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Carbapenem-Resistant Pseudomonas aeruginosa in Chronic Lung Infection: Current Resistance Profile and Hypermutability

Mila M Almeida1, Meyvianne T Freitas1, Tania W Folescu2

  • 1Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.

Current Microbiology
|January 6, 2021
PubMed

Insights

High rates of carbapenem-resistant Pseudomonas aeruginosa were found in cystic fibrosis patients in Brazil. However, hypermutable P. aeruginosa strains, often linked to antibiotic resistance, were rare in this study.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Pseudomonas aeruginosa is a major cause of lung disease in cystic fibrosis (CF) patients, increasing morbidity and mortality.
  • Hypermutable (HPM) P. aeruginosa strains are associated with antibiotic resistance in CF patients.
  • Carbapenem resistance is a growing global health concern.

Purpose of the Study:

  • To investigate the prevalence of carbapenem resistance and hypermutable phenotypes in P. aeruginosa isolates from CF patients in Rio de Janeiro, Brazil.
  • To characterize the antibiotic resistance profiles and genetic relatedness of these isolates.

Main Methods:

  • Disk diffusion and minimal inhibitory concentration (MIC) tests were used to determine antibiotic susceptibility.
  • Hypermutability was assessed, and genetic relatedness of HPM isolates was analyzed using pulsed-field gel electrophoresis (PFGE).
  • PCR screening was performed for carbapenemase genes (blaGES, blaIMP, blaKPC, blaNDM, blaOXA-48, blaSPM, and blaVIM).

Main Results:

  • High non-susceptible rates (>40%) were observed for imipenem, amikacin, and gentamicin.
  • 44.1% of isolates were carbapenem-resistant (CR), 39.6% were multidrug-resistant (MDR), and 4.4% were extensively drug-resistant (XDR).
  • Only 2.23% of isolates were hypermutable (HPM), and no carbapenemase genes were detected in CR isolates.

Conclusions:

  • There is a high occurrence of carbapenem-resistant and multidrug-resistant P. aeruginosa in CF patients in the studied Brazilian centers.
  • The prevalence of hypermutable P. aeruginosa strains remains unusual in this patient population.
  • The absence of common carbapenemase genes suggests other resistance mechanisms may be involved.

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