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Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar
BACKGROUND: Bloodstream infections (BSIs) caused by multidrug-resistant (MDR)-Pseudomonas aeruginosa are associated with poor clinical outcomes, at least partly due to delayed appropriate antimicrobial therapy. The characteristics of MDR-P. aeruginosa bloodstream isolates have not been evaluated in...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Taylor & Francis
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667892/ https://www.ncbi.nlm.nih.gov/pubmed/34882052 http://dx.doi.org/10.1080/07853890.2021.2012588 |
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author | Sid Ahmed, Mazen A. Hamid, Jemal M. Husain, Ahmed A. Hadi, Hamad Abdel Skariah, Sini Sultan, Ali A. Ibrahim, Emad Bashir Al Khal, Abdul Latif Soderquist, Bo Jass, Jana Omrani, Ali S. |
author_facet | Sid Ahmed, Mazen A. Hamid, Jemal M. Husain, Ahmed A. Hadi, Hamad Abdel Skariah, Sini Sultan, Ali A. Ibrahim, Emad Bashir Al Khal, Abdul Latif Soderquist, Bo Jass, Jana Omrani, Ali S. |
author_sort | Sid Ahmed, Mazen A. |
collection | PubMed |
description | BACKGROUND: Bloodstream infections (BSIs) caused by multidrug-resistant (MDR)-Pseudomonas aeruginosa are associated with poor clinical outcomes, at least partly due to delayed appropriate antimicrobial therapy. The characteristics of MDR-P. aeruginosa bloodstream isolates have not been evaluated in Qatar. Our study aimed to examine in vitro susceptibility, clinical and molecular characteristics, and mechanisms of resistance of MDR-P. aeruginosa bloodstream isolates from Qatar. MATERIALS AND METHODS: We included all MDR-P. aeruginosa isolated from blood cultures taken between October 2014 and September 2017. Blood cultures were processed using BD BACTEC™ FX automated system. BD Phoenix™ was used for identification, Liofilchem® MIC Test Strips for MIC determination. Whole-genome sequencing was performed using the Illumina-HiSeq-2000. RESULTS: Out of 362 P. aeruginosa bloodstream isolates, 16 (4.4%) were MDR. The median patient age was 55 years (range 43–81) and all patients presented with septic shock. Most patients received meropenem (12/16) and/or colistin (10/16). Clinical response was achieved in eight patients, and five patients died within 30-days. MDR-P. aeruginosa isolates belonged to 13 different sequence types. All isolates were non-susceptible to cefepime and ciprofloxacin. The most active agents were colistin (16/16) and aztreonam (10/16). Seven isolates produced bla(VIM,) and four possessed genes encoding extended-spectrum β-lactamases. Aminoglycoside modifying enzymes were present in 15/16, transferable qnr-mediated quinolone resistance gene was detected in 3/16, and the novel ciprofloxacin modifying enzyme CrpP-encoding gene in one isolate. CONCLUSION: MDR-P. aeruginosa KEY MESSAGES: MDR-P. aeruginosa constituted <5% of P. aeruginosa blood isolates over three years. Typical risk factors for MDR infections were highly prevalent in the study population and overall clinical outcomes are consistent with those previously reported. Colistin was the only agent with consistent antibacterial activity against the study isolates. |
format | Online Article Text |
id | pubmed-8667892 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-86678922021-12-14 Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar Sid Ahmed, Mazen A. Hamid, Jemal M. Husain, Ahmed A. Hadi, Hamad Abdel Skariah, Sini Sultan, Ali A. Ibrahim, Emad Bashir Al Khal, Abdul Latif Soderquist, Bo Jass, Jana Omrani, Ali S. Ann Med Infectious Diseases BACKGROUND: Bloodstream infections (BSIs) caused by multidrug-resistant (MDR)-Pseudomonas aeruginosa are associated with poor clinical outcomes, at least partly due to delayed appropriate antimicrobial therapy. The characteristics of MDR-P. aeruginosa bloodstream isolates have not been evaluated in Qatar. Our study aimed to examine in vitro susceptibility, clinical and molecular characteristics, and mechanisms of resistance of MDR-P. aeruginosa bloodstream isolates from Qatar. MATERIALS AND METHODS: We included all MDR-P. aeruginosa isolated from blood cultures taken between October 2014 and September 2017. Blood cultures were processed using BD BACTEC™ FX automated system. BD Phoenix™ was used for identification, Liofilchem® MIC Test Strips for MIC determination. Whole-genome sequencing was performed using the Illumina-HiSeq-2000. RESULTS: Out of 362 P. aeruginosa bloodstream isolates, 16 (4.4%) were MDR. The median patient age was 55 years (range 43–81) and all patients presented with septic shock. Most patients received meropenem (12/16) and/or colistin (10/16). Clinical response was achieved in eight patients, and five patients died within 30-days. MDR-P. aeruginosa isolates belonged to 13 different sequence types. All isolates were non-susceptible to cefepime and ciprofloxacin. The most active agents were colistin (16/16) and aztreonam (10/16). Seven isolates produced bla(VIM,) and four possessed genes encoding extended-spectrum β-lactamases. Aminoglycoside modifying enzymes were present in 15/16, transferable qnr-mediated quinolone resistance gene was detected in 3/16, and the novel ciprofloxacin modifying enzyme CrpP-encoding gene in one isolate. CONCLUSION: MDR-P. aeruginosa KEY MESSAGES: MDR-P. aeruginosa constituted <5% of P. aeruginosa blood isolates over three years. Typical risk factors for MDR infections were highly prevalent in the study population and overall clinical outcomes are consistent with those previously reported. Colistin was the only agent with consistent antibacterial activity against the study isolates. Taylor & Francis 2021-12-09 /pmc/articles/PMC8667892/ /pubmed/34882052 http://dx.doi.org/10.1080/07853890.2021.2012588 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Infectious Diseases Sid Ahmed, Mazen A. Hamid, Jemal M. Husain, Ahmed A. Hadi, Hamad Abdel Skariah, Sini Sultan, Ali A. Ibrahim, Emad Bashir Al Khal, Abdul Latif Soderquist, Bo Jass, Jana Omrani, Ali S. Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar |
title | Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar |
title_full | Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar |
title_fullStr | Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar |
title_full_unstemmed | Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar |
title_short | Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar |
title_sort | clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant pseudomonas aeruginosa isolated from bloodstream infections from qatar |
topic | Infectious Diseases |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667892/ https://www.ncbi.nlm.nih.gov/pubmed/34882052 http://dx.doi.org/10.1080/07853890.2021.2012588 |
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