Characterization of the etiological structure and genotypically determined phenotypic resistance to carbapenems of infectious complications leading pathogens in critically ill patients
DOI:
https://doi.org/10.14739/2310-1210.2018.3.130458Keywords:
anti-bacterial agents, gram-negative bacterial infections, critical states, burns, PCR, resistanceAbstract
The aim is to investigate the genotypically determined phenotypic resistance to carbapenems of gram-negative microorganisms isolated from patients with critical states.
Material and methods. Microbiological etiology of infectious complications in critically ill patients (n = 726) was investigated. In total, during the years 2011–2016, 933 clinical strains of infectious complications pathogens from patients with severe burns (n = 435) and from patients treated in intensive care units (n = 291) were isolated and identified. The sensitivity of microorganisms clinical isolates to antibiotics was investigated by means of the standard microbiological methods. In gram-negative bacteria resistant to carbapenems, a molecular genetic study of mechanisms of resistance, determined by the presence of VIM genes, was carried out using the method of real-time polymerase chain reaction.
Results. Studies have shown that gram-negative microorganisms (Acinetobacter spp. – 36.3 %, P. aeruginosa – 31.7 %, Enterobacter spp. – 13.5 %, Proteus spp. – 7.9 %, E. coli – 3.8 %; K. pneumoniae – 3.6 %, etc.) account for a significant part of infectious complications pathogens structure in critically ill patients. A. baumannii strains (67 %) have expressed phenotypic resistance to most antibiotics, in particular to carbapenems (up to 63.2 %). Poly-antibiotic resistance was also found in P. aeruginosa (72 %), and above one the 3rd part of strains of this pathogen was found to have phenotypic resistance to carbapenems. In-depth study of molecular genetic determinants of the resistance mechanism to β-lactam antibiotics among clinical strains of gram-negative bacteria there was proved VIM-induced resistance to carbapenems in A. baumannii, P. aeruginosa, P. mirabilis.
Conclusions. Enterobacteriaceae and non-fermenting gram-negative microorganisms (P. aeruginosa, P. mirabilis, A. baumannii), which are the leading causative agents of infectious complications in patients with severe burns and critically ill ones, phenotypically develop low sensitivity to carbapenems, which is genetically determined in 12.3 % by VIM genes expression.
References
Nazarchuk, O. A., Nagaychuk, V. I., & Paliy, V. G. (2016). Etiolohichna struktura, vlastyvosti zbudnykiv uskladnen u khvorykh z opikamy [Etiological structure, properties of pathogens of complications in patients with burns]. Profilaktychna medytsyna, 1–2(26), 68–72. [in Ukrainian].
Nagaychuk, V. I., Nazarchuk, O. A., Paliy, I. G., Burkot, V. M., & Gonchar, O.O. (2014). Do kharakterystyky suchasnykh infektsiynykh uskladnen' u khvorykh z opikamy [To characteristics of modern infectious complications in patients with burns]. Ukrainskyi medychnyi chasopys, 5(103), 123–126. [in Ukrainian].
Nazarchuk, O. A. (2017) Prohnostychni pokaznyky chutlyvosti nefermentuiuchykh bakterii do meropenemu, shliakhy yikh pokrashchennia [Prognostic criteria of sensitivity of nonfermenting bacteria to meropenem, ways of their improvement]. Dovkillia i zdorovia Proceedings of the Scientific and Practical Conference, (pp. 195–197). Ternopil [in Ukrainian].
Papp-Wallace, K. M., Endimiani, A., Taracila, M. A., & Bonomo, R. A. (2011). Carbapenems: Past, Present, and Future. Antimicrobial agents and chemotherapy, 55(11), 4943–4960. doi: 10.1128/AAC.00296-11.
Meletis, G., Vavatsi, N., Exindari, M., Sianou, E., Haitoglou, C., Sofianou, D. et al. (2014). Accumulation of carbapenemresistance mechanisms in VIM-2-producing Pseudomonas aeruginosa under selective pressure. European Journal of Clinical Microbiology and Infectious Diseases, 33, 253–258. doi: 10.1007/s10096-013-1952-3.
Zeng, Z. R., Wang, W. P., Huang, M., Shi, L. N., Wang, Y., & Shao, H. F. (2014). Mechanisms of carbapenem resistance in cephalosporin-susceptible Pseudomonas aeruginosain China. Diagnostic Microbiology and Infectious Disease, 78, 268–270. doi: 10.1016/j.diagmicrobio.2013.11.014.
Aghamiri, S., Amirmozafari, N., Fallah, J., & Kafil, H. S. (2014). Antibiotic Resistance Pattern and Evaluation of Metallo-Beta Lactamase Genes Including bla-IMP and bla-VIM Types in Pseudomonas aeruginosa Isolated from Patients in Tehran Hospitals. Microbiology. doi: 10.1155/2014/941507.
Nekrasova, L. S., Svyta, V. M., Hlushkevych, T. H., Tomchuk, V. V., Zherebko, N. M. & Yanovska, V. V. (2007). Vyznachennia chutlyvosti mikroorhanizmiv do antybakterial'nykh preparativ [Determination of the sensitivity of microorganisms to antibacterial drugs]. Кyiv. [in Ukrainian].
(2015) The European Committee on Antimicrobial Susceptibility Testing. Routine and extended internal quality control as recommended by EUCAST. Version 5.0, 2015. Retrieved from http://www.eucast.org.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
