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Rezaeiet al (2016) conducted
this study in
order to select a better antibiotic choice for treatment of infections caused
byPseudomonas aeruginosa as well as to investigate theoccurrence of
resistance of P. aeruginosa strains to some antipseudomonal ?-lactams
drugs in Iran. This also explain the relation among the presence of ?-lactams (ampC,
mexC1,2, and mexC3,4genes) resistance genes and phenotype between
P. aeroginosaisolates which is resistant were investigated.They collect 100
isolatesof P. aeruginosa, among them 89% mexC3,4genes, 86%
mexC1,2 and 82% had ampC, while the combinations of these genes
were found absent in most of isolateswhile only in 3% of isolates non of these
genes were seen. Among the isolates 41% were found to be resistant to
mezlocillin, 36% were resistant to cefepime and 29% ofisolates were resistant
topiperacillin/ tazobactam and ceftazidime antibiotic. In the current study Significant
relation (P value ?0.05 by Fisher Exacttest or Chi-square) was seen
among the existence of ampCgene and resistance to all the
studied?-lactams drugs. Phenotypically observed resistant isolates contains
these genes however no relation was found for mexCgenes. The current
study shows for the first time that the presence of mexCand ampCgenes in appropriate
percent of P. aeruginosa  among clinical isolatesinIran as well
as relation among resistance to ?-lactams and the presence of ampCgene.

Delgado et al. (2016)
reported that 113 bacterial isolates, 98(86.72%) remained unaffected by
(resistant) to nor?oxacin, 57 (50.44%), 92 (81.41%) and 35(30.93%) indicated
less vulnerability to o?oxacin, cipro?oxacin and levo?oxacin separately. More
than a few variations were noticed in E.coli,
Staphylococcus epidermidis, Pseudomonas on genetic level.

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Khan (2014) organized the current
cross sectional study from January 2012 to January 2013 at the department of
Microbiology, university of Karachi. The clinical isolates were collected from
different hospitals in order to investigate the frequency and pattern of
sensitivity of multi-drug resistant (MDR) strains of Pseudomonas aeruginosa. Screening of the diagnostic strains were
done by standard microbiological techniques. For the evaluation of
antimicrobial sensitivity they used the Kirby Bauer Disc diffusion technique.
The result was determined according to the Clinical and Laboratory Standards
Institute (CLSI) guidlines. Among the clinically isolated samples the Prevalence
of MDR P. aeruginosa were observed
30%. Amikacin followed by Quinolones followed by Co-trimaxazole antibiotics
were found to most effective.

kireçci (2014) defined that the
mortality and morbitity rate of the Pseudomonas
aeruginosa causes infection is very high. Urgent and competent antibiotic
therapy can successfully reduce these infections. The study was done in Iraq in
order to investigate the antibiotic susceptibility pattern of clinically
isolated P.  aeruginosa  strains obtained from different Sulaimani
Teaching Hospitals. This study was done in one year from June 2012 to June
2013. During this period of time total of 420 P.  aeruginosasamples were
tested Out of which they isolate 75 diagnostic isolates. Among the clinically
isolated samples(54.7%) were sensitive to gentamicin followed by 96% to
imipenem (96%), toward meropenem was 98.7%, towards imikacin was 62.7%,
piperacillin (70.7%), ceftazidime (82.7%), ciprofloxacin(73.3%), 69.3% to
tobramycin, 8% to ceftraxon and totaly resistant to cefotaxime antibiotic.
There results shows that the P.
Aeruginosa isolates collected from there hospitals were sensitive towards
imipenem, meropenem and ceftazidime by comparing with other antibiotics. 

Liu (2014) stated that the
extended-spectrum ?-lactamase (ESBL) OXA-142 genes (Blaaxa-142) in bacterial species Pseudomonas aeruginosa were found less in Asia as compared to
Bulgaria and other Countries of Europe. They isolate 90 samples of P aeruginosafond resistanant to
ceftazidem (MIC ?8 mg/L) from January 2009 to December 2012 and then with the
help of polymerase chain reaction they were tested for identification of
broad-spectrum ?-lactamase and ESBL genes. With the help of Pulsed-field gel
electrophoresis the clonal relation of these isolates were determined. Among
the ceftazidime resistant isolates three various positive ESBL producing
isolates carry the gene blaOXA-142. In class 1 integron the blaOXA-142
gene was joined. With the help of southern blot technique analysis on the
plasmid of all three isolates the integron containing blaOXA-142
gene was detected with the ?-lactamase and blaOXA-142 gene.

