Relation Between Resistance to Antipseudomonal β-Lactams and AmpC and MexC Genes of Pseudomonas Aeruginosa

Overview

Journal Iran J Pathol

Date 2016 Feb 13

PMID 26870143

Citations 1

Authors

Fatemeh Rezaei

Horieh Saderi

Shahrsam Boroumandi

Soghrat Faghihzadeh

Affiliations

Soon will be listed here.

Abstract

Background: In order to select a better antibiotic choice for treatment of Pseudomonas aeruginosa infections, this study was conducted to determine the frequency of resistance to some antipseudomonal β-lactams in P. aeruginosa isolates from patients in Tehran, Iran. In addition, the relation between presence of genes known to be responsible for resistance to β-lactams (ampC, mexC 1,2, and mexC 3,4 genes) and resistance phenotype among P. aeroginosa isolates was evaluated.

Methods: P. aeruginosa strains were isolated and identified by routine methods and PCR for oprL gene. Disk diffusion method was employed to determine the antimicrobial susceptibility pattern according to CLSI recommendations. PCR was used to detect the resistance genes.

Results: Among 100 isolates of P. aeruginosa, 82% had ampC, 86% mexC 1,2 and 89% mexC 3,4 genes and combinations of these genes were seen in most of isolates and only 3% of isolates had none of these genes. Resistance to mezlocillin, cefepime, ceftazidime and piperacillin/ tazobactam was seen in 46%, 41%, 36% and 29% of isolates, respectively. Significant relation (P value ≤0.05 by Chi-square or Fisher Exact test) was observed between the presence of ampC gene and resistance to all the studied β-lactams in this study. No relation was observed for mexC genes, although many of isolates containing these two genes were phenotypically resistant.

Discussion: This study had shown for the first time, the presence of ampC and mexC genes in significant percent of clinical isolates of P. aeruginosa in Tehran, Iran, and relation between presence of ampC gene and resistance to β-lactams.

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References

Ranjbar R, Owlia P, Saderi H, Mansouri S, Jonaidi-Jafari N, Izadi M . Characterization of Pseudomonas aeruginosa strains isolated from burned patients hospitalized in a major burn center in Tehran, Iran. Acta Med Iran. 2011; 49(10):675-9. View

Ma D, Cook D, Hearst J, Nikaido H . Efflux pumps and drug resistance in gram-negative bacteria. Trends Microbiol. 1994; 2(12):489-93. DOI: 10.1016/0966-842x(94)90654-8. View

Hancock R, Speert D . Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and impact on treatment. Drug Resist Updat. 2001; 3(4):247-255. DOI: 10.1054/drup.2000.0152. View

Ozer B, Duran N, Onlen Y, Savas L . Efflux pump genes and antimicrobial resistance of Pseudomonas aeruginosa strains isolated from lower respiratory tract infections acquired in an intensive care unit. J Antibiot (Tokyo). 2011; 65(1):9-13. DOI: 10.1038/ja.2011.102. View

Strateva T, Yordanov D . Pseudomonas aeruginosa - a phenomenon of bacterial resistance. J Med Microbiol. 2009; 58(Pt 9):1133-1148. DOI: 10.1099/jmm.0.009142-0. View

Shahcheraghi F, Badmasti F, Feizabadi M . Molecular characterization of class 1 integrons in MDR Pseudomonas aeruginosa isolated from clinical settings in Iran, Tehran. FEMS Immunol Med Microbiol. 2009; 58(3):421-5. DOI: 10.1111/j.1574-695X.2009.00636.x. View

Lambert P . Mechanisms of antibiotic resistance in Pseudomonas aeruginosa. J R Soc Med. 2002; 95 Suppl 41:22-6. PMC: 1308633. View

Narita S, Eda S, Yoshihara E, Nakae T . Linkage of the efflux-pump expression level with substrate extrusion rate in the MexAB-OprM efflux pump of Pseudomonas aeruginosa. Biochem Biophys Res Commun. 2003; 308(4):922-6. DOI: 10.1016/s0006-291x(03)01512-2. View

Morita Y, Komori Y, Mima T, Kuroda T, Mizushima T, Tsuchiya T . Construction of a series of mutants lacking all of the four major mex operons for multidrug efflux pumps or possessing each one of the operons from Pseudomonas aeruginosa PAO1: MexCD-OprJ is an inducible pump. FEMS Microbiol Lett. 2001; 202(1):139-43. DOI: 10.1111/j.1574-6968.2001.tb10794.x. View

10.

