背景:铜绿假单胞菌是医院感染的常见原因。然而,多重耐药菌株的出现使铜绿假单胞菌感染的治疗复杂化。虽然多粘菌素一直是治疗的支柱,对这些抗生素的耐药性在全球范围内增加。因此,我们的研究旨在确定2019年6月至2023年5月期间收集的铜绿假单胞菌临床分离株中粘菌素耐药的患病率和分子细节,以及粘菌素耐药铜绿假单胞菌分离株的遗传连锁.
结果:铜绿假单胞菌对粘菌素的耐药率为9%(n=18)。所有18种粘菌素抗性分离株都是生物膜生产者,并携带与生物膜形成相关的基因。此外,编码外排泵的基因的存在,TCS,在所有耐粘菌素铜绿假单胞菌菌株中观察到外膜孔蛋白,而未检测到mcr-1基因。仅在多药和粘菌素抗性菌株的PmrB蛋白中鉴定出氨基酸取代。mexA的表达水平,mexC,mexE,mexy,phoP,18株耐粘菌素铜绿假单胞菌中pmrA基因如下:88.8%,94.4%,11.1%,83.3%,83.3%,38.8%,分别。此外,在44.4%的耐粘菌素铜绿假单胞菌菌株中观察到oprD基因下调。
结论:本研究报告了Ardabil医院铜绿假单胞菌菌株中粘菌素耐药的各种机制。我们建议避免不必要的使用粘菌素,以防止未来粘菌素耐药性的潜在增加。
BACKGROUND: Pseudomonas aeruginosa is a common cause of nosocomial infections. However, the emergence of multidrug-resistant strains has complicated the treatment of P. aeruginosa infections. While polymyxins have been the mainstay for treatment, there is a global increase in resistance to these antibiotics. Therefore, our
study aimed to determine the prevalence and molecular details of colistin resistance in P. aeruginosa clinical isolates collected between June 2019 and May 2023, as well as the genetic linkage of colistin-resistant P. aeruginosa isolates.
RESULTS: The resistance rate to colistin was 9% (n = 18) among P. aeruginosa isolates. All 18 colistin-resistant isolates were biofilm producers and carried genes associated with biofilm formation. Furthermore, the presence of genes encoding efflux pumps, TCSs, and outer membrane porin was observed in all colistin-resistant P. aeruginosa strains, while the mcr-1 gene was not detected. Amino acid substitutions were identified only in the PmrB protein of multidrug- and colistin-resistant strains. The expression levels of mexA, mexC, mexE, mexY, phoP, and pmrA genes in the 18 colistin-resistant P. aeruginosa strains were as follows: 88.8%, 94.4%, 11.1%, 83.3%, 83.3%, and 38.8%, respectively. Additionally, down-regulation of the oprD gene was observed in 44.4% of colistin-resistant P. aeruginosa strains.
CONCLUSIONS: This
study reports the emergence of colistin resistance with various mechanisms among P. aeruginosa strains in Ardabil hospitals. We recommend avoiding unnecessary use of colistin to prevent potential future increases in colistin resistance.