Extended Spectrum B-lactamases and antimicrobial susceptibility among clinical isolates of Pseudomonas aeruginosa in the West Bank, Palestine

Abstract

Objectives: Class D oxacillinases are frequently acquired by gram negative bacteria in general and P.aeruginosa in par­ticular. P.aeruginosa is commonly implicated in causing nosocomial infections. The evolution of antibiotic resistance in P.aeruginosa and the acquisition of blaOXA genes interfere with successful treatment. Methods: A total of 49 clinical isolates of P.aeruginosa were obtained from Rafidia Hospital, West Bank, Palestine. Antimicrobial susceptibility testing of the isolates was performed by the standard disc diffusion method following the guidelines of CLSI. The prevalence of class D β-lactamases (OXA groups I, II and III) as well as the pseudomonas specific enzymes (CARB-3) were determined by PCR. Results: Susceptibility of P.aeruginosa to carbapenems was the highest 89%, and lowest to ticarcillin/clavulanic acid 70%. This study revealed that P.aeruginosa produced oxacillinase enzymes at rates of: OXA-10 (40.8%), OXA-2 (20.4%) and OXA-1 (18.4%). All ceftazidime resistant strains expressed OXA-1 and OXA-11, 18.4%. PSE group was expressed in 10.2%. Conclusions: This is the first research conducted to investigate the correlation between OXA genes (blaOXA-1, bla­OXA-2 and blaOXA-10) and antimicrobial resistance among P.aeruginosa clinical isolates in Palestine. The results ob­tained could contribute to better treatment and reduction of the evolution of resistant strains. In addition, it will provide important information regarding the geographical distribution of class D β-lactamases.

Keywords

• P.aeruginosa

Extended Spectrum B-lactamases and antimicrobial susceptibility among clinical isolates of Pseudomonas aeruginosa in the West Bank, Palestine

Öz

Amaç: D sınıfı oksasilinazlar gram negatif basiller içinde ve de özellikle P. aeruginosa kökenlerinde yaygındır. P. aeruginosa hastane enfeksiyonlarının sık nedenlerinden biridir. P. aeruginosa kökenlerinde antibiyotik direncinin ve blaOXA genlerinin kazanılması tedavi başarısını etkiler. Bu çalışmada P. aeruginosa kökenlerinde antibiyotik direnci ve blaOXA gen varlığının tedavi başarısı üzerine etkileri araştırıldı.Yöntemler: Toplam 49 klinik P. aeruginosa izolatı Filistin’de bulunan Rafidia Hastanesinden elde edildi. Antimikrobiyal duyarlılık testleri standart disk difüzyon metodu ile CLSI standartlarına göre yapıldı. D grubu β-lactamaz (OXA grop I, II ve III) sıklığı ve pseudomonasa özgün enzimlerin (CARB-3) varlığı PCR yöntemiyle araştırıldı.Bulgular: P. aeruginosa kökenlerinde en yüksek duyarlılık karbapenemlere (%89) ve en düşük duyarlılık ise tikarsilin/klavulanik aside (%70) karşı saptandı. Bu çalışmanın sonuçlarına göre; P. aeruginosa kökenlerinde OXA-10 oranı %40,8, OXA-2 %20,4 ve OXA-1 %18,4. Seftazidime dirençli kökenlerin hepsi OXA-1 taşırken %18,4’ü OXA-11 taşıyorlardı. PSE grubu salgılanması ise %10,2 idi.Sonuç: Bu çalışma Filistin’deki P. aeruginosa izolatları üzerinde yapılan ve OXA genleriyle (blaOXA-1, blaOXA-2 ve blaOXA-10 ) antimikrobiyal direnç arasındaki ilişkiyi araştıran ilk çalışmadır. Sonuçlarımız dirençli kökenlerdeki tedavi prensiplerini anlamaya yardımcı oldu ve D grubu β-laktamazların coğrafi dağılımı hakkında bilgi sahibi olmamızı sağladı

Anahtar Kelimeler

• P. aeruginosa, β-laktamaz, Duyarlılık, Oksasilinaz, blaOXA genleri

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