Prevalence of different virulence factors and their association with antimicrobial resistance among Pseudomonas aeruginosa clinical isolates from Egypt

BMC Microbiology

Research

Eva A. Edward¹  Marwa R. El Shehawy¹  Elsayed Aboulmagd²  Alaa Abouelfetouh³ 

[1] Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt;Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt;College of Pharmacy, Arab Academy for Science, Technology and Maritime, Alamein Branch, Alamein, Egypt;Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt;Department of Microbiology and Immunology, Faculty of Pharmacy, Alamein International University, Alamein, Egypt;

关键词: Multi-drug resistance;    Virulence genes;    Ambroxol;    Biofilm inhibition;    Alginate;    Quantitative reverse transcriptase polymerase chain reaction;   

DOI  :  10.1186/s12866-023-02897-8

 received in 2022-11-16, accepted in 2023-05-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEmergence of multi-drug resistant Pseudomonas aeruginosa, coupled with the pathogen’s versatile virulence factors, lead to high morbidity and mortality rates. The current study investigated the potential association between the antibiotic resistance and the production of virulence factors among P. aeruginosa clinical isolates collected from Alexandria Main University Hospital in Egypt. We also evaluated the potential of the phenotypic detection of virulence factors to reflect virulence as detected by virulence genes presence. The role of alginate in the formation of biofilms and the effect of ambroxol, a mucolytic agent, on the inhibition of biofilm formation were investigated.ResultsA multi-drug resistant phenotype was detected among 79.8% of the isolates. The most predominant virulence factor was biofilm formation (89.4%), while DNase was least detected (10.6%). Pigment production was significantly associated with ceftazidime susceptibility, phospholipase C production was significantly linked to sensitivity to cefepime, and DNase production was significantly associated with intermediate resistance to meropenem. Among the tested virulence genes, lasB and algD showed the highest prevalence rates (93.3% and 91.3%, respectively), while toxA and plcN were the least detected ones (46.2% and 53.8%, respectively). Significant association of toxA with ceftazidime susceptibility, exoS with ceftazidime and aztreonam susceptibility, and plcH with piperacillin-tazobactam susceptibility was observed. There was a significant correlation between alkaline protease production and the detection of algD, lasB, exoS, plcH and plcN; pigment production and the presence of algD, lasB, toxA and exoS; and gelatinase production and the existence of lasB, exoS and plcH. Ambroxol showed a high anti-biofilm activity (5% to 92%). Quantitative reverse transcriptase polymerase chain reaction showed that alginate was not an essential matrix component in P. aeruginosa biofilms.ConclusionsHigh virulence coupled with the isolates’ multi-drug resistance to commonly used antimicrobials would increase morbidity and mortality rates among P. aeruginosa infections. Ambroxol that displayed anti-biofilm action could be suggested as an alternative treatment option, yet in vivo studies are required to confirm these findings. We recommend active surveillance of antimicrobial resistance and virulence determinant prevalence for better understanding of coregulatory mechanisms.

【 授权许可】

CC BY   
© The Author(s) 2023

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