Evaluation and Molecular Characterization of Colistin-Resistant Isolates of Pseudomonas aeruginosa and Klebsiella pneumoniae from the Infected Wounds of Hospitalized Patients
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
This study was planned to determine the colistin-resistant (CR) gene distribution among two species of gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae. In total, 50 isolates of K. pneumoniae (14 isolates, 28%) and P. aeruginosa (36 isolates, 72%) were isolated between August 2023 and October 2023 from clinical wound samples at Jinnah Hospital and Lahore General Hospital Lahore, Pakistan. To determine the resistance genes linked to CR and assess antimicrobial susceptibility, all isolates were kept at -80°C in 15% glycerol broth. Using the right primer sets, a polymerase chain reaction (PCR) was utilized to identify the CR-associated mcr-1 gene of the gramnegative isolates. Out of 50, 40 isolates (80%) showed resistance against colistin with MICs of 8 and 128 μg/ml. The majority (97%) of P. aeruginosa CR strains were considered multidrug resistant (MDR). All K. pneumoniae isolates were resistant to cefepime, cotrimoxazole, ceftriaxone, and imipenem. The clinical CR isolates of P. aeruginosa were highly resistant to ceftriaxone, imipenem, cefepime, cotrimoxazole, ciprofloxacin, amikacin, and piperacillin/tazobactum. The antibiotic resistance pattern was terrifyingly high among both bacterial species. According to the PCR results, CR was prevalent among the gram-negative samples, and the mcr-1 gene was positive in 6/40 (15%) of the CR isolates, including four P. aeruginosa and two K. pneumoniae strains. The high CR (80%) reported in this research is cause for concern and underscores an urgent need to use colistin in a limited and logical manner, similar to other antibiotics.
Abstract
This study was planned to determine the colistin-resistant (CR) gene distribution among two species of gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae. In total, 50 isolates of K. pneumoniae (14 isolates, 28%) and P. aeruginosa (36 isolates, 72%) were isolated between August 2023 and October 2023 from clinical wound samples at Jinnah Hospital and Lahore General Hospital Lahore, Pakistan. To determine the resistance genes linked to CR and assess antimicrobial susceptibility, all isolates were kept at -80°C in 15% glycerol broth. Using the right primer sets, a polymerase chain reaction (PCR) was utilized to identify the CR-associated mcr-1 gene of the gramnegative isolates. Out of 50, 40 isolates (80%) showed resistance against colistin with MICs of 8 and 128 μg/ml. The majority (97%) of P. aeruginosa CR strains were considered multidrug resistant (MDR). All K. pneumoniae isolates were resistant to cefepime, cotrimoxazole, ceftriaxone, and imipenem. The clinical CR isolates of P. aeruginosa were highly resistant to ceftriaxone, imipenem, cefepime, cotrimoxazole, ciprofloxacin, amikacin, and piperacillin/tazobactum. The antibiotic resistance pattern was terrifyingly high among both bacterial species. According to the PCR results, CR was prevalent among the gram-negative samples, and the mcr-1 gene was positive in 6/40 (15%) of the CR isolates, including four P. aeruginosa and two K. pneumoniae strains. The high CR (80%) reported in this research is cause for concern and underscores an urgent need to use colistin in a limited and logical manner, similar to other antibiotics.
참고문헌 (34)
- Nation RL, "Colistin : the re-emerging antibiotic for multidrugresistant gram-negative bacterial infections", Lancet Infect. Dis, 6, pp.589~601 (2006)
- Global Antimicrobial Resistance Surveil- lance System (GLASS) report: early implementation 2016–2017, "World Health Organization (WHO)", WHO, ~ (2018)
- Tang SS, "Mechanisms of β-lactam antimicrobial resistance and epidemiology of major community- and healthcare-associated multidrug-resistant bacteria", Adv. Drug Deliv. Rev, 78, pp.3~13 (2014)
- Falagas ME, "Colistin : the revival of polymyxins for the management of multidrug-resistant Gramnegative bacterial infections", Clin. Infect. Dis, 40, pp.1333~1341 (2005)
- Kumar A, "Inhibitory interaction and pharmacological analyses of berries phenolics against Listeria monocytogenes virulent protein internalin B", World J. Tradit. Chin. Med, 9, pp.71~80 (2023)
- Gregoire N, "Clinical pharmacokinetics and pharmacodynamics of colistin", Clin. Pharmacokinet, 56, pp.1441~1460 (2017)
- Kanazawa K, "Contribution of each amino acid residue in polymyxin B(3)to antimicrobial and lipopolysaccharide-binding activity", Chem. Pharm. Bull, 57, pp.240~244 (2009)
- Kempf I, "What do we know about resistance to Colistin in Enterobacteriaceae in avian and pig production in Europe?", Int. J. Antimicrob Agents, 42, pp.379~383 (2013)
