Molecular Characterization and Antibiotic Resistance of UroPathogenic Escherichia coli (UPEC) Isolates from Patients within the Eastern Province of Saudi Arabia A

Abstract

Antibiotic resistance poses a global challenge in the control of bacterial disease and it is of serious concern in Saudi Arabia. Pseudomonas aeruginosa is one of the main causes of antibiotic resistance in Saudi Arabia and its production of metallo-beta-lactamases enables the pathogen to resist most antibiotics. This study assessed the antibiotic susceptibility and the occurrence of metallo-beta-lactamase genes such as blaVIM, blaNDM-1and INT-1 in 110 clinical samples obtained from King Fahd University Hospital. Pseudomonas aeruginosa strains were identified using VITEK 2 system. The identified strains were confirmed using Cetrimide agar after which antimicrobial susceptibility was identified using VITEK 2 antimicrobial susceptibility cards. Polymerase chain reaction based molecular screening techniques was used to analyze the presence of blaVIM, blaNDM-1, and INT-1. 108 strains of P. aeruginosa were identified. Most of the strains were identified from the urine (21.5 %) and wound samples (17.4 %). Most of the strains were susceptible to beta lactam antibiotics while the non-beta lactam antibiotics such as Tobramycin, Levofloxacin, Gentamicin, Amikacin, and Colistin were less susceptible. The ERIC-PCR finger printing showed that the strains have ERIC sequences of varying lengths as shown by variation in the migration distances. The dendogram showed twenty different ERIC clusters, with four major clusters. Most (65.7 %) of the identified strains had at least one of the three genotypes of interest with the highest number (48.1 %) being reported to be NDM producers while the VIM producers were the least frequent strains. The combination blaVIM and blaNDM genotypes were the most frequently observed gene combination among the identified strains of P. aeruginosa while the combination of blaVIM and INT1 occurred in the least number of strains. The information obtained from the study is important in strategizing on the best approach in the management antibiotic resistance caused by P. aeruginosa in Saudi Arabia.