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PubMed2001

Heterogeneity among infecting strains of Pseudomonas aeruginosa in diverse departments of a large Tunisian hospital.

Clinical isolates of Pseudomonas aeruginosa were obtained during a half-year screening period of five different wards of the La Rabta Hospital (Tunis). Distinct clinical isolates (N= 82) were obtained from patients, 40 (48%) of which originated from the Department of Otolaryngology. In order to define the local epidemiology of this opportunistic organism, all strains were serotyped, analysed for pyocin production and genetically characterized with the help of pulsed-field gel electrophoresis (PFGE). The data show that, despite the frequent occurrence of identical serotypes, most of the isolates represent unique pyocin types (N= 53) and genotypes (N= 64). A combination of the pyocin and PFGE data showed that nearly all strains were of unique types, except for two pairs of strains. A limited number of strain clusters was observed on the basis of DNA typing data alone. This involved eight genotypes, some of which were clustered with respect to clinical environment or time. Genotype 22 occurred most frequently (6/83, 7%) and independently of time and locale, indicating that it may represent either a clonal type constituting a major fraction of all P. aeruginosa isolates in the region or a more prevalent organism. Despite a relatively high incidence of P. aeruginosa infections, the polyclonality of these strains shows that, in La Rabta Hospital, pseudomonal infections are not primarily due to excessive spread of a single bacterial genotype.

Cross Infection↗

PubMed2004

[Antibiotic resistance and molecular epidemiology of Shigella spp. in northeastern Argentina].

OBJECTIVES: To evaluate the antibiotic resistance of strains of Shigella spp. isolated from feces samples from northeastern Argentina and to characterize the strains in terms of their molecular epidemiology. METHODS: We studied 132 isolates of Shigella spp. obtained from feces samples from 132 patients with diarrhea who were seen at various private and public laboratories in the Argentine provinces of Chaco and Corrientes during the period of 1998 to 2002. Each strain was characterized according to its serotype, its resistance to 13 individual or combination antibiotics, and its sensitivity to pyocins. With 52 strains selected in relation to their antimicrobial susceptibility profiles we conducted plasmid profile analysis using alkaline lysis, and the repetitive extragenic palindromic sequences were determined by amplifying repetitive DNA segments using polymerase chain reaction. The chi-square test was used to compare proportions, with a level of statistical significance of 0.05. RESULTS: Shigella flexneri was the most common species (78%), followed by S. sonnei (22%). In general, the resistance of S. flexneri to the antibiotics studied was greater than that of S. sonnei, and this difference was statistically significant (P < 0.001) for ampicillin, tetracycline, chloramphenicol, and the combination of ampicillin and sulbactam. The S. flexneri strains also showed multiple resistance more often than S. sonnei strains (84.5% vs. 31.0%; P < 0.001). The strains isolated from S. flexneri were grouped into five pyocin types, three plasmid profiles, and five patterns of repetitive palindromic sequences. The strains of S. sonnei formed three pyocin types, two plasmid profiles, and three patterns of repetitive palindromic sequences. CONCLUSIONS: Given that the Shigella species that were studied showed a high level of resistance to the most frequently used antibiotics, surveillance activities should be implemented in order to detect and control the appearance of new resistant strains. Applying epidemiological typing techniques can provide more precise information about the distribution and evolution of resistant strains of circulating microorganisms.

Argentina↗

PubMed1994

Genotypic and phenotypic characters and nosocomial significance of bacteria endemic in neonatal intensive care units.

