Survey of various carbapenem-resistant mechanisms of <i>Acinetobacter baumannii</i> and <i>Pseudomonas aeruginosa</i> isolated from clinical samples in Iran

Azimi, Leila and Fallah, Fatemeh and Karimi, Abdollah and Shirdoust, Mehdi and Azimi, Taher and Sedighi, Iraj Sedighi and Rahbar, Mohammad and Armin, Shahnaz (2020) Survey of various carbapenem-resistant mechanisms of <i>Acinetobacter baumannii</i> and <i>Pseudomonas aeruginosa</i> isolated from clinical samples in Iran. Iranian Journal of Basic Medical Sciences, 23 (11). pp. 1396-1400.

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Abstract

Objective(s): Pseudomonas aeruginosa and Acinetobacter baumannii resist antibiotics by different intrinsic and acquired mechanisms. This study aims to define various carbapenem-resistant mechanisms of isolated P. aeruginosa and A. baumannii from nine different provinces of Iran.Materials and Methods: In this cross-sectional study, all carbapenem-resistant P. aeruginosa and A. baumannii samples from nine provinces of Iran on a one-year time horizon were gathered. Modified Hedge Test (MHT) and Carba NP-Test were applied to the identification of producing-carbapenemase strains. The most important carbapenemase genes recognized by PCR and gene overexpression of the efflux pump were surveyed by efflux pump inhibitors (EPIs) and confirmed by Real-Time PCR. Results: Twenty-one percent and 43.5 of P. aeruginosa and A. baumannii isolates were resistant to carbapenem, respectively. MHT and Carba-NP tests identified 21 and 11 carbapenemase-producing strains in these Gram-negative bacteria, respectively. NDM-1 was the most prevalently detected carbapenemase in P. aeruginosa; OXA-51 and OXA-23 were the most significant genes in A. baumannii. EPIs identified active efflux pumps in 20 and 28 of P. aeruginosa and A. baumannii, respectively. Real-time PCR confirmed gene overexpression of efflux pumps in 54 and 30 of positive EPIs in P. aeruginosa and A. baumannii, respectively. Conclusion: P. aeruginosa and A. baumannii may become multi-drug-resistant (MDR) and Extensively Drug-Resistant (XDR) strains and cause a high rate of mortality and morbidity. Thus, it is of necessity to prohibit the spread of antibiotic-resistant strains in hospitals.

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