Ghamgosha (2014) suggested that one of
the major clinical problems is the formation of metallo-beta lactamases (MBL)
enzymes in the pseudomonas aeruginosa.
This enzymes group is a member of beta-lactamases responsible for the
production of Ambler class B, which have the ability to hydrolase the
antibiotic carbapenems. The main goal of the current was to analyse the
incidence rate of metallo-beta lactamases (MBL) by phenotypic and genotypic
technique and to investigate the pattern of antibiotic resistance P. Aeruginosa isolated in Iran from
Zahedan Hospital. 191 species were isolated after the minimum inhibitory
concentration (MIC) determination by biochemical methods and antibiotic
resistance pattern (ARP) against the p.
aeruginosa. Those isolates having MIC> 4 microgram / ml were examined by
phenotypic and genotype way.  The current
study shows that the rate of resistance to imipenem was 5.7% and after the
phenotypic experiments completion 9 isolates have the ability of production
Metallo-beta Lactamase (MBL) were determined. Total 7 out of 9 isolates were
confirmed by PCR analysis. The VIM-1 gene was found dominant among the
isolates. The results of the current research study showed the existance of
metallo-beta-lactam (MBL) genes in some isolated samples from Zahedan

(2014) Suggested that different strains of
Pseudomonas aeruginosa can produce Beta-lactamase which are responsible
mainly for casing hospital infections. The drug Carbapenem was considered the
most efficient antibiotic among all of the antibiotics agaist P. Aeruginosa but these are non
effective against the metallo-beta lactamase producing group of P. Aeruginosa. For the identification of
MBLs genes (bla-VIM and bla-IMP) and the
antibiotic sensitivity, various samples of P. aeruginosa were collected from
9 different hospital in Iran. During this study total 212 isolates of P. Aeruginosa
identified with the help of biochemical and PCR analysis. For the
identification of antibiotic sensitivity the Kirby-Burr disk diffusion
technique were used while with the help of DDST technique the resistant species
against imipenem were determined followed by PCR testing inorder to determine
the genes of MBL which are bla-VIM  andbla-IMP.  Among all of the species which were confirmed
as imepenim resistant by DDST phenotypic technique, 75 were confirmed as they
contain MBL gene. PCR technique reveals that 33% strains (70 isolates)
containing bla-VIM gene while 9% of the isolates (20 strains) carrying
the bla-IMP gene. There results shows that due to the production of
MBL enzymes in P.aeroginosa the limit
of antibiotic resistance increases. Therefore, the determination of antibiotic
sensitivity and presence of MBL gene is necessary inorder to control the
infection of P.aeroginosa.

et al. (2014) examined the presence of metallo-?-lactamase and
extended-spectrum ? lactamase (ESBL) in 122 P.
Aeruginosa isolates from january2011
to March 2012 obtained from two different hospitals in Cairo, Egypt. There
phenotypic screening for ESBLs and MBL 
as well as antibiotic sensitivity were determined. There ESBLs and MBLs gene
were detected by PCR and also determines MICs which shows that the resistance
rate of P. Aeruginosa was  39.34% 
to imipenem,80.3% to cefoperazone, 45.1% to aztreonam, 87.7% to
cefuroxime and 25.4% to tazobactam. Out of all 122 isolates 27% were MBL
positive and 7.4% were ESBL positive. The spread of blaNDMwas4.2%,
2.1% wasblaIMP-1 positive, 41.7% wasblaOXA-10 positive,
10.4% was blaVEB-1 and 58.3% containing blaVIM-2
gene. In the current research study the genes such as OXA-2, SPM-, GIM-
and SIM-, were not identified. The gene such as OXA-10 was linked to VEB and/or
VIM-2. In 12 strains the VIM-2 and OXA-10 genes were present, two isolates was
containg both theVEB and OXA-10 genes while only a single isolates have VEB,
VIM-2 and OXA-10 genes. It is cleared from the results that the genes blaOXA-10
and blaVIM-2 were widely present among P. Aeruginosa in Egypt while the genes blaOXA-10, blaIMP-1, BlaVIM-2
and  blaNDM,  were reported for the first time in P. aeruginosa in Egypt.