The degree of colonization was determined by complex typing (sero-, phage, colicin-, pyocin typing, plasmid profile analysis) of 212 Escherichia coli, 232 Klebsiella, 117 Pseudomonas aeruginosa and 52 Staphylococcus aureus strains isolated from nose, throat, ear and other sources of 563 new-born infants in gynaecological and maternity wards of two neonatal intensive care units (NICU I and II) during a one year period. The presence of Klebsiella strains was more frequent in NICU I and E. coli and P. aeruginosa in NICU II, S. aureus occurred in a low level in both units. In NICU I 34 kinds, in NICU II 43 kinds of E. coli serotype were found. In NICU I the accumulation of serotypes O6:H-, O6:H1, O19:H-, in NICU II O4:H-, O6:H1 was observed. The Klebsiella strains belonged in NICU I into 21, in NICU II into 12 phage types. Klebsiella was more frequent in NICU I than in NICU II, though the strains belonged to the same phage type in NICU II in 50.7%, but in NICU I 4 frequent and 19 rare phage types occurred. Sero- and pyocin typing was effective for typing of P. aeruginosa. The most frequent sero- and pyocin types were in NICU I:O11a,11b; in NICU II: O2a,2d,2f; 12v. The rate of antibiotic resistance in E. coli, Klebsiella, P. aeruginosa and S. aureus was nearly the same in both units, multiple resistance was more frequent in NICU I (except P. aeruginosa, it was multiple resistant in 100% in both units). In NICU I 267, in NICU II 174 infants were treated with antibiotics. The administration of penicillin derivatives was nearly similar in the two care units and the resistance among E. coli and Klebsiella strains was nearly the same too. Though, cephalosporins were used more frequently in NICU II, resistance to cephalosporins among E. coli and Klebsiella was a bit higher in NICU I. Aminoglycosides were more often used in NICU I, resistance to aminoglycosides among E. coli and Klebsiella was higher in this unit. The rate of isolation of the examined bacteria was significantly lower in the group treated with antibiotics, than in the untreated group.

Antigens, Bacterial↗

PubMed1988

Epidemiological typing of Pseudomonas aeruginosa.

Current knowledge of the typing of Pseudomonas aeruginosa and new methods for characterizing strains are reviewed. A combination of serotyping as a primary screen with pyocin typing for finer discrimination between isolates gives valid epidemiological data, is within the scope of most clinical laboratories and is to be recommended. Phage typing and H typing do provide good discrimination but are not reproducible in practice because a reaction-difference rule has to be applied to phage patterns, and diphasic variation reduces the accuracy of the identification of flagellar antigens. A problem remains with cystic fibrosis isolates, which show considerable heterogeneity in surface properties. For these strains pyocin production typing by the revised method of Govan is indicated. Newer techniques such as isoenzyme profile and DNA probes of the chromosome require independent evaluation and due to their technical difficulty may not be adopted in a routine context for some years to come.

Antigens, Bacterial↗

PubMed1988

Prevalence and profiles of plasmids in Pseudomonas aeruginosa.

The value of plasmid profile determination as an epidemiological tool in Pseudomonas aeruginosa infections was investigated by determining the prevalence of plasmids in 450 Pseudomonas aeruginosa strains and comparing the technique with other epidemiological tools. Since only 13.9% of these strains harbored plasmids and the majority of these plasmids were antibiotic resistant, the technique appeared to be less appropriate as an epidemiological tool in this organism than other techniques. Comparison of results obtained from plasmid profile determinations with those from antibiotyping, serotyping and pyocin typing in 50 non-epidemic strains showed the technique gave highly reproducible results and was sensitive; its ability to discriminate could be improved by additionally performing conjugation assays and hydrolysis of plasmidic DNA with restriction enzymes. It is concluded that plasmid profiles provide important epidemiological information on Pseudomonas aeruginosa infections when performed in conjunction with either serotyping or, more importantly, pyocin typing.

Anti-Bacterial Agents↗

PubMed1987

Multivariate analysis of antibiograms for typing Pseudomonas aeruginosa.

A method for typing Pseudomonas aeruginosa using antibiotic susceptibility patterns is presented, which allows recognition of clusters of the same strain among clinical isolates from different patients, thus indicating whether cross infection has occurred. An index of similarity (the euclidean or the oblique distance), which includes all the differences of disk zone sizes among isolates, is computed and then elaborated by a clustering algorithm that successively groups all the isolates in larger clusters. The results of clustering are presented as dendrograms, whose terminal branches are pruned down to a level below which differences are casual; isolates that still appear on a common branch are considered identical. The reliability of this technique for detecting nosocomial cross infections was assessed by comparing its results with that of serotyping and pyocin typing. Only 2 of 31 (6.4%) clusters detected by multivariate analysis were not confirmed, while 4 of 33 (12.1%) clusters were recognized by serotyping and pyocin typing, but not by multivariate analysis. In at least two instances the differences in susceptibility patterns were due to cytoplasmic R factors. The routine use of antibiogram data for typing purposes should be considered an essential part of nosocomial infection control.

