Prevalence of ESBL-producing Pseudomonas aeruginosa isolates in Warsaw, Poland, detected by various phenotypic and genotypic methods

PLoS One. 2017 Jun 28;12(6):e0180121. doi: 10.1371/journal.pone.0180121. eCollection 2017.

Abstract

Knowledge of the prevalence of ESBL enzymes among P. aeruginosa strains compared to the Enterobacteraiceae family is limited. The phenotypic tests recommended by EUCAST for the detection of ESBL-producing Enterobacteriaceae are not always suited for P. aeruginosa strains. This is mainly due to the presence of other families of ESBLs in P. aeruginosa isolates more often than in Enterobacteriaceae, production of natural AmpC cephalosporinase and its overexpression, and co-production of metallo-β-lactamases. The aim of this study was to determine the occurrence of ESBLs in P. aeruginosa isolated from patients from hospitals in Warsaw, to evaluate the ESBL production of these isolates using currently available phenotypic tests, their modifications, multiplex PCR and molecular typing of ESBL-positive isolates by PFGE. Clinical isolates of P. aeruginosa were collected in 2000-2014 from four Warsaw hospitals. Based on the data obtained in this study, we suggest using three DDST methods with inhibitors, such as clavulanic acid, sulbactam and imipenem, to detect ESBL-producing P. aeruginosa strains. Depending on the appearance of the plates, we suggest a reduction in the distance between discs with antibiotics to 15 mm and the addition of boronic acid at 0.4 mg per disc. The analysed isolates carried genes encoding ESBL from the families VEB (69 isolates with VEB-9), GES (6 with GES-1, 1 GES-5, 5 GES-13 and 2 with GES-15), OXA-2 (12 with OXA-15, 1 OXA-141, 1 OXA-210, 1 OXA-543 and 1 with OXA-544) and OXA-10 (5 isolates with OXA-74 and one with OXA-142). The most important result of this study was the discovery of three new genes, blaGES-15, blaOXA-141 and blaOXA-142; their nucleotide sequences have been submitted to the NCBI GenBank. It is also very important to note that this is the first report on the epidemiological problem of VEB-9-producing bacterial strains, not only in Poland but also worldwide.

MeSH terms

  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Disk Diffusion Antimicrobial Tests
  • Electrophoresis, Gel, Pulsed-Field
  • Humans
  • Multiplex Polymerase Chain Reaction
  • Poland / epidemiology
  • Prevalence
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / enzymology*
  • Pseudomonas Infections / epidemiology
  • Pseudomonas aeruginosa / enzymology*
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / metabolism
  • beta-Lactam Resistance / genetics
  • beta-Lactamases / genetics*

Substances

  • beta-Lactamases

Grants and funding

The study was funded partially by a grant from the State Committee for Scientific Research (KBN) “The presence of extended-spectrum beta-lactamases among the drug-resistant isolates of Pseudomonas aeruginosa” (grant no. 2PO5D 018 30), AEL, JP, DD, RW, BS, and Foundation for the Development of Diagnostics and Therapy, Warsaw, Poland. REGON:006220910, NIP:5262173856, KRS:0000195643, AEL, ST, and Medical University of Warsaw, statutory funds, AEL, ST. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.