Morales E, Cots F, Sala M, Comas M, Belvis F, Riu M . Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. BMC Health Serv Res. 2012; 12:122. PMC: 3412693. DOI: 10.1186/1472-6963-12-122. View

11.

De Vos D, Lim Jr A, Pirnay J, Struelens M, Vandenvelde C, Duinslaeger L . Direct detection and identification of Pseudomonas aeruginosa in clinical samples such as skin biopsy specimens and expectorations by multiplex PCR based on two outer membrane lipoprotein genes, oprI and oprL. J Clin Microbiol. 1997; 35(6):1295-9. PMC: 229737. DOI: 10.1128/jcm.35.6.1295-1299.1997. View

12.

Aghazadeh M, Hojabri Z, Mahdian R, Nahaei M, Rahmati M, Hojabri T . Role of efflux pumps: MexAB-OprM and MexXY(-OprA), AmpC cephalosporinase and OprD porin in non-metallo-β-lactamase producing Pseudomonas aeruginosa isolated from cystic fibrosis and burn patients. Infect Genet Evol. 2014; 24:187-92. DOI: 10.1016/j.meegid.2014.03.018. View

13.

Tohidpour A, Najar Peerayeh S, Mehrabadi J, Yazdi H . Determination of the efflux pump-mediated resistance prevalence in Pseudomonas aeruginosa, using an efflux pump inhibitor. Curr Microbiol. 2009; 59(3):352-5. DOI: 10.1007/s00284-009-9444-5. View

14.

Johnson J, Church G . Alignment and structure prediction of divergent protein families: periplasmic and outer membrane proteins of bacterial efflux pumps. J Mol Biol. 1999; 287(3):695-715. DOI: 10.1006/jmbi.1999.2630. View

15.

Phillips I . Identification of Pseudomonas aeruginosa in the clinical laboratory. J Med Microbiol. 1969; 2(1):9-16. DOI: 10.1099/00222615-2-1-9. View

16.

Yetkin G, Otlu B, Cicek A, Kuzucu C, Durmaz R . Clinical, microbiologic, and epidemiologic characteristics of Pseudomonas aeruginosa infections in a University Hospital, Malatya, Turkey. Am J Infect Control. 2006; 34(4):188-92. DOI: 10.1016/j.ajic.2005.11.010. View

17.

Piddock L . Clinically relevant chromosomally encoded multidrug resistance efflux pumps in bacteria. Clin Microbiol Rev. 2006; 19(2):382-402. PMC: 1471989. DOI: 10.1128/CMR.19.2.382-402.2006. View

18.

Japoni A, Alborzi A, Kalani M, Nasiri J, Hayati M, Farshad S . Susceptibility patterns and cross-resistance of antibiotics against Pseudomonas aeruginosa isolated from burn patients in the South of Iran. Burns. 2006; 32(3):343-7. DOI: 10.1016/j.burns.2005.10.017. View

19.

Conejo M, Martinez-Martinez L, Garcia I, Picabea L, Pascual A . Effect of siliconized latex urinary catheters on the activity of carbapenems against Pseudomonas aeruginosa strains with defined mutations in ampC, oprD, and genes coding for efflux systems. Int J Antimicrob Agents. 2003; 22(2):122-7. DOI: 10.1016/s0924-8579(03)00119-5. View

20.

Croft A, DAntoni A, Terzulli S . Update on the antibacterial resistance crisis. Med Sci Monit. 2007; 13(6):RA103-18. View