- Gunn JS, "The Salmonella PmrAB regulon : lipopolysaccharide modifications, antimicrobial peptide resistance and more", Trends Microbiol, 6, pp.284~290 (2008)
- Cannatelli A, "In vivo emergence of Colistin resistance in Klebsiella pneumoniae producing KPC-type carbapenemases mediated by insertional inactivation of the PhoQ", PhoP mgrB regulator, 2013, pp.57, 5521~5526
- Liu Y-Y, "Emergence of plasmid-mediated Colistin resistance mechanism MCR-1 in animals and human beings in China : a microbiological and molecular biological study", Lancet Infect. Dis, 16, pp.161~168 (2016)
- Zurfuh K, "Occurrence of the plasmid-borne mcr-1Colistin resistance gene in extended-spectrum β-lactamase-producing Enterobacteriaceae in river water and imported vegetable samples in Switzerland", Antimicrob. Agents Chemother, 60, pp.2594~2595 (2016)
- Malhotra-Kumar S, "Colistin-resistant Escherichia coli harbouring mcr-1 isolated from food animals in Hanoi, Vietnam", Lancet Infect. Dis, 16, pp.286~287 (2016)
- "M100 Performance Standards for Antimicrobial Susceptibility Testing 30th ed. An Informational Supplement"[URL]
- Sherry N, "Emerging Gram-negative resistance to last-line antimicrobial agents fosfomycin, Colistin and ceftazidime avibactam-epidemiology, laboratory detection and treatment implications", Expert Rev. Anti Infect. Ther, 16, pp.289~306 (2018)
- Talbot GH, "Bad bugs need drugs : an update on the development pipeline from the antimicrobial availability task force of the infectious disease’s society of America", Clin. Infect. Dis, 42, pp.657~668 (2006)
- Xavier BB, "Identification of a novel plasmid-mediated colistin-resistance gene, mcr2, in Escherichia coli, Belgium", Euro. Surveill, 21, pp.130~280 (2016)
- Di Pilato V, "MCR-1.2, a new mcr variant carried on a transferable plasmid from a colistin-resistant KPC carbapenemase-producing Klebsiella pneumoniae strain of sequence type 512", Antimicrob. Agents Chemother, 60, pp.5612~2615 (2016)
- Yang YQ, "Colistin resistance gene mcr-1 and its variant in Escherichia coli isolates from chickens in China", Antimicrob Agents Chemother, 61, pp.e01204~e01205 (2017)
- Bilal H, "Detection of mcr-1 gene in extended-spectrum β-lactamaseproducing Klebsiella pneumoniae from human urine samples in Pakistan", Jundishapur. J. Microbiol, 13, pp.236~376 (2020)
- Cheesebrough M, "District laboratory practice in tropical countries", pp.30~71 (2006), Cambridge University Press
- Magiorakos AP, "Multidrug-resistant, extensively drugresistant and pandrug-resistant bacteria : an international expert proposal for interim standard definitions for acquired resistance", Clin. Microb. Infect, 18, pp.268~281 (2011)
- Zubair KU, "Frequency of urinary tract infection and antibiotic sensitivity of uropathogens in patients with diabetes", Pak J. Med. Sci, 35, pp.1664~1899 (2019)
- Liu J, "Clinical factors affecting platelet growth in the treatment of aplastic anemia by tonifying kidney and generating blood", World J. Tradit. Chin. Med, 9, pp.438~446 (2023)
- Liu Y, "Emergence of plasmid-mediated colistin resistance mechanism MCR-1in animals and human beings in China : a microbiological and molecular biological study", Lancet Infect. Dis, 16, pp.161~168 (2016)
- Wang J, "Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa isolates from Chinese hospitals", Int. J. Antimicrob. Agents Chemother, 35, pp.486~491 (2021)
- Peirano G, "Extended-spectrum β-lactamase-producing Enterobacterales : update on molecular epidemiology and treatment options", Drugs, 82, pp.1477~1494 (2022)
- Li R, "Occurrence of plasmid-mediated colistin resistance gene mcr-1 in clinical isolates of Klebsiella pneumoniae from China", Antimicrob. Agents Chemother, 65, pp.89~150 (2021)
- Mendes RE, "First report of mcr-1-mediated colistin resistance in Pseudomonas aeruginosa isolates from South America", Antimicrob. Agents Chemother, 67, pp.45~52 (2023)
- Surveillance of antimicrobial resistance in Europe – Annual report of the European Antimicrobial Resistance Surveillance Network (EARS-Net), "European Centre for Disease Prevention and Control (ECDC)", ECDC, ~ (2022)
- Liu YY, "Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China : a microbiological and molecular biological study", Lancet Infect. Dis, 16, pp.161~168 (2016)
- Poirel L, "Polymyxins : antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes", Clin. Microbiol. Rev, 30, pp.557~596 (2017)
- Mohamed Abd El-Gawad El-Sayed Ahmed, "Colistin and its role in the Era of antibiotic resistance : an extended review(2000-2019)", Emerg. Microbes Infect, 9, pp.868~885 (2020)
- Li XY, "Mechanism of Mingjing granules in treating wet age-related macular degeneration based on network pharmacology and experimental verification", World J. Tradit. Chin. Med, 10, pp.22~32 (2024)