Anna Diana in 2014 conducted a study
to investigate the prevalence of genes encoding resistance toaminoglycosides
and fluoroquinolones among twenty-five among twenty-five Pseudomonas
aeruginosa isolated between2002 and 2009. In PCR, following genes were
detected: ant(2″)-Ia in 9 (36.0%), aac(6′)-Ib in 7 (28.0%), qnrBin
5 (20.0%), aph(3″)-Ibin 2 (8.0%) of isolates.

Poirel,2012 studied p
lasmid-associatedresistance to fluroquinolones can be mediated by the
productionof Qnr proteins, which preserve DNA gyrase andtopoisomerase IV from
inhibition by quinolones.

Borra (2013) suggested that the
Metallo-?-lactamases (MBLs) are widely spread among those Gram-negative
bacteria which are clinically significant because it show resistance to beta
lactam antibiotics especially to carbapenems. In 2002 the gene blaGIM-1 were
discovered in Pseudomonas aeruginosa strain for the first time
while now discovered in Enterobacteriaceae. In the current research
study they present the crystaline structure of GIM-1 in the mono-zinc,
dizinc(where Cys221 was found to be oxidized) and apo-zinc which is metal-free,
and arranged nine autonomously complicated views of enzymes. The gene GIM-1 is
unlike from the other correlated MBLs in maintenance of a narrow active site
channel definite by aromatic side chains (Tire 233 and Trip 228) on usually
present in hydrophilic residues in other MBLs. By screening there structures
shows important elasticity in there two loops (Residues 60 to 66 represent the
loop1 while residues 223 to 242 show the loop2) moreover to active site with
closed and open arrangement cleared by pattern of alternative hydrogen binding
which involves Trp228. They recommend that the rearrangement ability of the
gene GIM-1 allows to hydrolyse a wide variety of ?-lactams regardless of having
a more restricted active site. There results focus the structural variability
among the family of MBL enzyme.

(2012) studied three clinically metallo-?-lactamase (MBL) producing isolates of
Pseudomonas aeruginosa which were
WCH2813, WCH2677 and WCH2837 from the Women’s and Children’s Hospital,
Adelaide, Australia. All the clinically isolates for known MBL genes were
negative by PCR. A gene bank was prepared in which the bla (AIM-1) gene belong
from MBL family, was cloned and characterized completely. AIM-1 Encoded enzyme
which belong to group B3MBL has highest level of identity to Thin-B and L1. It
is chromosomal and flanked by two copies (one intact and one truncated) of an
ISCR element, ISCR15. Southern hybridization screening identifies the movement
of both bla(AIM-1) and ISCR15 among the three different clinical strains. AIM-1
possesses efficiently high k(cat) values for carbapenems and cefepime than most
other MBLs and AIM-1 can hydrolyze most of the ?-lactams drugs except aztreonam
and up to some extent to ceftazidime. The first identified mobile group B3
enzyme was AIM-1 declaires more problems for already present antibiotics used
to treat the severe infection caused by
P. aeruginosa and other Gram-negative bacteria.

Abdelrazig (2012)
studed the existence of antimicrobial resistance genes involved in the
production of infection by Pseudomonas
aeruginosa. A total of 74 P.
aeruginosa isolates were obtained from the admitted patients in Khartoum
Teaching Hospital of Sudan. These obtaining isolates and serotype were studied
at the Research Laboratory in University of Science and Theology Sudan from
February to June 2011. The different strains were collected from different
types of infection, mainly from postoperative wound infection, respiratory
tract and urinary tract infections. By the help of PCR the genes involved in antimicrobial
drug resistance were investigated. The first step was denaturation of cell wall
in order to jump out the extraction of DNA. In the isolates of P. Aeruginosa the IMP-6 and IMP-7 genes
were investigated which belong to the IMP Gene family. Among the P. aeruginosa isolates the IMP-10 and
IMP-7 were reported for the first time in Khartoum State, Sudan.

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