AUTHOR=Patil Sandip , Chen Xiaowen , Dong Shaowei , Mai Huirong , Lopes Bruno Silvester , Liu Sixi , Wen Feiqiu 

TITLE=Resistance genomics and molecular epidemiology of high-risk clones of ESBL-producing Pseudomonas aeruginosa in young children

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1168096

DOI=10.3389/fcimb.2023.1168096

ISSN=2235-2988

ABSTRACT=<sec><title>Introduction</title><p>The emergence of multidrug-resistant <italic>Pseudomonas aeruginosa</italic> poses a global threat, but the distribution and resistance profiling are unclear, especially in young children. Infections due to <italic>P. aeruginosa</italic> are common, associated with high mortality, and increasingly β-lactam drug resistant.</p></sec><sec><title>Methods</title><p>We studied the molecular epidemiology and antibiotic resistance mechanisms in 294 clinicalisolates of <italic>P. aeruginosa</italic> from a pediatric hospital in China. Non-duplicate isolates were recovered from clinical cases and were identified using an API-20 kit followed by antimicrobial susceptibility testing using the VITEK®2 compact system (BioMerieux, France) and also by broth dilution method. In addition, a double-disc synergy test for the ESBL/E-test for MBL was performed. The presence of beta-lactamases, plasmid types, and sequence types was determined by PCR and sequencing.</p></sec><sec><title>Results</title><p>Fifty-six percent (<italic>n</italic> = 164) of the isolates were resistant to piperacillin–tazobactam, followed by cefepime (40%; <italic>n</italic> = 117), ceftazidime (39%; <italic>n</italic> = 115), imipenem (36%; <italic>n</italic> = 106), meropenem (33%; <italic>n</italic> = 97), and ciprofloxacin (32%; <italic>n</italic> = 94). Forty-two percent (n = 126) of the isolates were positive for ESBL according to the double-disc synergy test. The blaCTX-M-15 cephalosporinase was observed in 32% (n = 40/126), while 26% (n = 33/126) werepositive for blaNDM-1 carbapenemase. Aminoglycoside resistance gene <italic>aac(3)IIIa</italic>was observed in 16% (n = 20/126), and glycylcyclines resistance gene tet(A) was observed in 12% (n = 15/126) of the isolates. A total of 23 sequence types were detected, including ST1963 (12%; n = 16), followed by ST381 (11%; <italic>n</italic> = 14), ST234 (10%; <italic>n</italic> = 13), ST145 (58%; <italic>n</italic> = 10), ST304 (57%; <italic>n</italic> = 9), ST663 (5%; n = 7), and a novel strain. In ESBL-producing <italic>P. aeruginosa</italic>, 12 different Incompatibility groups (Inc) were observed, the most common being IncFI, IncFIS, and IncA/C. The MOBP was the most common plasmid type, followed by MOBH, MOBF, and MOBQ.</p></sec><sec><title>Discussion</title><p>Our data suggest that the spread of antibiotic resistance is likely due toclonal spread and dissemination of different clinical strains of <italic>P. aeruginosa</italic> harbouring different plasmids. This is a growing threat in hospitals particularly in young children which needs robust prevention strategies.</p></sec>