Investigation of Carbapenemase-Producing Pseudomonas aeruginosa at Secondary Care Hospital in Bolu, Turkey.

IF 2.3 4区 医学 Q3 INFECTIOUS DISEASES
Zuhal Kalaycı Çekin, Elif Seren Tanrıverdi, Barış Otlu
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Abstract

The global increase in carbapenem resistance poses a significant public health threat due to the potential emergence of multidrug-resistant pathogens and limited treatment options. To learn more about this issue and offer potential solutions, we conducted a study of carbapenem-resistant Pseudomonas aeruginosa (CRPA) infections in a secondary care hospital setting. The study utilized the carbapenem inactivation method (CIM), a leading phenotypic analysis, to determine carbapenemase activity in 63 CRPA isolates. Additionally, polymerase chain reaction (PCR) analysis was conducted to test for the presence of carbapenemase genes associated with the production or expression of various carbapenemase enzymes, including blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP, and blaGES. Arbitrary primed PCR (AP-PCR) was performed to assess the clonal relationship between different isolates. The isolates were also classified as either health care-associated infections or community-acquired infections, and their clonal relationship and gene positivity were evaluated. A total of 63 CRPA samples underwent evaluation, with 14 isolates determined to be carbapenemase producers via CIM tests. PCR assays revealed that 14 isolates carried carbapenemase genes, with 9 carrying blaNDM, 2 carrying blaGES, 2 carrying blaVIM, and 1 carrying blaIMP. CRPA exhibited a 22% prevalence of carbapenemase genes, of which 64% were attributed to the NDM gene responsible for multidrug resistance. AP-PCR revealed high clonal diversity among the isolates. Molecular epidemiological evaluation also showed no dominant outbreak strain among PA isolates. This study presents significant data on the prevalence and distribution of carbapenemase-producing CRPA strains isolated from secondary health care facilities. Typically, the literature focuses on resistance rates in tertiary care public hospitals. These findings may aid in understanding resistance and its mechanisms, as well as in developing effective treatment strategies and infection control measures.

土耳其博卢二级医院铜绿假单胞菌碳青霉烯酶产生情况调查。
由于可能出现耐多药病原体和治疗方案有限,全球碳青霉烯类耐药性的增加对公共卫生构成了重大威胁。为了进一步了解这一问题并提供潜在的解决方案,我们对二级医院环境中的耐碳青霉烯类铜绿假单胞菌(CRPA)感染进行了研究。该研究利用碳青霉烯灭活法(CIM)--一种领先的表型分析方法--确定了 63 个 CRPA 分离物的碳青霉烯酶活性。此外,还进行了聚合酶链反应(PCR)分析,以检测是否存在与生产或表达各种碳青霉烯酶相关的碳青霉烯酶基因,包括 blaKPC、blaNDM、blaVIM、blaOXA-48、blaIMP 和 blaGES。进行了任意引物 PCR(AP-PCR),以评估不同分离物之间的克隆关系。这些分离物还被分为医疗相关感染或社区获得性感染,并对其克隆关系和基因阳性率进行了评估。共有 63 份 CRPA 样本接受了评估,其中 14 个分离物通过 CIM 测试被确定为碳青霉烯酶生产者。PCR 检测显示,14 个分离株携带碳青霉烯酶基因,其中 9 个携带 blaNDM、2 个携带 blaGES、2 个携带 blaVIM、1 个携带 blaIMP。CRPA显示碳青霉烯酶基因的流行率为22%,其中64%归因于具有多药耐药性的NDM基因。AP-PCR 显示分离株之间存在高度克隆多样性。分子流行病学评估还显示,在 PA 分离物中没有优势爆发菌株。这项研究提供了从二级医疗机构分离出的产碳青霉烯酶 CRPA 菌株的流行率和分布情况的重要数据。通常,文献主要关注三级公立医院的耐药率。这些发现可能有助于了解耐药性及其机制,以及制定有效的治疗策略和感染控制措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Microbial drug resistance
Microbial drug resistance 医学-传染病学
CiteScore
6.00
自引率
3.80%
发文量
118
审稿时长
6-12 weeks
期刊介绍: Microbial Drug Resistance (MDR) is an international, peer-reviewed journal that covers the global spread and threat of multi-drug resistant clones of major pathogens that are widely documented in hospitals and the scientific community. The Journal addresses the serious challenges of trying to decipher the molecular mechanisms of drug resistance. MDR provides a multidisciplinary forum for peer-reviewed original publications as well as topical reviews and special reports. MDR coverage includes: Molecular biology of resistance mechanisms Virulence genes and disease Molecular epidemiology Drug design Infection control.
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