Microbiological Monitoring within the System of Epidemiological Surveillance of Infections Caused by Pseudomonas aeruginosa

Introduction: According to the World Health Organization, Pseudomonas aeruginosa as a causative agent of purulent inflammation is a microorganism with a critical priority level due to the presence of numerous pathogenicity factors and a high level of acquired antibiotic resistance.

Objective: To study phenotypic characteristics of P. aeruginosa clinical isolates and to analyze their molecular genetic features.

Materials and methods: We analyzed 103 P. aeruginosa isolates. The phenotype of sensitivity to antibacterial drugs was determined using the disk diffusion test while the minimum inhibitory concentration of colistin was determined using the MIC Colistin kit. The Illumina iSeq (Illumina, USA) was used for genome-wide sequencing.

Results: Typical biochemical activity was characteristic of all strains. 90 % of the analyzed P. aeruginosa strains showed phenotypic resistance to penicillin, half of the isolates were resistant to cefepime and ceftazidime, and two thirds of the strains were sensitive to ceftazidime/avibactam. Imipenem was active against 10.0 % of the strains, meropenem – against 38.0 %. When testing doripenem, 84.8 % of the strains were in the category of moderately resistant; amikacin and tobramycin showed high activity in vitro, with colistin exhibiting the maximum activity. Numerous determinants of pathogenicity factors were found in the genome of all sequenced strains of P. aeruginosa, including pyoverdin and pyochelin siderophores, genes encoding the production of exotoxins ExoS, ExoT, ExoY, and ExoU. The algT gene was detected in nine strains of P. aeruginosa accounting for a hypermucoid phеnotype. The tss gene, which is a key factor in the pathogenicity of P. aeruginosa, was found in all strains. The structure of the resistome of P. aeruginosa strains includes genes encoding various beta-lactamases of the OXA, PDC and VEB groups. The blaVIM-2 metal-beta-lactamase gene was found in one strain. Mutations in the OprD gene responsible for changing the structure of porin channels were found in nine P. aeruginosa strains, and mutations in the МехА, B, and D activation genes of efflux pumps were found in 11 strains.

Conclusion: Regular microbiological monitoring makes it possible to track the circulation of antibiotic-resistant strains and is an important tool for ensuring epidemiological safety.

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