Virulence factors and integrons are associated with MDR and XDR phenotypes in nosocomial strains of Pseudomonas aeruginosa in a Venezuelan university hospital

Multidrug resistance (MDR), virulence and transferable elements potentiate Pseudomonas aeruginosa’s role as an opportunistic pathogen creating a high risk for public health. In this study, we evaluated the possible association of multidrug resistance, virulence factors and integrons with intrahospital P. aeruginosa strains isolated from patients at Cumana hospital, Venezuela. Relevant clinical-epidemiological data were collected to study 176 strains (2009-2016) isolated from different hospital units. Bacterial resistance was classified as susceptible, low-level resistant (LDR), multidrug resistant (MDR) and extensively drugresistant (XDR). Most strains produced pyoverdine, DNase, gelatinase and hemolysin. Around 73% of the strains showed some type of movement. MDR and XDR strains increased from 2009 (24.2% and 4.8%, respectively) to 2016 (53.1% and 18.8%); while LDR decreased from 64.5% to 6.3%. The exoU and exoS genes were found in a significant number of strains (38.1 and 7.4%, respectively). Class I integrons were detected in 35.8% of the strains and the frequency was associated with resistance (42.9, 22.4, 41.4 and 61.9%, for susceptible, LDR, MDR and XDR, respectively). The MDR/XDR strains were positively associated with hemolysins and exoU, but negatively associated with bacterial twitching. MDR/XDR phenotypes were also associated with the Intensive Care Unit (ICU), septicemia, bronchial infection and diabetic foot ulcers, as well as long hospital stay (≥10 days) and previous antimicrobial treatment. High frequency of MDR/XDR strains and their association with classI integrons and virulence factors can increase the infection potential, as well as morbidity and mortality of patients attending this hospital and could spread infection to the community, creating a health risk for the region

Primer reporte de cepas de Enterobacter spp productoras de metalobetalactamasas de Venezuela

Clinical strains of Enterobacter were isolated from Cumana's Central Hospital in Venezuela, and classified as E. cloacae (21), E. aerogenes (7), E. intermedium (1), E. sakazakii (1) and three unclassified. The strains showed high levels of resistance, especially to SXT (58.1%), CRO (48.8%), CAZ (46.6%), PIP (46.4%), CIP (45.2%) and ATM (43.3%). This is the first report for South America of blaVIM-2 in two E. cloacae and one Enterobacter sp., which also showed multiple mechanisms of resistance. Both E. cloacae showed blaTEM-1, but only one showed blaCTX-M-15 gene, while no blaSHV was detected.Cepas clínicas de Enterobacter fueron aisladas del Hospital central de Cumaná en Venezuela, y se clasificaron como E. cloacae (21), E. aerogenes (7), E. intermedium (1), E. sakazakii (1) y 3 sin clasificar. Las cepas mostraron altos niveles de resistencia, especialmente a SXT (58.1%), CRO (48.8%), CAZ (46.6%), PIP (46.4%), CIP (45.2%) and ATM (43.3%). Este es el primer reporte de América del Sur de blaVIM-2 en dos cepas de E. cloacae y una de Enterobacter sp., las cuales también mostraron múltiples mecanismos de resistencia. Ambas especies de E. cloacae mostraron genes blaTEM-1, pero solo una mostro el gen blaCTX-M-15, mientras que blaSHV no fue detectado

FIRST REPORT OF METALLO-β-LACTAMASES PRODUCING Enterobacter spp. STRAINS FROM VENEZUELA

Clinical strains of Enterobacter were isolated from Cumana's Central Hospital in Venezuela, and classified as E. cloacae (21), E. aerogenes (7), E. intermedium (1), E. sakazakii (1) and three unclassified. The strains showed high levels of resistance, especially to SXT (58.1%), CRO (48.8%), CAZ (46.6%), PIP (46.4%), CIP (45.2%) and ATM (43.3%). This is the first report for South America of blaVIM-2 in two E. cloacae and one Enterobacter sp., which also showed multiple mechanisms of resistance. Both E. cloacae showed blaTEM-1, but only one showed blaCTX-M-15 gene, while no blaSHV was detected

Especies de Acinetobacter identificadas en el Hospital Universitario “Antonio Patricio de Alcalá”, Cumaná, Venezuela

Con el objeto de determinar la(s) genoespecie(s) de Acinetobacter, se analizaron 62 aislados preservados, obtenidos de muestras provenientes de pacientes atendidos en el Servicio Autónomo Hospital Universitario “Antonio Patricio de Alcalá” (SAHUAPA), estado Sucre, durante el período junio-diciembre de 2008. Una vez recuperados los aislados, fueron identificados mediante pruebas bioquímicas convencionales, el sistema comercial VITEK® 1 y el método de análisis de restricción del ADNr 16S amplificado (ARDRA). Según las pruebas convencionales, 49 aislados se identificaron como complejo A. calcoaceticus-A. baumannii y 13 como Acinetobacter sp., mientras que por el VITEK® 1, 54 aislados se ubicaron en el complejo A. calcoaceticus - A. baumannii y 8 se identificaron a nivel de género solamente. Mediante el ARDRA se identificó como A. baumannii al 80,7 % de los aislados (50); el 3,2% correspondió a A. genoespecie 16(2); 1,6% fue identificado como A. pittii (1) y A. nosocomialis (1), respectivamente, y el 12,9% (8 aislados) no pudo ser identificado porobservarse patrones de bandas no compatibles con los descritos hasta ahora para esta bacteria. Se concluyó que, además de A. baumannii, se están aislado otras genoespecies de Acinetobacter, como A. pitti, A. nosocomialis y A. genoespecie 16, en los pacientes atendidos en el SAHUAPA