Characterization of Pseudomonas aeruginosa Strains Isolated from Burned Patients Hospitalized in a Major Burn Center in Tehran, Iran
Pseudomonas aeruginosa is an important life-threatening nosocomial pathogen and plays a prominent role in serious infections in burned patients. The current study was undertaken to characterize P. aeruginosa strains isolated from burned patients in Tehran, Iran. The study was conducted in a major burn center in Tehran, Iran in 2007. A total of seventy specimens obtained from different clinical origin with positive culture results for P. aeruginosa were included in the study. Antimicrobial susceptibility test was performed according to the standard CLSI guideline. The relationship between the strains was also determined using antimicrobial drug resistance pattern analysis and plasmid profiling. All strains were multi drug resistant. The percentage of resistance to tested antibiotics was: imipenem 97.5%, amikacin 90%, piperacillin 87.5%, ceftizoxime 72.7%, gentamicin 67.5%, ciprofloxacin 65%, ceftriaxone 60%, and ceftazidime 57.5%. Thirteen resistant phenotypes were recognized, R3 (TET, IPM, AMK, CIP, PIP, GM, CAZ, CRO, CT) was the predominant resistance pattern seen in 27.5% of isolates. Results obtained from E-test showed that 100% of P. aeruginosa strains were resistant to cefoxitin, 97% to cefotetan, 93% to ticarcillin, 89% to ticarcillin/clav, 76% to gentamicin and imipenem, 63% to piperacillin, 49% to tetracycline, and 20% to meropenem. Nine different plasmid profiles were observed among the strains. The current study showed an increase rate of resistance for some antibiotics tested among P. aeruginosa strains isolated from burned patients in Tehran. A combination of antibiotic susceptibility testing and profile plasmid analysis, which are relatively cheap and available methods, showed to be useful to characterize the clinical strains of P. aeruginosa isolated from burned patients in Iran.
Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev 2006;19(2):403-34.
Pruitt BA Jr, McManus AT, Kim SH, Goodwin CW. Burn wound infections: current status. World J Surg 1998;22(2):135-45.
Pirnay JP, De Vos D, Cochez C, Bilocq F, Pirson J, Struelens M, Duinslaeger L, Cornelis P, Zizi M, Vanderkelen A. Molecular epidemiology of Pseudomonasaeruginosa colonization in a burn unit: persistence of a multidrug-resistant clone and a silver sulfadiazine-resistant clone. J Clin Microbiol 2003;41(3):1192-202.
Enoch DA, Simpson AJ, Kibbler CC. Predictive value of isolating Pseudomonas aeruginosa from aerobic and anaerobic blood culture bottles. J Med Microbiol 2004;53(Pt 11):1151-4.
Shahcheraghi F, Feizabadi MM, Yamin V, Abiri R, Abedian Z. Serovar determination, drug resistance patterns and plasmid profiles of Pseudomonas aeruginosa isolated from burn patients at two hospitals of Tehran (IRAN). Burns 2003;29(6):547-51.
Nikbin VS, Abdi-Ali A, Feizabadi MM, Gharavi S. Pulsed field gel electrophoresis & plasmid profile ofPseudomonas aeruginosa at two hospitals in Tehran, Iran. Indian J Med Res 2007;126(2):146-51.
Hall GS. Nonfermenting Gram negative bacilli. In: Mahon CR, Manuselis G, editors. Textbook of Diagnostic Microbiology. 2nd ed. Philadelphia: WB Saunders; 2000. p. 542-62.
Forbes BA, Sahm DF, Weissfeld A, editors. Bailey and Scott's Diagnostic Microbiology. 11th ed. St. St Louis: Mosby Inc; 2002.
