Unveiling clones and integrons dynamics associated with carbapenemase-producing P. aeruginosa clinical isolates in a portuguese hospital

Abstract

[Excerpt] Particular epidemic lineages (e.g. 235, 111, ST175 and 244) are associated with carbapenemase-producing P. aeruginosa (CPPA) isolates causing infections. Due to limited therapeutic options and possible carbapenemase spread, CPPA infections are of great concern. Nevertheless, the occurrence, genetic background and clonal dynamics over a long period of time of CPPA strains in Portuguese hospitals are unknown. The study aimed to assess the occurrence and the genetic background of CPPA isolates obtained from a Portuguese University Hospital. Carbapenem-resistant P. aeruginosa isolates obtained from different biological samples from inpatients attending the Hospital Geral de Santo António, Porto during 2006 (n=27) and 2011-3 (n=135) were included. Carbapenemase production was searched by Blue-Carba. Carbapenemase and associated integrons were characterized by PCRs and sequencing. Antimicrobial susceptibility was performed by disc diffusion, E-test and agar dilution methods. Clonality was assessed by MLST. The bla genes location was assessed by I-CeuI/ S1 PFGE and hybridization with specific probes. Plasmid analysis included identification of incompatibility groups by PCR and electrotransformation of P. aeruginosa PAO1. [...]