Frequency of Class I and II Integrons in Metalobetalactamase Producing Clinical Isolates of Pseudomonas Aeruginosa

Background and Objective: Pseudomonas aeruginosa is an opportunistic nosocomial pathogen. Evidence suggests that the incidence of enzyme-producing strains of Pseudomonas aeruginosa Metalo Beta Lactamases (MBL) is a major problem in the treatment of infections caused by this organism. The aim of this study was to investigate the frequency of class I and II integrons among metalobetalactamase producing Pseudomonas aeruginosa isolated from clinical samples from Zanjan hospitals. Materials and Methods: In this cross-sectional study, 120 Pseudomonas aeruginosa isolates from clinical specimens were collected from Zanjan hospitals in 2012-2013. After verifying isolates by biochemical tests, antibiotic susceptibility testing (Kirby-Baur method) was performed according to CLSI guidelines against 7 antibiotics. The DDST was then carried out for detection of MBLs. Finally, the presence of IntI1, IntI2, blaVIM and blaGIM genes was determined by PCR. Results: In our study, the highest and the lowest resistant patterns were related to Cefotaxime and Amikacin with 43.3% and 21.6%, respectively. Of 120 isolates, the metallo- beta-lactamase was detected in 35 (29%) isolates. According to results, the frequency of intI1, intI2, blaVIM genes in MBL producers were 32(91%), 3(9%), and 6(17%), respectively, but no blaGIM positive isolate was detected. Also all of IntI2 positive isolates carried IntI1 and blaVIM,, simultaneously. Conclusion: The results of this study indicate high frequency of class I integron gene among MBL producing Pseudomonas aeruginosa isolates. Due to the importance of integrons in dissemination of antibiotic resistance genes, detection and prevention of these elements are necessary. References 1- Kohlenberg A, Weitzel-Kage D, van der Linden P, et al. Outbreak of carbapenem-resistant Pseudomonas aeruginosa infection in a surgical intensive care unit. J Hosp Infect. 2010 74: 350-7. 2- Crespo MP, Woodford N, Sinclair A, et al. Outbreak of carbapenem-resistant Pseudomonas aeruginosa producing VIM-8, a novel metallo-β-lactamase, in a tertiary care center in cali, Colombia. J Clin Microbiol. 2004 42: 5094-101. 3- Siegel RE. Emerging gram-negative antibiotic resistance: daunting challenges, declining sensitivities and dire consequences. Respir Care. 2008 53: 471-79. 4- Siarkou V, Vitti D, Protonotariou E. Molecular epidemiology of outbreak-related Pseudomonas aeruginosa strains carrying the novel variant bla VIM-17 metallo-β-lactamase gene. Antimicrob Agents Chemother. 2009 53:1325-30. 5- Nasehi L, Shahcheraghi F, Nikbin VS, Nematzadeh Sh. PER, CTX-M, TEM and SHV beta-lactamases in clinical isolates of Klebsiella pneumoniae isolated from Tehran, Iran. Iranian J Med Sci. 2010 13: 111-18. 6- Singh R, Saxena A, Singh H. Identification of group specific motifs in beta-lactamase family of proteins. J biomed sci. 2009 16: 109-15. 7- Pitout JDD, Gregson DB, Poirel L, Mcclure JA, Le P, Church DL. Detection of Pseudomonas aeruginosa producing metallo-beta-lactamases in a large centralized laboratory. J Clin Microbiol. 2005 43: 3129-35. 8- Toleman MA, Vinodh H, Sekar U, Kamat V, Walsh TR. Bla VIM-2-harboring integrons isolated in India, Russia, and the United States arise from an ancestral class 1 integron predating the formation of the 39 conserved sequences. Antimicrob Agents Chemother. 2007 51: 2636-38. 9- Queenan AM, Bush K. Carbapenemases: the versatile β-lactamases. Clin Microbiol Rev. 2007, 20:440-58. 