Back to Journals » Infection and Drug Resistance » Volume 13

Prevalence and Some Possible Mechanisms of Colistin Resistance Among Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa

Authors Abd El-Baky RM, Masoud SM, Mohamed DS, Waly NGFM, Shafik EA, Mohareb DA, Elkady A, Elbadr MM, Hetta HF

Received 15 November 2019

Accepted for publication 11 January 2020

Published 3 February 2020 Volume 2020:13 Pages 323—332

DOI https://doi.org/10.2147/IDR.S238811

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Rehab M Abd El-Baky, 1, 2 Salwa M Masoud, 1 Doaa S Mohamed, 2 Nancy GFM Waly, 1 Engy A Shafik, 3 Dina A Mohareb, 4 Azza Elkady, 5 Mohamed M Elbadr, 6 Helal F Hetta 7, 8

1Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia 61519, Egypt; 2Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia 11566, Egypt; 3Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 4Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Sohag General Hospital, Sohag, Egypt; 6Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt; 7Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 8Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Correspondence: Helal F Hetta
Department of Internal Medicine, University of Cincinnati College of Medicine, PO Box 670595, Cincinnati, OH 45267-0595, USA
Email helal.hetta@uc.edu

Background and Aim: The emergence of colistin-resistant strains is considered a great threat for patients with severe infections. Here, we investigate the prevalence and some possible mechanisms of colistin resistance among multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (P. aeruginosa).
Methods: Antimicrobial susceptibility was performed using disc diffusion methods while colistin resistance was detected by agar dilution method. Possible mechanisms for colistin resistance were studied by detection of mcr-1 and mcr-2 genes by conventional PCR, detection of efflux mechanisms using Carbonyl Cyanide 3-Chlorophenylhydrazone (CCCP), studying outer membrane protein profile and Lipopolysaccharide (LPS) profile of resistant isolates.
Results: It was found that MDR and XDR represented 96% and 87% of the isolated P. aeruginosa, respectively, and colistin resistance represented 21.3%. No isolates were positive for mcr-2 gene while 50% of colistin-resistant isolates were positive for mcr-1. Efflux mechanisms were detected in 3 isolates. Protein profile showed the presence of a band of 21.4 KDa in the resistant strains which may represent OprH while LPS profile showed differences among colistin-resistant mcr-1 negative strains, colistin-resistant mcr-1 positive strains and susceptible strains.
Conclusion: The current study reports a high prevalence of colistin resistance and mcr-1 gene in P. aeruginosa strains isolated from Egypt that may result in untreatable infections. Our finding makes it urgent to avoid unnecessary clinical use of colistin.

Keywords: Pseudomonas aeruginosa, colistin resistance, mcr-1, mcr-2, toxA gene, XDR, MDR


Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]