Distribution of Ambler Class A Β-lactamase Genes and Evaluation of Resistance Patterns in Multi-Drug and Extensively-Drug Resistant P. aeruginosa Clinical Isolates

Background and Objectives: Emergence and spread of multidrug-resistant (MDR) and extensively-drug resistant (XDR) Pseudomonas aeruginosa strains could complicate antipseudomonal chemotherapy. Dissemination of resistance genes, such as βlactamases encoding genes by horizontal gene transfer can lead to development of multidrug resistance in P. aeruginosa. The purpose of this study was to investigate the latest resistance patterns in MDR and XDR strains and evaluate Ambler class A β-lactamase gene distribution in P. aeruginosa clinical isolates. Methods: One hundred molecularly and biochemically identified P. aeruginosa strains isolated from different clinical specimens were tested for sensitivity to 17 antibiotics using the Kirby-Bauer disk diffusion method. PCR was performed to detect bla TEM-1, bla SHV-1, bla REP-1 and bla VEB-1 genes. Results were analyzed using SPSS and NTSYSpc softwares. Results: Based on the results of antibiogram, the highest rate of resistance was observed against amikacin (100%), aztreonam (83%), ceftazidime (55%), cefepime (55%) and netilmicin (48%). In addition, the frequency of MDR and XDR isolates was 95% and 5%, respectively. The blaSHV-1, bla TEM-1, bla PER-1 and bla VEB-1 genes were detected in 31%, 24%, 13% and 10% of the isolates, respectively. Conclusion: Antibiotic resistance to β-lactam antibiotics and frequency of βlactamase genes were relatively high in the study area. We also found that a significant proportion of XDR strains with different antibiotic resistance profile is isolated from tracheal