Unveiling a high-risk epidemic clone (ST 357) of 'Difficult to Treat Extensively Drug-Resistant' (DT-XDR) Pseudomonas aeruginosa from a burn patient in Bangladesh: A resilient beast revealing coexistence of four classes of beta lactamases

Spencer Mark Mondol; Md Rafiul Islam; Nadira Naznin Rakhi; Shahriar Kabir Shakil; Israt Islam; Jannatul Ferdous Mustary; Amiruzzaman; Hussain Md Shahjalal; Donald James Gomes; Md Mizanur Rahaman

doi:10.1016/j.jgar.2023.11.014

Unveiling a high-risk epidemic clone (ST 357) of 'Difficult to Treat Extensively Drug-Resistant' (DT-XDR) Pseudomonas aeruginosa from a burn patient in Bangladesh: A resilient beast revealing coexistence of four classes of beta lactamases

J Glob Antimicrob Resist. 2024 Mar:36:83-95. doi: 10.1016/j.jgar.2023.11.014. Epub 2023 Dec 19.

Affiliations

¹ Department of Microbiology, University of Dhaka, Dhaka, Bangladesh.
² Department of Microbiology, University of Dhaka, Dhaka, Bangladesh; Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University, Noakhali, Bangladesh.
³ Microbiology Department, Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.
⁴ Department of Medicine, Sir Salimullah Medical College, Dhaka, Bangladesh.
⁵ Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, Bangladesh.
⁶ Department of Microbiology, University of Dhaka, Dhaka, Bangladesh. Electronic address: razu002@du.ac.bd.

PMID: 38122983
DOI: 10.1016/j.jgar.2023.11.014

Abstract

Objectives: Pseudomonas aeruginosa (P. aeruginosa) stands out as a key culprit in the colonization of burn wounds, instigating grave infections of heightened severity. In this study, we have performed comparative whole genome analysis of a difficult to treat extensively drug resistant P. aeruginosa isolated from a burn patient in order to elucidate genomic diversity, molecular patterns, mechanisms and genes responsible for conferring antimicrobial resistance and virulence.

Method: P. aeruginosa SHNIBPS206 was isolated from an infected burn wound of a critically injured burn patient. Whole genome sequencing was carried out and annotated with Prokka. Sequence type, serotype, antimicrobial resistance genes and mechanisms, virulence genes, metal resistance genes and CRISPR/Cas systems were investigated. Later, pangenome analysis was carried out to find out genomic diversity.

Result: P. aeruginosa SHNIBPS206 (MLST 357, Serotype O11) was resistant to 14 antibiotics including carbapenems and harboured all four classes of beta lactamase producing genes: Class A (bla_PME-1, bla_VEB-9), Class B (bla_NDM-1), Class C (bla_PDC-11) and Class D (bla_OXA-846). Mutational analysis of Porin D gave valuable insights. Several efflux pump, virulence and metal resistance genes were also detected. Pangenome analysis revealed high genomic diversity among different strains of P. aeruginosa.

Conclusion: To our knowledge, this is the first report of an extensively drug resistant ST 357 P. aeruginosa from Bangladesh, which is an epidemic high-risk P. aeruginosa clone. Further research and in-depth comprehensive studies are required to investigate the prevalence of such high-risk clone of P. aeruginosa in Bangladesh.

Keywords: Antimicrobial resistance; Beta lactamase; Burn wound infection; DT-XDR; Pseudomonas aeruginosa; ST 357.

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Bangladesh
Burns* / complications
Humans
Multilocus Sequence Typing
Pseudomonas Infections* / epidemiology
Pseudomonas aeruginosa
beta-Lactamases / genetics

Substances

beta-Lactamases
Anti-Bacterial Agents