Anti-Bacterial Agents↗

PubMed1982

Isolation of a lipopolysaccharide mutant of Neisseria gonorrhoeae: an analysis of the antigenic and biologic difference.

Analysis of the surface constituents of a pyocin 611 131-resistant variant of strain no. JW-31 of Neisseria gonorrhoeae revealed substantial differences in the lipopolysaccharide (LPS) but not changes in the auxotype or outer-membrane proteins. Immunodiffusion and an enzyme-linked immunosorbent assay showed that the variant strain (no. JW-31R) lost both the LPS serotype and the variable antigens while retaining at least a portion of the common determinant. The use of monoclonal antibody indicated that LPSs from strain no. JW-31R and pyocin 611 131-resistant strains of other LPS serotypes lack a D-galactosaminyl-D-galactopyranosyl-D-glucose moiety. The LPS-derived polysaccharide from strain no. JW-31 binds to wheat-germ lectin in precipitin and inhibition systems, whereas the JW-31R polysaccharide exhibits a markedly reduced affinity. In the presence of normal human serum, 99% of strain no. JW-31R was killed within 20 min and strain no. JW-31 was not.

Animals↗

PubMed1985

Pseudomonas aeruginosa: evidence for the involvement of lipopolysaccharide in determining outer membrane permeability to carbenicillin and gentamicin.

The role of lipopolysaccharide (LPS) in determining the permeability of the outer membrane of Pseudomonas aeruginosa to carbenicillin and gentamicin was investigated. The susceptibility of P. aeruginosa isolates to smooth LPS-specific phages and to pyocin R1 gave indirect evidence of an altered LPS structure in strains resistant to carbenicillin, gentamicin, or both. Some secondary mutation, however, also appeared to be required for acquisition of the antibiotic-resistant phenotype. Phage- and pyocin-resistant variants demonstrating both wild-type and mutant responses to the drugs were subsequently isolated. Four-, eight-, and 16-fold increases in resistance to carbenicillin, supersusceptible responses to gentamicin, or both, were associated with a number of the LPS-altered mutants. The results supported the hypothesis that a primary mutation involving LPS, in combination with some undefined secondary mutation, determines the permeability of the outer membrane to carbenicillin and to gentamicin.

Bacteriophages↗

PubMed1990

Ecology of Pseudomonas aeruginosa in patients with cystic fibrosis.

The occurrence of various Pseudomonas aeruginosa strains in the sputum of 15 patients with cystic fibrosis (CF) was monitored over periods ranging from 2 to 60 months. Isolates of P. aeruginosa were typed by four different techniques, namely serotyping, active and passive pyocin typing, and phage typing. The maximum number of different serotypes found in the patients was three (one serotype in nine patients; two serotypes in five patients; three serotypes in one patient). Pyocin and phage typing showed no marked differences between strains of the same serotype in individual patients. Exacerbations of chronic respiratory infection were not associated with changes in the sputum flora, the composition of P. aeruginosa strains in which remains constant over long periods in patients with CF.

Adolescent↗

PubMed2003

Identification of type II and type III pyoverdine receptors from Pseudomonas aeruginosa.

Pseudomonas aeruginosa produces, under conditions of iron limitation, a high-affinity siderophore, pyoverdine (PVD), which is recognized at the level of the outer membrane by a specific TonB-dependent receptor, FpvA. So far, for P. aeruginosa, three different PVDs, differing in their peptide chain, have been described (types I-III), but only the FpvA receptor for type I is known. Two PVD-producing P. aeruginosa strains, one type II and one type III, were mutagenized by a mini-TnphoA3 transposon. In each case, one mutant unable to grow in the presence of the strong iron chelator ethylenediaminedihydroxyphenylacetic acid (EDDHA) and the cognate PVD was selected. The first mutant, which had an insertion in the pvdE gene, upstream of fpvA, was unable to take up type II PVD and showed resistance to pyocin S3, which is known to use type II FpvA as receptor. The second mutant was unable to take up type III PVD and had the transposon insertion in fpvA. Cosmid libraries of the respective type II and type III PVD wild-type strains were constructed and screened for clones restoring the capacity to grow in the presence of PVD. From the respective complementing genomic fragments, type II and type III fpvA sequences were determined. When in trans, type II and type III fpvA restored PVD production, uptake, growth in the presence of EDDHA and, in the case of type II fpvA, pyocin S3 sensitivity. Complementation of fpvA mutants obtained by allelic exchange was achieved by the presence of cognate fpvA in trans. All three receptors posses an N-terminal extension of about 70 amino acids, similar to FecA of Escherichia coli, but only FpvAI has a TAT export sequence at its N-terminal end.

