Prevalence and Some Possible Mechanisms of Colistin Resistance Among Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa
Prevalence and Some Possible Mechanisms of Colistin Resistance Among Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa
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DOI：
10.2147/idr.s238811
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发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Hetta, Helal F.
中科院分区：
文献类型：
--
作者：
Abd El-Baky, Rehab M.;Masoud, Salwa M.;Hetta, Helal F.
背景和目的：粘菌素耐药菌株的出现被认为是严重感染患者的一大威胁。为此，我们调查了多重耐药(MDR)和广泛耐药(XDR)铜绿假单胞菌对粘菌素的耐药性及其可能的机制。方法：采用纸片扩散法检测抗生素敏感性，琼脂稀释法检测粘菌素耐药性。通过常规聚合酶链式反应检测mcr-1和mcr-2基因，用3-氯苯肼(CCCP)检测外排机制，研究耐药株的外膜蛋白谱和内毒素谱，探讨粘菌素耐药的可能机制。结果：分离的铜绿假单胞菌MDR和XDR分别占分离菌株的96%和87%，粘菌素耐药性占21.3%。无一株mcr-2基因阳性，而50%的粘菌素耐药株mcr-1阳性。在3个分离株中检测到外排机制。蛋白谱显示耐药株出现一条21.4 KDa的条带，可能代表OprH，而内毒素谱显示粘菌素耐药的mcr-1阴性株、耐粘菌素的mcr-1阳性株和敏感株之间存在差异。结论：本研究报告了埃及铜绿假单胞菌分离株中粘菌素耐药性和mcr-1基因的高流行率，可能导致无法治疗的感染。我们的发现使得避免不必要的粘菌素临床应用成为当务之急。
Background and Aim: The emergence of colistin-resistant strains is considered a great threat for patients with severe infections. Here, we investigate the prevalence and some possible mechanisms of colistin resistance among multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (P. aeruginosa).Methods: Antimicrobial susceptibility was performed using disc diffusion methods while colistin resistance was detected by agar dilution method. Possible mechanisms for colistin resistance were studied by detection of mcr-1 and mcr-2 genes by conventional PCR, detection of efflux mechanisms using Carbonyl Cyanide 3-Chlorophenylhydrazone (CCCP), studying outer membrane protein profile and Lipopolysaccharide (LPS) profile of resistant isolates.Results: It was found that MDR and XDR represented 96% and 87% of the isolated P. aeruginosa, respectively, and colistin resistance represented 21.3%. No isolates were positive for mcr-2 gene while 50% of colistin-resistant isolates were positive for mcr-1. Efflux mechanisms were detected in 3 isolates. Protein profile showed the presence of a band of 21.4 KDa in the resistant strains which may represent OprH while LPS profile showed differences among colistin-resistant mcr-1 negative strains, colistin-resistant mcr-1 positive strains and susceptible strains.Conclusion: The current study reports a high prevalence of colistin resistance and mcr-1 gene in P. aeruginosa strains isolated from Egypt that may result in untreatable infections. Our finding makes it urgent to avoid unnecessary clinical use of colistin.