Resistance to Colistin and Detection of mcr-1 Gene in Multidrug-Resistant Pseudomonas Aeruginosa Isolated from Wounds of the Hospitalized Burned Patients

Document Type : Original Article(s)

Authors

1 Master of Medical Microbiology, Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The surge in antibiotic resistance, especially to colistin in multidrug-resistant Pseudomonas aeruginosa (MDR P. aeruginosa) is one of the important factors of mortality in wound infections in burn patients. The aim of this study was to investigate the prevalence of resistance to colistin as a last line treatment in MDR P. aeruginosa isolates from the wounds of hospitalized patients and for the detection mcr-1 gene.
Methods: Seventy-two P. aeruginosa isolates were obtained from Imam Musa Kazem Hospitals’ laboratories and confirmed using standard microbiological techniques. Antibiotic sensitivity was evaluated by the standard disk diffusion method against 8 antibiotics and minimum inhibitory concentration (MIC) of colistin was determined. The presence of mcr-1 gene was detected using specific primers by Polymerase chain reaction (PCR) test.
Findings: Out of 72 isolates, 50 (69.44%) were identified as MDR P. aeruginosa, with the highest resistance to Levofloxacin (98%) and Ciprofloxacin (92%) and the lowest. Resistance was to piperacillin tazobactam (40%). Only 2% of isolates showed complete resistance to all antibiotics. Colistin resistance was detected in 14% and mcr-1 gene in 2% of the isolates.
Conclusion: The resistance of P. aeruginosa to colistin (14%) among the isolates from burn infections in Isfahan and the prevalence of mcr-1 gene (2%) in this study, shows the importance of early detection of colistin resistance, following antibiotic resistance genes and avoid recommending this drug unnecessarily to control hospital infections.

Keywords

References

  1. Kanayama A, Kawahara R, Yamagishi T, Goto K, Kobaru Y, Takano M, et al. Successful control of an outbreak of GES-5 extended-spectrum β-lactamase-producing Pseudomonas aeruginosa in a long-term care facility in Japan. J Hosp Infect 2016; 93(1): 35-41.
  2. Klockgether J, Tümmler B. Recent advances in understanding Pseudomonas aeruginosa as a pathogen. F1000Res 2017; 6: 1261.
  3. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18(3): 268-81.
  4. Poirel L, Jayol A, Nordmann P. Polymyxins: antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes. Clin Microbiol Rev 2017; 30(2): 557-96.
  5. Olaitan AO, Morand S, Rolain JM. Mechanisms of polymyxin resistance: acquired and intrinsic resistance in bacteria. Front Microbiol 2014; 5: 643.
  6. Yu Z, Qin W, Lin J, Fang S, Qiu J. Antibacterial mechanisms of polymyxin and bacterial resistance. Biomed Res Int 2015; 2015: 679109.
  7. Kato A, Chen HD, Latifi T, Groisman EA. Reciprocal control between a bacterium's regulatory system and the modification status of its lipopolysaccharide. Mol Cell 2012; 47(6): 897-908.
  8. Liu YY, Wang Y, Walsh TR, Yi LX, Zhang R, Spencer J, et al. 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 2016; 16(2): 161-8.
  9. Zeng KJ, Doi Y, Patil S, Huang X, Tian GB. Emergence of the plasmid-mediated mcr-1 gene in colistin-resistant Enterobacter aerogenes and Enterobacter cloacae. Antimicrob Agents Chemother 2016; 60(6): 3862-3.
  10. Tramper-Stranders GA, Van der Ent C, Wolfs TF. Detection of pseudomonas aeruginosa in patients with cystic fibrosis. J Cyst Fibros 2005; 4(Suppl 2): 37-43.
  11. Matuschek E, Åhman J, Webster C, Kahlmeter G. Antimicrobial susceptibility testing of colistin-evaluation of seven commercial MIC products against standard broth microdilution for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp. Clin Microbiol Infect 2018; 24(8): 865-70.
  12. Satlin MJ, Lewis JS, Weinstein MP, Patel J, Humphries RM, Kahlmeter G, et al. Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing position statements on polymyxin B and colistin clinical breakpoints. Clin Infect Dis 2020; 71(9): e523-9.
  13. Abed Y, Davin A, Charrel RN, Bollet C, De Micco P. Variation of RAPD-fingerprint patterns using different DNA-extraction methods with Gram-positive bacteria. World J Microbiol Biotechnol 1995; 11(2): 238-9.
  14. Moosavian M, Emam N. The first report of emerging mobilized colistin-resistance (mcr) genes and ERIC-PCR typing in Escherichia coli and Klebsiella pneumoniae clinical isolates in southwest Iran. Infect Drug Resist 2019; 12: 1001-10.
  15. Tahmasebi H, Dehbashi S, Arabestani MR. Co-harboring of mcr-1 and β-lactamase genes in Pseudomonas aeruginosa by high-resolution melting curve analysis (HRMA): molecular typing of superbug strains in bloodstream infections (BSI). Infect Genet Evol 2020; 85: 104518.
  16. Hameed F, Khan MA, Muhammad H, Sarwar T, Bilal H, Rehman TU. Plasmid-mediated mcr-1 gene in Acinetobacter baumannii and Pseudomonas aeruginosa: first report from Pakistan. Rev Soc Bras Med Trop 2019; 52: e20190237.
  17. Manohar P, Shanthini T, Ayyanar R, Bozdogan B, Wilson A, Tamhankar AJ, et al. The distribution of carbapenem-and colistin-resistance in Gram-negative bacteria from the Tamil Nadu region in India. J Med Microbiol 2017; 66(7): 874-83.
  18. Izadi Pour Jahromi S, Mardaneh J, Sharifi A, Pezeshkpour V, Behzad-Behbahani A, Seyyedi N, et al. Occurrence of a multidrug resistant Pseudomonas aeruginosa strains in hospitalized patients in southwest of Iran: Characterization of resistance trends and virulence determinants. Jundishapur J Microbiol 2018;11(4): e57341.
  19. Abd El-Baky RM, Masoud SM, Mohamed DS, Waly NG, Shafik EA, Mohareb DA, et al. Prevalence and some possible mechanisms of colistin resistance among multidrug-resistant and extensively drug-resistant Pseudomonas aeruginosa. Infect Drug Resist 2020; 13: 323-32.
  20. Ye H, Li Y, Li Z, Gao R, Zhang H, Wen R, et al. Diversified mcr-1-harbouring plasmid reservoirs confer resistance to colistin in human gut microbiota. mBio 2016; 7(2): e00177-16.
  21. Dadashi M, Sameni F, Bostanshirin N, Yaslianifard
    S, Khosravi-Dehaghi N, Nasiri MJ, et al. Global prevalence and molecular epidemiology of mcr-mediated colistin resistance in Escherichia coli clinical isolates: A systematic review. J Glob Antimicrob Resist 2022; 29: 444-61.
Journal of Isfahan Medical School
Volume 40, Issue 686
2nd Week, November
November and December 2022
Pages 678-684

Files

History

  • Receive Date: 08 June 1401
  • Accept Date: 10 July 1401

Share

How to cite

Statistics