Community Acquired Pseudomonas aeroginosa Urinary Tract Infections in Children Hospitalized in a Baqiatallah Hospital, Tehran, Iran: Virulence Profile and Antibiotic Resistance Properties

M. Dadmanesh1, M. Pilehvarzadeh2, M. Eramabadi3 , P. Eramabadi3, M.B. Moghadam4 and F. Mashayekhi5*

1Department of Infectious Diseases, School of Medicine, AJA University of Medical Sciences,Tehran , Iran 2Master of Nursing Education, Lecturer of Nursing Midwifery Faculty, Jiroft university of Medical Sciences, Jiroft, Iran. 3Young Researchers and Elite Club, Chalous Branch, Islamic Azad University, Chalous, Iran. 4Baqiyatallah University of Medical Sciences, Tehran , Iran. 5Intensive and Critical Care Nursing Lecturer Faculty Member of Jiroft university of Medical Sciences, Jiroft , Iran.

ABSTRACT:

Pseudomonas aeroginosa is the third most common pathogen associated with hospital-acquired UTIs. From a clinical perspective, it is important to know which virulence profile and antibiotic resistance properties are present in P. aeroginosa strains in pediatric patients suffering from urinary tract infections. The purpose of this clinical study was, virulence profile and antibiotic resistance properties Pseudomonas aeroginosa urinary tract infections in children hospitalized. Two hundred and twenty urine samples were collected from the hospitalized pediatrics of Baqiat-alah Hospital, Tehran, Iran. Samples were cultured and those that were P. aeroginosa-positive were analyzed for the presence of antibiotic resistance genes and bacterial virulence factors using PCR. Antimicrobial susceptibility was performed using disk diffusion method. Eight out of 90 (8.88%) male and 15 out of 130 (11.53%) female urine samples were positive for P. aeroginosa. The highest levels of antibiotic resistance of the P. aeroginosa isolates of our investigation was observed against ampicillin (52.17%), gentamycin (47.82%), ciprofloxacin (39.13%) and netilmycin (34.78%), while resistance against piperacillin and imipenem were 4.34% and 17.39%, respectively. The incidence of genes encoding resistance against a-lactamse antibiotic i.e., blaSHV, blaTEM, blaDHA and blaOXA were 69.56%, 47.82%, 34.78% and 30.43%, respectively. The most commonly detected virulence factors were exoS (73.91%), toxA (69.56%), exoT (65.21%) and phzM (43.47%). Conclusions : Our findings should raise awareness about antibiotic resistance in pediatrics with UTIs. Regular prescription of piperacillin, imipenem, polymyxin B and colistin has been suggested fro clinicians.

KEYWORDS:

P. aeroginosa; Virulence profile; Antibiotic resistance; Urinary tract infections; Pediatrics

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