High prevalence of atypical virulotype and genetically diverse background among Pseudomonas aeruginosa isolates from a referral hospital in the Brazilian Amazon.
Yan Corrêa RodriguesIsmari Perini FurlanetoArthur Henrique Pinto MacielAna Judith Pires Garcia QuaresmaEliseth Costa Oliveira de MatosMarília Lima ConceiçãoMarcelo Cleyton da Silva VieiraGiulia Leão da Cunha BraboEdilene do Socorro Nascimento Falcão SargesLuana Nepomuceno Godim Costa LimaKarla Valéria Batista LimaPublished in: PloS one (2020)
Pseudomonas aeruginosa is an opportunistic pathogen causing different types of infections, particularly in intensive care unit patients. Characteristics that favor its persistence artificial environments are related to its high adaptability, wide arsenal of virulence factors and resistance to several antimicrobial classes. Among the several virulence determinants, T3SS stands as the most important due to the clinical impact of exoS and exoU genes in patient's outcome. The molecular characterization of P. aeruginosa isolates helps in the comprehension of transmission dynamics and enhance knowledge of virulence and resistance roles in infection process. In the present study, we investigated virulence and resistance properties and the genetic background of P. aeruginosa isolated from ICUs patients at a referral hospital in Brazilian Amazon. A total of 54 P. aeruginosa isolates were characterized by detecting 19 virulence-related genes, antimicrobial susceptibility testing, molecular detection of β-lactamase-encoding genes and genotyping by MLST and rep-PCR. Our findings showed high prevalence of virulence-related markers, where 53.7% of the isolates presented at least 17 genes among the 19 investigated (P = 0.01). The rare exoS+/exoU+ cytotoxic virulotype was detected in 55.6% of isolates. Antimicrobial susceptibility testing revealed percentages of antibiotic resistance above 50% to carbapenems, cephalosporins and fluoroquinolones associated to MDR/XDR isolates. Isolates harboring both blaSPM-1 and blaOXA genes were also detected. Genotyping methods demonstrated a wide genetic diversity of strains spread among the different intensive care units, circulation of international MDR/XDR high-risk clones (ST111, ST235, ST244 and ST277) and emergence of seven novel MLST lineages. Finally, our findings highlight the circulation of strains with high virulence potential and resistance to antimicrobials and may be useful on comprehension of pathogenicity process, treatment guidance and establishment of strategies to control the spread of epidemic P. aeruginosa strains.
Keyphrases
- pseudomonas aeruginosa
- genetic diversity
- escherichia coli
- biofilm formation
- staphylococcus aureus
- genome wide
- intensive care unit
- cystic fibrosis
- acinetobacter baumannii
- antimicrobial resistance
- multidrug resistant
- klebsiella pneumoniae
- drug resistant
- candida albicans
- healthcare
- primary care
- genome wide identification
- gene expression
- dna methylation
- emergency department
- end stage renal disease
- bioinformatics analysis
- high throughput
- acute care
- chronic kidney disease
- patient reported outcomes
- combination therapy
- risk assessment
- human health
- patient reported
- genome wide analysis
- anti inflammatory