National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Information Supplement. [Online] 2011 Jan [cited 2011 Aug 15]; M100-S12;31(1); Available from: URL:http://www.clsi.org/source/orders/free/m100-s21.pdf
Ranjbar R, Mammina C, Pourshafie MR, Soltan-Dallal MM. Characterization of endemic Shigella boydii strains isolated in Iran by serotyping, antimicrobial resistance, plasmid profile, ribotyping and pulsed-field gel electrophoresis. BMC Res Notes 2008;1:74.
Ranjbar R, Soltan Dallal MM, Talebi M, Pourshafie MR. Increased isolation and characterization of Shigella sonnei obtained from hospitalized children in Tehran, Iran. J Health Popul Nutr 2008;26(4):426-30.
Ranjbar R, Owlia P, Saderi H, Bameri Z, Izadi M, Jonaidi N, Morovvati S. Isolation of clinical strains ofPseudomonas aeruginosa harboring different plasmids. PakJ Biol Sci 2007;10(17):3020-2.
Japoni A, Farshad S, Alborzi A, Kalani M, Mohamadzadegan R. Comparison of arbitrarily primedpolymerase chain reaction and plasmid profiles typing ofPseudomonas aeruginosa strains from burn patients and hospital environment. Saudi Med J 2007;28(6):899-903.
Hadadi A, Rasoulinejad M, Maleki Z, Yonesian M, Shirani A, Kourorian Z. Antimicrobial resistance pattern of Gramnegative bacilli of nosocomial origin at 2 university hospitals in Iran. Diagn Microbiol Infect Dis 2008;60(3):301-5.
Boroumand MA, Esfahanifard P, Saadat S, Sheihkvatan M, Hekmatyazdi S, Saremi M, Nazemi L. A report ofPseudomonas aeruginosa antibiotic resistance from a multicenter study in Iran. Indian J Med Microbiol 2007;25(4):435-6.
Rastegar Lari A, Bahrami Honar H, Alaghehbandan R. Pseudomonas infections in Tohid Burn Center, Iran. Burns 1998;24(7):637-41.
Ferreira AC, Gobara S, Costa SE, Sauaia N, Mamizuka EM, van der Heijden IM, Soares RE, Almeida GD, Fontana C, Levin AS. Emergence of resistance in Pseudomonas aeruginosa and Acinetobacter species after the use of antimicrobials for burned patients. InfectControl Hosp Epidemiol 2004;25(10):868-72.
Igumbor E, Gwanzura L, Chirara M, Obi C, Muza D. Antibiotic sensitivity and plasmid profiles of Pseudomonas aeruginosa. Cent Afr J Med 2000;46(11):296-300.
Plesiat P, Alkhalaf B, Michel-Briand Y. Prevalence and profiles of plasmids in Pseudomonas aeruginosa. Eur JClin Microbiol Infect Dis 1988;7(2):261-4.
Puzová H, Siegfried L, Kmetová M, Durovicová J, Kerestesová A. Characteristics of Pseudomonas aeruginosa strains isolated from urinary tract infections. Folia Microbiol (Praha) 1994;39(4):337-41.
Mascellino MT, Iegri F, Delogu G, Catania S, Sorice F. Plasmid profile as epidemiological marker forPseudomonas aeruginosa in an intensive care unit. J Chemother 1989;1(4 Suppl):401-3.
Wu T. Plasmid profiles of 120 strains of Pseudomonasaeruginosa. Zhonghua Liu Xing Bing Xue Za Zhi 1993;14(5):304-6.
Walia S, Madhavan T, Williamson T, Kaiser A, Tewari R. Protein patterns, serotyping and plasmid DNA profiles in the epidemiologic fingerprinting of Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis 1988;7(2):248-55.
Ding MJ, Wu TM. Serogrouping, plasmid and drug resistance of Pseudomonas aeruginosa in Taiwan. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1988;21(3):165-78.
Poh CL, Yap EH, Tay L, Bergan T. Plasmid profiles compared with serotyping and pyocin typing for epidemiological surveillance of Pseudomonas aeruginosa. J Med Microbiol 1988;25(2):109-14.