to at least 1 agent in 3 or more classes and 16.9% resistant to every class of antimicrobials tested. Thirteen sequence types (STs) were identified: ST235, ST277, ST234, ST170, ST381, ST175, ST1455, ST1963, ST313, ST207, ST664, ST357 and ST348. Plasmid replicon types IncFI, IncFII, IncA/C, IncL/M, IncN, IncX, IncR and IncFIIK and MOB types F11, F12, H121, P131 and P3 were detected. Meropenem/AgNPs and Amikacin/AgNPs showed enhanced antibacterial activity. We reported the coexistence of carbapenemases and aminoglycoside resistance genes among carbapenem-resistant <i>P. aeruginosa</i> with diverse clonal lineages from Pakistan. Furthermore, we highlighted AgNP's potential role in handling future antimicrobial resistance concerns. |
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| Item Description: | 10.3390/antibiotics13020191 2079-6382 |