10- Hall RM, Collis CM. Mobile gene cassettes and integrons: capture and spread of genes by site-specific recombination. Mol Microbiol. 1995 15: 593-600. 11- Collis CM, Hall RM. Site-specific deletion and rearrangement of integron insert genes catalyzed by the integron DNA integrase. J Bacteriol. 1992 174: 1574-85. 12- Bennett PM. Integrons and gene cassettes: a genetic construction kit for bacteria. J Antimicrob Chemother. 1999 43: 1-4. 13- National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing, 15th informational supplement (M100-s15). NCCLS, Wayne, Pa. 2005. 14- Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing 21th informational supplement. CLSI document M100-S21. 2011 Vol. 31 No.1 15- Yong D, Lee K, Yum JH, Shin HB, Rossolini GM, Chong Y. Imipenem-EDTA disk method for differentiation of metallo-ß-lactamase- producing clinical isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol. 2002 40: 3798-801. 16- Yan JJ, Hsueh PR, Ko WC, et al. Metallo-beta-lactamases in clinical Pseudomonas isolates in Taiwan and identification of VIM-3, a novel variant of the VIM-2 enzyme. Antimicrob Agents Chemother. 2001 45: 2224-8. 17- Srephen H, Gillespie DM, Timothy DM. Antibiotic resistance protocols. Second editation. Springer Publication. 2010. 18- Yan H, Li L, Zong M, Jahangir Alam M, Shinoda S, Shi L. Occurrence and characteristics of class I and II integrons in clinical bacterial isolates from patient in South China. J Health Sci. 2010 56 442-50. 19- Kalntar E, Torabi V, Salimizand H, et al. First survey of metallo-beta-lactamases producers in clinical isolates of Pseudomonas aeruginosa from a referral burn center kurdistan province. Jundishapur J Nat Pharm Prod. 2012 7: 23-26. 20- Poonsuk K, Tribuddharat C, Rungtip C. Class 1 integrons in Psudomonas aeruginosa and Acintobacter baumannii isolated from clinical isolates. Southeast Asian J Trop Med Public Health. 2012 376-48. 21- Gomes FMR, Caiaffa-Filho HH, Burattin MN, Rossi F. Metallo-beta-lactamases among imipenem-resistant Pseudomonas aeruginosa in a brazilian university hospital. Clin Sci. 2010 65: 825-29. 22- Varaiya A, Kulkarni N, Kulkarni M, Bhalekar P, Dogra J. Incidence of metallo beta lactamase producing Pseudomonas aeruginosa in ICU patients. Indian J Med Res. 2008 127: 398-402. 23- Camargo CH, Nascimento AB, Mondelli AL, Montelli AC, Sadatsune T. Detection of SPM and IMP metallo-β-lactamases in clinical specimens of Pseudomonas aeruginosa from a Brazilian public tertiary hospital. Braz J Infect Dis. 2011 15: 478-81. 24- Rieber H, Frontzek A, von Baum H, Pfeifer Y. Emergence of metallo- β -lactamases GIM-1 and VIM in multidrug-resistant Pseudomonas aeruginosa in North Rhine- Westphalia, Germany. J Antimicrob Chemother. 2012 57: 1-2. 25- Khosravi Y, Tee Tay S, Vadivelu J. Analysis of integrons and associated gene cassettes of metallo- β -lactamase-positive Pseudomonas aeruginosa in Malaysia. J Med Microiol. 2011 60: 988-94. 26- Martinez L, Lopez-Jimenez L, Fuste E. Class1integrons in environmental and clinical isolates of Pseudomonas aeruginosa. Int J Antimicrob Agant. 2011 2: 113-19. 27- Yousefi S, Nahaei MR, Farajnia S, et al. Class 1 integron and imipenem resistance in clinical isolates of Pseudomonas aeruginosa: prevalence and antibiotic susceptibility. Iran J Microbiol. 2010 2: 113-119. 28- Nikokar I, Tishayar A, Flakiyan Z, et al. Antibiotic resistance and frequency of class 1 integrons among Pseudomonas aeruginosa, isolated from burn patients in Guilan, Iran. Iran J Microbiol. 2013 5: 36-41.

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Keywords: Integron ، Mtallo-beta-lactamase ، Pseudomonas aeruginosa