Molecular Detection of Aminoglycoside Modifying Enzymes Genes in Extensively Drug-resistant Pseudomonas aeruginosa from Burn Patients in Kerbala Hospitals

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

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Department of Medical Microbiology, Faculty of Medicine, University of Al-Kufa, Iraq

10.21608/ejmm.2025.389389.1672

Abstract

Background: Pseudomonas aeruginosa is a leading cause of nosocomial infections in patients with burns, and resistance to aminoglycosides poses a significant therapeutic challenge. Aminoglycoside-modifying enzymes (AMEs) are key mediators of resistance; however, their prevalence in extensively drug-resistant (XDR) P. aeruginosa isolates from burn patients in Iraq remains understudied. Objective: This study aimed to investigate the prevalence of AME genes (aac (3)-II, aac(6')-I, aac(6')-Ib, aac(6')-IIb, aph(3')-VI) in XDR P. aeruginosa isolates from burn patients in Kerbala Hospital. Methodology: From July to November 2024, 114 burn swabs were collected from two hospitals. The isolates were identified by culture, biochemical tests, and VITEK-2. Antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method (CLSI 2024 guidelines). XDR isolates were screened for AME genes using PCR. Results: Of 114 samples, 29 (25.4%) were confirmed as P. aeruginosa. Among these, 20 (68.9%) were XDR, exhibiting resistance to all aminoglycosides except colistin and polymyxin B. PCR revealed aac(6')-Ib as the most prevalent gene (75%, 15/20), followed by aac(3)-II and aac(6')-I (35% each). Co-occurrence of AME genes was observed in 55% of isolates, with two isolates harboring all five genes. Conclusion: The high prevalence of AME genes, particularly aac (6')-Ib, underscores enzymatic modification as a dominant resistance mechanism. These findings highlight the urgent need for antimicrobial stewardship and surveillance to curb the spread of XDR P. aeruginosa in burn-care settings.

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