Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa

Introduction: Antimicrobial resistant bacterial infections are widespread globally and increases in antimicrobial resistance presents a major threat to public health. Pseudomonas aeruginosa is an opportunistic healthcare-associated pathogen with high rates of morbidity and mortality and an extensiv...

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Main Authors: Ashika Singh-Moodley, Adriano Duse, Preneshni Naicker, Ranmini Kularatne, Trusha Nana, Ruth Lekalakala, Nontombi Mbelle, Halima Dawood, Khine Swe Swe Han, Praksha Ramjathan, Prathna Bhola, Andrew Whitelaw, Olga Perovic
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2018-08-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/9539
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author Ashika Singh-Moodley
Adriano Duse
Preneshni Naicker
Ranmini Kularatne
Trusha Nana
Ruth Lekalakala
Nontombi Mbelle
Halima Dawood
Khine Swe Swe Han
Praksha Ramjathan
Prathna Bhola
Andrew Whitelaw
Olga Perovic
author_facet Ashika Singh-Moodley
Adriano Duse
Preneshni Naicker
Ranmini Kularatne
Trusha Nana
Ruth Lekalakala
Nontombi Mbelle
Halima Dawood
Khine Swe Swe Han
Praksha Ramjathan
Prathna Bhola
Andrew Whitelaw
Olga Perovic
author_sort Ashika Singh-Moodley
collection DOAJ
description Introduction: Antimicrobial resistant bacterial infections are widespread globally and increases in antimicrobial resistance presents a major threat to public health. Pseudomonas aeruginosa is an opportunistic healthcare-associated pathogen with high rates of morbidity and mortality and an extensive range of resistance mechanisms. This study describes the antibiotic susceptibility profiles of P. aeruginosa isolates from patients with bacteraemia submitted by sentinel laboratories in South Africa from 2014 to 2015. Methodology: Organism identification and antimicrobial susceptibility testing were done using automated systems. Molecular methods were used to detect common resistance genes and mechanisms. Results: Overall the susceptibility was high for all antibiotics tested with a decrease over the two-year period. There was no change in the MIC50 and MIC90 breakpoints for all antibiotics from 2014 to 2015. The MIC50 was within the susceptible breakpoint range for most antibiotics and the MIC90 was within the susceptible breakpoint range for colistin only. Phenotypically carbapenem non-susceptible isolates harboured the following plasmid-mediated genes: blaVIM (n = 81, 12%) and blaGES (n = 6, 0.9%); blaNDM (n = 4, 0.6%) and blaOXA-48 and variants (n = 3, 0.45%). Porin deletions were observed in one meropenem non-susceptible isolate only, and multi-drug resistance efflux pumps were expressed in the majority of the non-susceptible isolates investigated. BlaVEB-1, blaIMP and blaKPC were not detected. Conclusion: The prevalence of resistance to commonly used antibacterial agents was low for P. aeruginosa isolates and similarly, tested resistance mechanisms were detected in a relatively small proportion of isolates. Findings in this study represent baseline information for understanding antimicrobial susceptibility patterns in P. aeruginosa isolates from blood. Our surveillance report may assist in contributing to hospital treatment guidelines.
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institution Kabale University
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publishDate 2018-08-01
publisher The Journal of Infection in Developing Countries
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spelling doaj-art-7c7b2b9ed25a4fe1848c4ba0919f2b942025-08-20T03:52:38ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-08-01120810.3855/jidc.9539Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South AfricaAshika Singh-Moodley0Adriano Duse1Preneshni Naicker2Ranmini Kularatne3Trusha Nana4Ruth Lekalakala5Nontombi Mbelle6Halima Dawood7Khine Swe Swe Han8Praksha Ramjathan9Prathna Bhola10Andrew Whitelaw11Olga Perovic12National Institute for Communicable Diseases, Johannesburg, South AfricaUniversity of the Witwatersrand and National Health Laboratory Service, Johannesburg, South AfricaUniversity of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South AfricaUniversity of the Witwatersrand and National Health Laboratory Service, Johannesburg, South AfricaUniversity of the Witwatersrand and National Health Laboratory Service, Johannesburg, South AfricaUniversity of Limpopo and National Health Laboratory Service, Polokwane, South AfricaUniversity of Pretoria and National Health Laboratory Services, Pretoria, South AfricaUniversity of KwaZulu-Natal, South AfricaUniversity of KwaZulu-Natal, Durban, South AfricaUniversity of KwaZulu-Natal and National Health Laboratory Service, KwaZulu-Natal, South AfricaUniversity of KwaZulu-Natal Durban, South AfricaStellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South AfricaNational Institute for Communicable Diseases, Johannesburg, South Africa Introduction: Antimicrobial resistant bacterial infections are widespread globally and increases in antimicrobial resistance presents a major threat to public health. Pseudomonas aeruginosa is an opportunistic healthcare-associated pathogen with high rates of morbidity and mortality and an extensive range of resistance mechanisms. This study describes the antibiotic susceptibility profiles of P. aeruginosa isolates from patients with bacteraemia submitted by sentinel laboratories in South Africa from 2014 to 2015. Methodology: Organism identification and antimicrobial susceptibility testing were done using automated systems. Molecular methods were used to detect common resistance genes and mechanisms. Results: Overall the susceptibility was high for all antibiotics tested with a decrease over the two-year period. There was no change in the MIC50 and MIC90 breakpoints for all antibiotics from 2014 to 2015. The MIC50 was within the susceptible breakpoint range for most antibiotics and the MIC90 was within the susceptible breakpoint range for colistin only. Phenotypically carbapenem non-susceptible isolates harboured the following plasmid-mediated genes: blaVIM (n = 81, 12%) and blaGES (n = 6, 0.9%); blaNDM (n = 4, 0.6%) and blaOXA-48 and variants (n = 3, 0.45%). Porin deletions were observed in one meropenem non-susceptible isolate only, and multi-drug resistance efflux pumps were expressed in the majority of the non-susceptible isolates investigated. BlaVEB-1, blaIMP and blaKPC were not detected. Conclusion: The prevalence of resistance to commonly used antibacterial agents was low for P. aeruginosa isolates and similarly, tested resistance mechanisms were detected in a relatively small proportion of isolates. Findings in this study represent baseline information for understanding antimicrobial susceptibility patterns in P. aeruginosa isolates from blood. Our surveillance report may assist in contributing to hospital treatment guidelines. https://jidc.org/index.php/journal/article/view/9539Antimicrobial susceptibility testingresistance genescarbapenemasesefflux pumpsporins
spellingShingle Ashika Singh-Moodley
Adriano Duse
Preneshni Naicker
Ranmini Kularatne
Trusha Nana
Ruth Lekalakala
Nontombi Mbelle
Halima Dawood
Khine Swe Swe Han
Praksha Ramjathan
Prathna Bhola
Andrew Whitelaw
Olga Perovic
Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa
Journal of Infection in Developing Countries
Antimicrobial susceptibility testing
resistance genes
carbapenemases
efflux pumps
porins
title Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa
title_full Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa
title_fullStr Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa
title_full_unstemmed Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa
title_short Laboratory based antimicrobial resistance surveillance for Pseudomonas aeruginosa blood isolates from South Africa
title_sort laboratory based antimicrobial resistance surveillance for pseudomonas aeruginosa blood isolates from south africa
topic Antimicrobial susceptibility testing
resistance genes
carbapenemases
efflux pumps
porins
url https://jidc.org/index.php/journal/article/view/9539
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