Virulence Constitution of Multi-Drug-Resistant Pseudomonas aeruginosa in Upper Egypt

• Published in: Infection and drug resistance 2020-02, Vol.13, p.587-595
• Main Authors: Hassuna, Noha A, Mandour, Sahar A, Mohamed, Ebtisam Samir
• Format: Article
• Language: English
• Subjects: Antibiotics; Antimicrobial agents; Cross infection; Cytotoxicity; Dehydrogenases; Deoxyribonucleic acid; Disease transmission; DNA; Drug resistance; Enzymes; Epidemiology; exou; Gene distribution; Genes; Genotypes; Hospital patients; Identification; Infections; Intensive care units; mdr; Original Research; p. aeruginosa; Pathogenesis; Pathogens; Patients; Pneumonia; Pseudomonas aeruginosa; Statistical analysis; Ventilator-associated pneumonia; virulence; Virulence (Microbiology); Virulence factors
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S233694

Ventilator-associated pneumonia caused by ( ) is a major health-care problem. In this study, we explored the epidemiology of virulence determinants among multi-drug-resistant (MDR) clinical isolates from hospitalized patients with ventilator-associated pneumonia in intensive care units in Upper Egypt. MDR isolates were screened for the presence of eight virulence factors and typed by ERIC-PCR. A total of 39 clinical MDR isolates were selected out of 173 isolated showing a combination of adhesion and cytotoxicity virulence patterns, with the detection of A, U, S, B, D, A in 74.3%, 58.9%, 46.1%, 41.2%, 30.7%, 20.5% of the isolates, respectively. The MDR isolates were grouped into 13 different virulence profiles according to the pattern of virulence gene distribution. U genotype was more predominant among the isolates with more than 48% of the isolates harboring this gene alone, 7% harboring both U and S and 43.5% harboring S gene. An intermediate degree of diversity was detected by ERIC-PCR typing where the isolates were clustered in 7 major groups, indicating possible cross-infection within the hospital. Our results highlight the increased frequency of virulent isolates with a shift to the more virulent cytotoxic U genotype. Further hospital infection-control measures are mandatory to control the hospital cross-transmission of these highly virulent isolates. This study could vastly be a help to develop efficient treatment policies against induced ventilator-associated pneumonia.