Detection of OprD Porin Gene in Multidrug Resistant Pseudomonas Aeruginosa Isolates in Patients with Chronic Liver Disease

Document Type : New and original researches in the field of Microbiology.

Authors

1 Medical Microbiology & Immunology Department, National Liver Institute, Menoufia University

2 Gastrohepatology Department, National Liver Institute - Menoufia University

Abstract

Background: Pseudomonas aeruginosa is a gram-negative opportunistic organism that causes severe global healthcare-associated infections such as respiratory tract infections, sepsis, urinary tract and surgical site infections. A key determinant of P. aeruginosa is its remarkable resistance to antibiotics especially in immunocompromised patients and many of the isolates are multiple drug resistant. Objectives: The aim of the study is to investigate the existence of multidrug-resistant Pseudomonas aeruginosa among chronic hepatic patients in National Liver Institute, Menoufia university, to evaluate the multidrug resistance profile of isolated P. aeruginosa and detect oprD gene expression role in multidrug-resistant strains. Methodology: From 230 patients admitted in NLI, samples were taken after 48 hours from admission, and cultured on cetrimide agar, the GN-ID cards of VITEK-2 system was used to confirm Pseudomonal isolation and species identification. Antibiotic susceptibility was done using VITEK2 AST-GN73 cards and conventional-PCR was used for identification of oprD gene. Results: P. aeruginosa was the most common type of pseudomonal species, it represents (78.72%) of Pseudomonas species isolated mainly from urine samples. (81.08%) of the tested strains of P. aeruginosa were MDR. Parenteral nutrition was the significant risk factor, also Pseudomonas species were the most common cause of peritonitis and wound infections. 90% of multidrug-resistant P. aeruginosa strains showed oprD gene, while 10% of the isolates were oprD negative. The highest percentage of oprD gene was detected in P.aeruginosa isolates resistant to Carbapenems, Cephalosporins, and Quinolones. Conclusion: Identifying the resistance mechanism of bacteria is very complicated. Although oprD gene plays an important role in the resistance of antibiotic in P.aeruginosa because the action of oprD gene in a nonspecific manner. It is elusive to consider or describe an antibiotic resistance on the presence or absence of oprD gene.

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