Annals of clinical and laboratory science · 2020
Dissemination of SHV, TEM and CTX-M Genotypes in Pseudomonas aeruginosa: A Pre-eminent Reason for Therapeutic Failure in Pediatrics.
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Ejaz Hasan
Аннотация
OBJECTIVE: Dissemination of extended-spectrum beta-lactamase (ESBL) genotypes in Pseudomonas aeruginosa gained attention as superbugs, which are extremely difficult to treat with conventional antibiotics. The study aimed to delineate the empirical therapy and the occurrence of SHV, TEM, and CTX-M encoding P. aeruginosa among pediatric patients.
METHODS: A total number of 33,400 continuous and non-repetitive clinical specimens collected from the debilitated pediatric patients processed for the isolation of P. aeruginosa. The characterization of the isolated strains performed using phenotypic and molecular methods. The spectrum of antibacterial resistance observed against all the isolated strains of P. aeruginosa. RESULTS: A total of 74 (18.8%) ESBL producers isolated, out of which 58 (78.4%) were bla CTX-M, 53 (71.6%) bla SHV, and 38 (51.4%) were bla TEM genes. The mortality was significantly associated (p<0.001) in patients infected with ESBL producing P. aeruginosa and neonatal age group. The mean length of stay for the patients infected with ESBL and non-ESBL producing P. aeruginosa was 7.93±7.26 and 8.26±5.40, respectively. Antibiogram showed high resistance of spectrum with cephalosporins while resistance against cefoperazone-sulbactam (32; 43.2%), carbapenems (23; 31.1%), and piperacillin-tazobactam (14; 18.9%) was comparatively low.
CONCLUSION: The dissemination and co-existence of bla CTX-M, bla SHV, and bla TEM genes in P. aeruginosa clones make it difficult to treat the infected pediatric patients without the new synergistic combinational regimens.
METHODS: A total number of 33,400 continuous and non-repetitive clinical specimens collected from the debilitated pediatric patients processed for the isolation of P. aeruginosa. The characterization of the isolated strains performed using phenotypic and molecular methods. The spectrum of antibacterial resistance observed against all the isolated strains of P. aeruginosa. RESULTS: A total of 74 (18.8%) ESBL producers isolated, out of which 58 (78.4%) were bla CTX-M, 53 (71.6%) bla SHV, and 38 (51.4%) were bla TEM genes. The mortality was significantly associated (p<0.001) in patients infected with ESBL producing P. aeruginosa and neonatal age group. The mean length of stay for the patients infected with ESBL and non-ESBL producing P. aeruginosa was 7.93±7.26 and 8.26±5.40, respectively. Antibiogram showed high resistance of spectrum with cephalosporins while resistance against cefoperazone-sulbactam (32; 43.2%), carbapenems (23; 31.1%), and piperacillin-tazobactam (14; 18.9%) was comparatively low.
CONCLUSION: The dissemination and co-existence of bla CTX-M, bla SHV, and bla TEM genes in P. aeruginosa clones make it difficult to treat the infected pediatric patients without the new synergistic combinational regimens.