Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units

Detalhes bibliográficos
Autor(a) principal: Souza, Gleyce Hellen de Almeida de
Data de Publicação: 2021
Outros Autores: Rossato, Luana, Brito, Gabriel Teixeira, Bet, Graciela Mendonça dos Santos, Simionatto, Simone
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/191029
Resumo: Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.
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spelling Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care unitsHealthcare-associated infectionsAntimicrobial resistancePublic healthCarbapenemasePseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2021-09-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/19102910.1590/S1678-9946202163071Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71Revista do Instituto de Medicina Tropical de São Paulo; v. 63 (2021); e711678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/191029/176114Copyright (c) 2021 Gleyce Hellen de Almeida de Souza, Luana Rossato, Gabriel Teixeira Brito, Graciela Mendonça dos Santos Bet, Simone Simionattohttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessSouza, Gleyce Hellen de Almeida de Rossato, Luana Brito, Gabriel Teixeira Bet, Graciela Mendonça dos Santos Simionatto, Simone 2022-05-16T13:44:35Zoai:revistas.usp.br:article/191029Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:52:59.907587Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true
dc.title.none.fl_str_mv Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
title Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
spellingShingle Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
Souza, Gleyce Hellen de Almeida de
Healthcare-associated infections
Antimicrobial resistance
Public health
Carbapenemase
title_short Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
title_full Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
title_fullStr Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
title_full_unstemmed Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
title_sort Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
author Souza, Gleyce Hellen de Almeida de
author_facet Souza, Gleyce Hellen de Almeida de
Rossato, Luana
Brito, Gabriel Teixeira
Bet, Graciela Mendonça dos Santos
Simionatto, Simone
author_role author
author2 Rossato, Luana
Brito, Gabriel Teixeira
Bet, Graciela Mendonça dos Santos
Simionatto, Simone
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Souza, Gleyce Hellen de Almeida de
Rossato, Luana
Brito, Gabriel Teixeira
Bet, Graciela Mendonça dos Santos
Simionatto, Simone
dc.subject.por.fl_str_mv Healthcare-associated infections
Antimicrobial resistance
Public health
Carbapenemase
topic Healthcare-associated infections
Antimicrobial resistance
Public health
Carbapenemase
description Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.
publishDate 2021
dc.date.none.fl_str_mv 2021-09-29
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/191029
10.1590/S1678-9946202163071
url https://www.revistas.usp.br/rimtsp/article/view/191029
identifier_str_mv 10.1590/S1678-9946202163071
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/191029/176114
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by-nc/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
dc.source.none.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71
Revista do Instituto de Medicina Tropical de São Paulo; v. 63 (2021); e71
1678-9946
0036-4665
reponame:Revista do Instituto de Medicina Tropical de São Paulo
instname:Instituto de Medicina Tropical (IMT)
instacron:IMT
instname_str Instituto de Medicina Tropical (IMT)
instacron_str IMT
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reponame_str Revista do Instituto de Medicina Tropical de São Paulo
collection Revista do Instituto de Medicina Tropical de São Paulo
repository.name.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)
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