Molecular epidemiological survey in quinolone and carbapenem-resistant genotype and its association with Type III Secretion System in Pseudomonas aeruginosa.

This study evaluated the predictors of mortality and the impact of inappropriate therapy on patients outcomes with bacteremia and ventilator-associated pneumonia (VAP). Additionally, it was evaluated the correlation among the Type Three Secretion System (TTSS) effector genotype with the resistance to carbapenems and fluoroquinolones, mutations in the Quinolone Resistance Determining Regions (QRDRs), Metallo-Beta-Lactamase (MBL) and virulence factors. A retrospective cohort was conducted at a tertiary hospital in patients with multidrug-resistant (MDR) P. aeruginosa bacteremia (157 patients) and VAP (60 patients). Genes blaIMP, blaVIM, blaSIM, blaGIM and blaSPM and virulence genes (exoT, exoS, exoY, exoU, lasB, algD, toxA) were detected; the sequencing was conducted for QRDR genes on fluoroquinolone-resistant strains. The multivariate analyses showed that predictors independently associated with death in patients with bacteremia were cancer and inappropriate therapy. Carbapenem resistance was more frequent among strains of VAP (53.3) and we observed in blood 66.6% blaSPM genotype and 33.3% blaVIM genotype. exoS gene was found in all isolates, while for the exoU, the frequency was low (9.4%). Substitution of threonine to isoleucine at position 83 in gyrA was the most frequent mutation among fluoroquinolone-resistant strains. Our study showed a mutation at position 91 in parC gene (Glu91Lys) associated with mutation in gyrA (Thre83Ile) in a strain of extensively drug-resistant P...
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research