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. 2022 May;49(5):3811-3822.
doi: 10.1007/s11033-022-07225-3. Epub 2022 Feb 15.

Antibiotic resistance, biofilm production ability and genetic diversity of carbapenem-resistant Pseudomonas aeruginosa strains isolated from nosocomial infections in southwestern Iran

Reza Heidari  1   2 , Ahmad Farajzadeh Sheikh  3   4 , Mohammad Hashemzadeh  1   2 , Zahra Farshadzadeh  1   2 , Shokrollah Salmanzadeh  2   5 , Morteza Saki  1   2
Affiliations

Antibiotic resistance, biofilm production ability and genetic diversity of carbapenem-resistant Pseudomonas aeruginosa strains isolated from nosocomial infections in southwestern Iran

Reza Heidari et al. Mol Biol Rep. 2022 May.

Abstract

Background: This study was aimed to evaluate the antibiotic resistance, biofilm formation, and genetic diversity of carbapenem-resistant Pseudomonas aeruginosa (CRPA) strains isolated from four types of nosocomial infections (NIs) including urinary tract infection (UTI), ventilator-associated pneumonia (VAP), surgical site infection (SSI), and bloodstream infection (BSI).

Methods and results: In total, 115 isolates of NIs-causing P. aeruginosa were collected from NIs. Antibiotic susceptibility testing (AST) was performed using disk diffusion method and minimum inhibitory concentrations. Biofilm formation was tested on 96-well polystyrene microtiter plates (MTP). CRPA isolates were genotyped using multiple-locus variable number of tandem repeat analysis (MLVA). The most resistance and susceptibility rates were observed to amikacin (70.6%) and colistin (96.1%), respectively. Colistin and meropenem were the most active antimicrobial agents in VAP, SSI, and BSI. While, colistin and cefepime were the most active in UTIs. In total, 52.2% (n = 60/115) of P. aeruginosa isolates were carbapenem resistant, of which 95.0%, 55.0%, and 5.0% were multidrug-resistant, extensively drug-resistant, and pandrug-resistant, respectively. There was a significant association between resistance to carbapenem and resistance to other antibiotics except for piperacillin/tazobactam. The biofilm production of CRPA isolates was 95.0%, of which 23.3% were strong biofilm producers. Based on MLVA, there were 34 different types of CRPA isolates classified into three main clusters and 5 sub clusters.

Conclusion: The association of CRPA with other antibiotic resistance, the high rates of biofilm production, and the high genetic diversity of the isolates may be a warning of the need for a careful surveillance program.

Keywords: Antibiotic resistance; Biofilm; MLVA; Nosocomial infections; Pseudomonas aeruginosa.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Clustering analysis of MLVA results of Carbapenem-resistant Pseudomonas aeruginosa isolates using UPGMA algorithm. bl blood, ba broncho alveolar lavage, ca catheter, bs burns, wd wound, ur urine, tr tracheal
Fig. 2
Fig. 2
Minimum spanning tree of the MLVA results of Carbapenem-resistant Pseudomonas aeruginosa isolates. bl blood, ba broncho alveolar lavage, ca catheter, bs burns, wd wound, ur urine, tr tracheal
See this image and copyright information in PMC

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