Epidemiological profile and antibiotic resistance of Pseudomonas aeruginosa isolates in burn and Traumatology center in Tunisia over a three-year period

##plugins.themes.academic_pro.article.sidebar##

Published Nov 23, 2012
Download
pdf
Vol. 90 No. 11 (2012): Issue Nov 2012

##plugins.themes.academic_pro.article.main##

Lamia Thabet
Ayoub Zoghlami
Lamia Kanzari
Jalel Boukadida
Amen Allah Messadi
Abdelraouef Ghanem

Abstract

Background: Pseudomonas aeruginosa is a known opportunistic pathogen frequently causing serious infections in burned patients.
Aim: To analyze the epidemiological profile of Pseudomonas aeruginosa isolated in a Tunisian burn unit.
Methods: During a 3-year period (from 01 July 2008 to 30 June 2011), 544 non repetitive strains of P. aeruginosa were isolated from burn patients. Susceptibility to antibiotics was assessed according to CA-SFM guidelines. Serotypes were identified by slide agglutination test using P.aeruginosa O antisera (Biorad). Producing carbapenemase was analyzed for 202 imipenem resistant isolates by EDTAtest. Susceptibility testing data were stored in a laboratory data base using whonet 5.3 software.
Results: The most frequent sites of isolation were cutaneous infections and blood cultures (83.4%). The percentages of resistant isolates were as follows: ceftazidime: 34%; imipenem: 37.1%, ciprofloxacin: 27.1% and amikacin: 29.6%. The most prevalent serotypes were: 011(51%), 06(17%), 03 (8%), 04(12%), 012(5%). Among the 202 imipenem resistant strains, 58% expressed a metallocarbapenemase. All theses strains were resistant to all tested antibiotics except colistin and belonged to the serotype O11.
Conclusion: The dissemination of carbapenemases strains must be contained by implementation of timely identification, strict isolation methods and better hygienic procedures.

Keywords:

Antibiotic resistance, burn patients, carbapenemase, P. aeruginosa, serotype

##plugins.themes.academic_pro.article.details##

References

  1. E Tredget, H Shankowsky, R Rennie, R Burrel, S Logsetty. Pseudomonas infections in the thermally injured patient. Burns 2004; 30:3-26.
  2. N Mesaros, P Normand, P Plesiat, P Leclerque, F Van Bambeke. Pseudomonas aeruginosa : résistance et options thérapeutiques à l'aube du deuxième millénaire. Antibiotiques 2007; 9 :189-98.
  3. P Berthelot, F Grattard, FO Mallaval, A Ros, F Lucht, B Pozzetto. Epidémiologie des infections nosocomiales à Pseudomonas aeruginosa, Burkholderia cepacia et Stenotrophomonas maltophila. Path.Biol 2005; 53:341-8.
  4. Comité de l'antibiogramme de la SFM. Bull. Soc. Fr. Microbiol. 2008.
  5. C Franklein, L Lilios, AY Peleg. Phenotypic detection of carbapenem-susceptible metallo-‚-lactamase producing Gram negative bacilli in the clinical laboratoty. J Clin Microbiol 2006; 44: 3139-44.
  6. WSong, Lee Kyu Man, HJ Kang, DH Shin, DK Kim. Microbiologic aspects of predominant bacteria isolated from the burn patients in Korea. Burns 2001; 27: 136-9.
  7. H Estahbanati , P Kashani , F Ghanaatpished. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics. Burns 2002;28: 340-8.
  8. M A Bahar, S Jamali, A Samadi kuchaksaraei. Imipenem resistant Pseudomonas aeruginosa strains carry metallo ‚ lactamase gene bla VIM in a level Iranian burn hospital. Burns 2010; 36: 826-30.
  9. A Japoni, A Alborzi, M Kalani, J Nasiri, M Hayati, S Farshad. Susceptibility patterns and cross-resistance of antibiotics against Pseudomonas aeruginosa isolated from burn patients in the south of Iran. Burns 2006; 32:343-7.
  10. L Thabet, K Bousselmi, S Ben Redjeb, AA Messadi. Profil épidémiologique et sensibilité aux antibiotiques des souches de Pseudomonas aeruginosa isolées dans un service de réanimation des brûlés. Tunis. Med 2007; 85: 124-7.
  11. P Nordmann. Mécanismes de résistance aux bêta-lactamines de Pseudomonas aeruginosa. Ann Fr Anesth Reanim 2003; 22: 527-30.
  12. L Thabet, V Dubois, C Andre, A Messadi, C Quentin. Imipenemresistant Pseudomonas aeruginosa in a Tunisian Burn center: overlapping outbreaks and cross-infections of strains exhibiting various resistance mechanisms, including VIM-2 production. 49th ICAAC(interscience on antimicrobial agents and chemotherapy) San Francisco: 12-15 septembre 2009.
  13. S Hammami, I Boutiba, R Ghozi, M Saidani, A SlimA, S Ben Redjeb. Nosocomial outbreak of imipenem resistant Pseudomonas aeruginosa producing VIM-2 metallo ‚ lactamase in a kidney transplantation unit. Diagn Pathol 20011; 6: 106.
  14. W Mansour, L Poirel, D Bettaieb, O Bouallégue, N Boujaafer, P Nordmann. Metallo‚-lactamase-producing Pseudomonas aeruginosa isolates in Tunisia. Diagn Microbiol Infect Dis. 2009; 64: 458-61.
  15. YT Huang, SH Chang, T Lauderdale, A Yang, JT Wang. Molecular epidemiology of carbapenem-resistant Pseudomonas aeruginosa carrying metallo-‚-lactamase genes in Taiwan. Diagn Microbiol Infect Dis. 2007; 59: 211-6.
  16. D Hocquet,P Plesiat , B Dehecq , P Mariotte , D Talon , X Bertrand , ONERBA. Nationwide investigation of extended spectrum betalactamases, metallo-beta-lactamases,and extended-spectrum oxacillinases produced by ceftazidime-resistant Pseudomonas aeruginosa strains in France. Antimicrob Agents Chemother 2010; 54: 3512-5.
  17. A Ben Hadj Khalifa, H Thien, C Pourel, M Khedher, M Mastouri, D Moissenet. Caractérisation phénotypique et génotypique de 96 isolats cliniques de Pseudomonas aeruginosa à l'Hôpital F.Bourguiba (Monastir, Tunisie). Pathol. Biol 2010; 58: 84-8.
  18. H Richet . Prise en charge d'une épidémie à Pseudomonas aeruginosa. Ann Fr Anesth Reanim 2003; 22: 544-7.
  19. JJ Fanner, RA Weinstein, CH Zierdt, CD Brokopp. Hospital outbreaks caused by Pseudomonas aeruginosa importance of serotypes O11. J Clin Microbiol 1982; 16: 266-70.
  20. F Grattard, OG Gaudin, B Pozzetto, A Ros, AD Mbida. Genotypic homogeneity of Pseudomonas aeruginosa O12 strains demonstrated by analysis of protein profiles, DNA fingerprints and rRNA gene restriction patterns. Eur J Clin Microbiol Infect Dis 1993; 12: 57-61.
  21. S Hammai, R Ghozzi, B Burghoffer, G Arlet, S Ben Redjeb . Mechanisms of carbapenem resistance in non metallo-.‚-lactamaseproducing clinical isolates of Pseudomonas aeruginosa from a Tunisian hospital. Pathol. Biol 2009; 57: 530-5.
  22. X Bertrand ,C Slekovec , P Cholley , D Talon . Epidémiologie des infections à Pseudomonas aeruginosa. Revue Francophone des laboratoires 2001; 435: 35-40.