Karbapenem dirençli pseudomonas aeruginosa izolatlarının direnç ve virülans genlerinin taranması ve PFGE ile moleküler epidemiyolojisinin incelenmesi

Introduction and Purpose: Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative, non-fermentative, opportunistic pathogen that can cause serious infections, especially in patients in intensive care. In recent years, the increase in multi-drug resistant P. aeruginosa strains has complicated treatment. This study aimed to investigate the antibiotic resistance, virulence genes and clonal relationship among carbapenem-resistant clinical isolates of P. aeruginosa that were obtained from patients admitted to Recep Tayyip Erdogan University Training and Research Hospital. Materials & Methods: Fifty-eight carbapenem-resistant P. aeruginosa isolates identified by the VITEK-2 automated system were included in the study. Antibiotic resistance genes and virulence genes were screened by PCR. PFGE method was used to determine the clonal similarity between the strains. Pearson's Chi-square and Fisher's compatibility tests were used to investigate the relationship between demographic data, antibiotic resistance and detected genes. Results: The antibiotic susceptibility of the isolates was as follows: amikacin 41.8%, gentamicin 67.2%, tobramycin 48.2%, ceftazidime 81.03%, cefepime 81.03%, ciprofloxacin 67.2%, levofloxacin 75.8%, and piperacillin-tazobactam 91.38%. Of the resistance genes, blaVIM was detected in three isolates, and mexY was detected in 28 isolates. Among the virulence genes, exoY was found in 65.5% of isolates, exoT in 56.8%, algD in 44.8%, and exoA in 15.5%. Quorum-sensing genes were not found. A statistically significant correlation was found between exoT and PRP (p=0.012) and also between the absence of exoY and gentamicin resistance (p=0.037). No dominant epidemic strain was detected in PFGE. Forty-one different genotypes were found(observed), and the isolates were collected into 12 different clusters. The clustering rate was found to be 47%. Discussion & Conclusions: In this study, high levels of antibiotic resistance were found in isolates. High resistance of ear drainage culture isolates was noted. The resistance is low compared to other country's gene rates however it is compatible with the studies in our country. The virulence gene rates were found lower than studies conducted in our country and the world. According to the results of the PFGE analysis, most of the isolates were unrelated. No significant relationship was found between isolates whose band profiles were the same or closely related and demographic data. In order to control the transmission of carbapenem-resistant bacteria between patients and wards, molecular epidemiological vii studies should be expanded at national and international levels to identify the source of infections and to develop preventive strategies. Keywords: Pseudomonas aeruginosa, carbapenem resistance, virulence gene, PFGE