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Abstract：
BACKGROUND: Hospital-acquired infections caused by multidrug-resistant Pseudomonas aeruginosa incline hospital stay and costs of treatment that resulted in an increased mortality rate. The frequency of P. aeruginosa high-risk clones producing carbapenemases was investigated in our clinical samples.
METHODS: In this cross-sectional study, 155 non-repetitive P. aeruginosa isolates were included from different medical centers of Iran. Antibiotic susceptibility testing was determined, and the presence of β-lactamases were sought by phenotypic and genotypic methods. The clonal relationship of all isolates was investigated, and multi-locus sequence typing (MLST) was used for finding the sequence types of carbapenemase-producers.
RESULTS: The agent with highest percent susceptibility rate was recorded for colistin (94.9%). MOX and FOX were found both as low as 1.95% (3/155). The most frequent narrow spectrum β-lactamase was SHV with 7.7% (12/155) followed by PER, OXA-1, and TEM with the frequency of 7.1% (11/155), 3.2% (5/155), and 1.3% (2/155), respectively. Carbapenemases were detected in 28 isolates (18%). The most frequent carbapenemase was IMP with 9% (14/155) followed by NDM, 8.4% (13/155). OXA-48 and VIM were also detected both per one isolate (0.65%). MLST of carbapenem resistant P. aeruginosa isolates revealed that ST244, ST664, ST235, and ST357 were spread in subjected clinical settings. REP-PCR uncovered high genomic diversity in our clinical setting.
CONCLUSIONS: Clonal proliferation of ST235 strain plays a key role in the propagation of MDR pattern in P. aeruginosa. Our data showed that high-risk clones has distributed in Iran, and programs are required to limit spreading of these clones.
METHODS: In this cross-sectional study, 155 non-repetitive P. aeruginosa isolates were included from different medical centers of Iran. Antibiotic susceptibility testing was determined, and the presence of β-lactamases were sought by phenotypic and genotypic methods. The clonal relationship of all isolates was investigated, and multi-locus sequence typing (MLST) was used for finding the sequence types of carbapenemase-producers.
RESULTS: The agent with highest percent susceptibility rate was recorded for colistin (94.9%). MOX and FOX were found both as low as 1.95% (3/155). The most frequent narrow spectrum β-lactamase was SHV with 7.7% (12/155) followed by PER, OXA-1, and TEM with the frequency of 7.1% (11/155), 3.2% (5/155), and 1.3% (2/155), respectively. Carbapenemases were detected in 28 isolates (18%). The most frequent carbapenemase was IMP with 9% (14/155) followed by NDM, 8.4% (13/155). OXA-48 and VIM were also detected both per one isolate (0.65%). MLST of carbapenem resistant P. aeruginosa isolates revealed that ST244, ST664, ST235, and ST357 were spread in subjected clinical settings. REP-PCR uncovered high genomic diversity in our clinical setting.
CONCLUSIONS: Clonal proliferation of ST235 strain plays a key role in the propagation of MDR pattern in P. aeruginosa. Our data showed that high-risk clones has distributed in Iran, and programs are required to limit spreading of these clones.
摘要：
背景：多重耐药铜绿假单胞菌引起的医院获得性感染增加了住院时间和治疗费用，导致死亡率增加。在我们的临床样品中研究了产生碳青霉烯酶的铜绿假单胞菌高风险克隆的频率。
方法：在这项横断面研究中，来自伊朗不同医疗中心的155种非重复性铜绿假单胞菌分离株。确定了抗生素敏感性测试，通过表型和基因型方法寻找β-内酰胺酶的存在。研究了所有分离株的克隆关系，和多位点序列分型（MLST）用于寻找碳青霉烯酶生产者的序列类型。
结果：粘菌素敏感率最高的药物（94.9%）。MOX和FOX均低至1.95%(3/155)。最常见的窄谱β-内酰胺酶是SHV，占7.7%(12/155)，其次是PER。OXA-1，TEM频率为7.1%(11/155)，3.2%(5/155)，和1.3%(2/155)，分别。在28个分离株（18％）中检测到碳青霉烯酶。最常见的碳青霉烯酶是IMP，占9％（14/155），其次是NDM，8.4%（13/155）。每个分离株也检测到OXA-48和VIM(0.65%)。耐碳青霉烯类铜绿假单胞菌分离物的MLST显示ST244、ST664、ST235和ST357在受影响的临床环境中传播。REP-PCR在我们的临床环境中揭示了高度的基因组多样性。
结论：ST235菌株的克隆增殖在铜绿假单胞菌MDR模式的传播中起关键作用。我们的数据显示，高风险克隆在伊朗分布，和程序需要限制这些克隆的传播。
方法：在这项横断面研究中，来自伊朗不同医疗中心的155种非重复性铜绿假单胞菌分离株。确定了抗生素敏感性测试，通过表型和基因型方法寻找β-内酰胺酶的存在。研究了所有分离株的克隆关系，和多位点序列分型（MLST）用于寻找碳青霉烯酶生产者的序列类型。
结果：粘菌素敏感率最高的药物（94.9%）。MOX和FOX均低至1.95%(3/155)。最常见的窄谱β-内酰胺酶是SHV，占7.7%(12/155)，其次是PER。OXA-1，TEM频率为7.1%(11/155)，3.2%(5/155)，和1.3%(2/155)，分别。在28个分离株（18％）中检测到碳青霉烯酶。最常见的碳青霉烯酶是IMP，占9％（14/155），其次是NDM，8.4%（13/155）。每个分离株也检测到OXA-48和VIM(0.65%)。耐碳青霉烯类铜绿假单胞菌分离物的MLST显示ST244、ST664、ST235和ST357在受影响的临床环境中传播。REP-PCR在我们的临床环境中揭示了高度的基因组多样性。
结论：ST235菌株的克隆增殖在铜绿假单胞菌MDR模式的传播中起关键作用。我们的数据显示，高风险克隆在伊朗分布，和程序需要限制这些克隆的传播。
