Intestinal colonization of infants with multidrug resistant Pseudomonas aeruginos in tertiary care center in Jordan

Abstract

Background: Pseudomonas.aeruginosa is among the most common opportunistic hospital pathogens, which exhibit an innate resistance and has developed increasing resistance to many useful antimicrobial agents over the last decades. This study investigated the occurrence of important types of ESBLs and MBLs in association with potential important virulence factors among P. aeruginosa isolates from feces of Jordanian infants.   Methods: A total of 302 feces samples were obtained randamely from neonates and infants admitted to Pediatric Clinic and the Neonate Intensive Care Unit (NICU)/Jordan University Hospital (JUH), over a  9-months period(2016- 2017). Fecal samples were cultured for P.aeruginosa and their growth was identified and tested using microbiological and antibiotic susceptibility methods. Additionly,  virulence factors, antimicrobial resistance genes and genotypes were detected using Polymerase Chain Reaction (PCR). Results: A total of 16/302 (5.3%) of P. aeruginosa isolates were recovered from feces samples. Antimicrobial susceptibility of the isolates ranged between the lowest 18.75% to meropenem and highest of 87.5% to azetreonam among 9 tested drugs. The percentage of specific genes of ESBLs and MBLs in 16 P.aeruginosa isolates were the following: blaOXA-50, blaTEM, blaCTX-M , blaVIM ,blaKPC , blaSHV ,blaGES, and blaVEB were detected at the rate of  13(81.2%), 13(81.2%), 12(75%), 12(75%), 11(68.7%), 10(62.5%), 2(12.5),1(6.2%), respectively. The percentage of the potential virulence genes in the same isolates were detected as follow:  lasB, algD , toxA, exo S and exo U at the rate of 100%, 87.5% , 81.2%, 81.2%,31.2, respectively. All P.aeruginosa isolates observed to develop beta-hemolysis on both human and sheep blood agar, and to produce either pyoverdin ((56.3%) or pyocyanin (43.7%).  Conclusions: The present study demonstrates high occurrence of multidrug resistant P.aeruginosa isolates in infant feces which carried high rates of important genes of ESBLs and MBLs and potential virulence factors.