Amino Acid Sequence↗

PubMed1994

[Formation of drug-induced serotype variants of Pseudomonas aeruginosa: changes in biochemical properties, drug susceptibility and outer membrane proteins].

The serotype variants were formed in some isolates of Pseudomonas aeruginosa in the presence of anti-pseudomonal drugs in vitro. Pyocin type, various biochemical properties and drug susceptibility of these variants were compared with those of the parent cells. Furthermore, the patterns of outer membrane proteins were also examined for some respective parent and variant cells by the SDS-PAGE and compared with their drug susceptibilities. In P. aeruginosa No. 1-S (serotype E) and No. 1-R (serotype C), simultaneously isolated from the identical specimen of the infectious patient, the serotype variants were formed by anti-pseudomonal drugs and accompanied by changes in pyocin types, some biochemical properties and susceptibilities to various kinds of anti-pseudomonal drugs. When the profiles of outer membrane proteins of P. aeruginosa No. 1-R parent and two variant cells were evaluated by the SDS-PAGE, the quantitative differences of the porin proteins between the parent and variant cells were well related to their drug susceptibilities. Although eight variant cells with other serotype were formed from the parent cells (serotype A) of P. aeruginosa No. 13, four variants with serotype M and one non-typable variant showed changes in drug susceptibility such as resistance to imipenem only and no changes in biochemical properties. On the other hand, three other variants showed marked changes in two kinds of biochemical properties and in susceptibilities to various kinds of anti-pseudomonal drugs. From the results of SDS-PAGE, it was found that the porin protein profiles of outer membranes of these parent and variant cells except a few cells which corresponded to their drug susceptibility.

Anti-Bacterial Agents↗

PubMed1979

[Verification of nosocomial infection chains with Pseudomonas aeruginosa (author's transl)].

With all 3 typing methods (sero, lyso, pyocin type) errors can arise. The pyocin test following heat curing can be expected to give the least erroneous results. This was demonstrated by a test of 200 non-selected strains which were grown within 4 weeks. The possibility exists that a single patient discharges several different strains simultaneously or in succession. These results must be considered when efforts are made to detect infection chains in a hospital.

Bacteriophage Typing↗

PubMedDate not supplied

[Epidemiologic markers in the study of Pseudomonas aeruginosa from a pediatric intensive care unit].

A study was made on 198 Pseudomonas aeruginosa strains isolated at a pediatric intensive care unit from January to August 1988, using pyocin typing and antibiotic typing as markers. The most frequent circulating pyocin types were 31.83 and atypical 23578. The germ showed high resistance in vitro to the antimicrobial drugs used and the resistance patterns were distributed in 19 different antibiotic types.

Bacterial Typing Techniques↗

PubMed2001

Molecular characterization of the klebicin B plasmid of Klebsiella pneumoniae.

The nucleotide sequence of a bacteriocin-encoding plasmid isolated from Klebsiella pneumoniae (pKlebB-K17/80) has been determined. The encoded klebicin B protein is similar in sequence to the DNase pyocins and colicins, suggesting that klebicin B functions as a nonspecific endonuclease. The klebicin gene cluster, as well as the plasmid backbone, is a chimera, with regions similar to those of pore-former colicins, nuclease pyocins and colicins as well as noncolicinogenic plasmids. Similarities between pKlebB plasmid maintenance functions and those of the colicin E1 plasmid suggest that pKlebB is a member of the ColE1 plasmid replication family.

Amino Acid Sequence↗

PubMed1987

Susceptibility to mercurials of clinical Pseudomonas aeruginosa isolated in México.

