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Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar

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submitted on 2024-07-01, 05:22 and posted on 2024-07-01, 05:23 authored by Mazen A. Sid Ahmed, Jemal M. Hamid, Ahmed A. Husain, Hamad Abdel Hadi, Sini Skariah, Ali A. Sultan, Emad Bashir Ibrahim, Abdul Latif Al Khal, Bo Soderquist, Jana Jass, Ali S. Omrani

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 blaVIM, 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 BSIs are relatively uncommon in Qatar but are highly resistant, harbour multiple resistance genes, and are commonly associated with unfavourable clinical outcomes. Colistin was the only agent with consistent activity against the study isolates.

Other Information

Published in: Annals of Medicine
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1080/07853890.2021.2012588

Funding

Open Access funding provided by the Qatar National Library.

Qatar National Library (N/A).

Hamad Medical Corporation (IRGC-01–51-033).

Qatar National Research Fund (NPRP12S-0219-190109), Molecular and genomic epidemiology of invasive, multi drug resistant gram-negative bacteria in the State of Qatar.

Swedish Research Council (219-2014-837).

Hamad Medical Corporation (N/A).

History

Language

  • English

Publisher

Taylor & Francis

Publication Year

  • 2021

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Hamad Medical Corporation
  • Hamad General Hospital - HMC
  • Communicable Disease Center - HMC
  • Weill Cornell Medicine - Qatar
  • Qatar University
  • Biomedical Research Center - QU

Geographic coverage

Qatar

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    Hamad General Hospital - HMC

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