Expression of aph(3')-IIb and Aminoglycoside Efflux Pump Regulatory Genes in Clinical Extensive Drug Resistant Pseudomonas aeruginosa.
Running title: Relative gene expression of Aminoglycoside modifying enzyme aph(3')-IIb and efllux pump regulatory genes in XDR Pseudomonas aeruginosa.
Keywords:
XDR P. aeruginosa, aminoglycoside modifying enzymes, aph (3')-IIb, MexXY- OprM Pump, Aminoglycoside resistance.Abstract
Background: A remarkable level of aminoglycosides resistance expressed by Pseudomonas aeruginosa is well known. One of the most important mechanisms of aminoglycoside resistance is over expression of efflux pumps and aminoglycoside modifying enzymes.
Aim of Study: To evaluate the expression of aph(3')-IIb and MexXY-OprM Pump Regulatory Genes in XDR Pseudomonas aeruginosa in Al-Diwaniyah city.
Methods: During the period from November 2021 to August 2022, 50 clinical P. aeruginosa isolated from hospitalized patients admitted to Al-Diwaniyah Burn Center and Al-Diwaniyah Teaching Hospital including 25(31.3%) burns, 15(22.7%) wounds, and 10(18.5%) diabetic foot ulcers. The vitek2 compact system was employed for identification and antibiotic susceptibility test of P. aeruginosa. The isolates were submitted to PCR and qRT-PCR for aph(3')-IIb, mexZ, and parR detection and gene expression.
Results: Out of 50 P. aeruginosa, 22(44%) XDR and 9(18%) MDR isolates were detected. All XDR isolates were resistance to all tested antibiotics except one. Aminoglycoside resistance was exhibited in 100% of XDR isolates phenotypically. All isolates harbored aph(3')-IIb, mexZ, and parR genes. The qRT-PCR results showed significant overexpression of aph(3')-IIb and parR, while mexZ revealed significant low expression in XDR P. aeruginosa compared with susceptible P. aeruginosa isolates.
Conclusion: High frequencies of XDR P. aeruginosa from various clinical sources, which further restricts the range of available treatments. The predominant mechanisms of aminoglycosides resistance exhibited by XDR P. aeruginosa in this region are overexpression of efflux pumps, and aminoglycoside modifying enzyme, aph(3')-IIb.
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