Susceptibility to inorganic mercuric ions and to organomercurials of 237 Pseudomonas aeruginosa clinical strains isolated in Mexico was determined by agar dilution tests. Resistant strains fell into two classes: i) narrow-spectrum resistant strains (27% of total isolates) resistant only to mercuric ions and to merbromin, and most grouped in pyocin type 1; and ii) broad-spectrum resistant strains (5%) with additional resistances to thimerosal, phenylmercury, methylmercury and p-hydroxymercuribenzoate, that belonged mostly to pyocin type 10. Mercurial resistant isolates showed a higher proportion of resistance to antibiotics and metals than did mercurial sensitive isolates, and broad-spectrum resistant strains had the highest frequency of resistance to antibiotics and to tellurite and arsenate.

Humans↗

PubMed1995

Epidemiological characteristics of Pseudomonas aeruginosa strains causing infection in an Italian general hospital. A one-year surveillance.

During the 1989 calendar year, P. aeruginosa caused clinical infections in 0.46% of patients admitted to Ospedali Riuniti (a general hospital), Bergamo, Italy. Strains (n = 267) of P. aeruginosa were collected during this period, and epidemiological characteristics were studied. The mean prevalence of P. aeruginosa infection in inpatients was 1.1% (range 0.06-7.3), whereas outpatients showed a significantly lower prevalence of infection (0.05%). Strains were recovered from inpatients of surgical wards (n = 126; 47.2%), and outpatients (n = 15; 5.6%). Males were more often affected than females (2.7:1). Infection of the urinary tract was the most common (34.1%). Pseudomonas aeruginosa was also involved in lower respiratory tract infections (18.7%) and septicaemia (17.6%). Four typing methods were performed, i.e. serotyping, antibiotyping, pyocin typing, and restriction endonuclease analysis (REA). Serotypes O:11 and O:6 were endemic in the hospital. Some serotypes correlated with specific clinical wards. Pyocin typing was an unreliable epidemiological tool. However, antibiotyping showed the presence of some epidemic clusters, probably related to the antibiotic consumption of the patients. REA suggested the circulation of edemic P. aeruginosa strains in both the obstetrics and neurosurgery wards.

Cross Infection↗

PubMed2001

Spread of a multiresistant strain of Pseudomonas aeruginosa in an adult cystic fibrosis clinic.

We initiated a prospective surveillance study to investigate possible Pseudomonas aeruginosa cross-infection in our cystic fibrosis centre. We characterised isolates by pyocin typing and pulsed-field gel electrophoresis. 22 (14%) of 154 patients with chronic P aeruginosa had isolates with similar and new pyocin and pulsed-field gel electrophoresis types. The shared isolates showed unusual phenotypic features: they were non-pigmented, non-motile, and resistant to a number of antipseudomonal antibiotics. Cross-infection by a multiresistant P aeruginosa strain has therefore occurred in patients attending our cystic fibrosis centre. We recommend microbiological surveillance in other cystic fibrosis centres.

Adult↗

PubMed1996

Typing of Pseudomonas aeruginosa strains from patients with cystic fibrosis: phenotyping versus genotyping.

OBJECTIVE: To assess the discriminatory power of two genotypic and two phenotypic techniques by analysis of Pseudomonas aeruginosa sputum isolates obtained with long term intervals from 29 independent cystic fibrosis (CF) patients. METHODS: Fifty-eight strains of P. aeruginosa were subjected to serotyping and pyocin production was assessed. Arbitrarily primed polymerase chain reaction (AP PCR) and pulsed-field gel electrophoresis (PFGE) were applied in order to detect genetic polymorphisms. RESULTS: From the results of different typing techniques, it appeared that the numbers of separate types varied between 11 and 43, and the percentage of identical P. aeruginosa pairs from individual patients varied between 51% and 72%, depending on the test system used. AP PCR and PFGE displayed enhanced resolution when compared to serotyping and pyocin typing; both DNA typing techniques generated concordant results, although differences in resolution are apparent. This results in 15% discordance, which may be the result of differences in the definitions of (sub)clonal relatedness as applied for AP PCR and PFGE, respectively. CONCLUSIONS: Molecular typing techniques are superior to phenotyping where P. aeruginosa is concerned. AP PCR is a fast and useful technique for determining clonality among P. aeruginosa strains from chronically colonized CF patients. It is clear, however, that the interpretation of data and comparative analysis of PFGE and AP PCR results necessitates additional (international) standardization and the development of practical guidelines.

Journal Article↗