Epidemiology of carbapenem non-susceptible Pseudomonas aeruginosa isolates in Eastern Algeria

Antimicrobial Resistance and Infection Control

Samah Meradji²  Abouddihaj Barguigua¹  Khalid Zerouali¹  Dekhil Mazouz⁴  Houria Chettibi²  Naima Elmdaghri³  Mohammed Timinouni³ 

[1] Microbiology Laboratory, Faculty of Medicine and Pharmacy, 1 Street Hospital, Casablanca, 20360, Morocco

[2] Department of Biology, Biochemstry and Applied Microbiology Laboratory, Badji Mokhtar Faculty of sciences, Annaba University, Sidi Amar, Annaba, 23000, Algeria

[3] Molecular Bacteriology Laboratory, Pasteur Institute of Morocco, 1, Place Louis Pasteur, Casablanca,, 20360, Morocco

[4] Microbiology Laboratory, University Hospital Ibn Rochd, Annaba, 23000, Algeria

关键词: Carbapenem resistance;    Risk factors;    Prevalence;    Pseudomonas aeruginosa;   

Others  :  1220722
DOI  :  10.1186/s13756-015-0067-2

 received in 2015-02-23, accepted in 2015-06-04,  发布年份 2015

【 摘 要 】

Background

Carbapenem resistance among Pseudomonas aeruginosa has become a serious life-threatening problem due to the limited therapeutic options. In this study, we investigated the prevalence and the molecular epidemiology of carbapenem resistant Pseudomonas aeruginosa (CRPA) isolated from three hospitals in Annaba city, Algeria.

Methods

During the study period (January, 2012 to December, 2013), all patients infected by P. aeruginosa were considered as the potential study population. Antibiotic susceptibility testing was performed as recommended by the CLSI. Screening of carbapenemase producer isolates was performed by using imipenem-EDTA double-disk synergy test and modified Hodge test. CRPA isolates were tested for the presence of genes encoding β-lactamases, plasmid mediated quinolone resistance, aminoglycoside resistance and class 1 integrons were investigated by PCR and sequencing. The clonal relatedness among CRPA isolates was analyzed by pulsed-field gel electrophoresis method. The clinical data were collected to identify risk factors for CRPA carriage of P. aeruginosa infection.

Results

The overall prevalence of CRPA was 18.75 %. The risk factors for carrying CRPA were the length of hospital stay (p = 0.04), co-infections with Staphylococcus aureus (p = 0.01), and the use of urinary catheter (p = 0.03). The in-hospital mortality rate among case patients was 13.33 % compared with 1.53 % for control patients (p = 0.09). All CRPA isolates were multidrug resistance and the most effective antibiotic against CRPA isolates was amikacin and colistin. PFGE revealed an epidemic clonal dissemination of CRPA isolates. None of CRPA isolated were found to be carbapenemase-producers. The bla_PSE-1 and aac(3)-II gene was detected in two and five strains respectively. The class1 integrons were detected in 2 isolates with the presence of aadA7 gene cassette in these integrons.

Conclusion

The endemic clonal dissemination and multi-drug resistance of CRPA isolates in our institution is highly alarming. Strict measure will be required to control the further spread of these pathogens in hospital setting.

【 授权许可】

   
2015 Meradji et al.

【 图 表 】

Fig. 1.

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