Prevalence of class 1 ntegron-carrying enterobacteriaceae species and pseudomonas aeruginosa in intensive care units of ain shams original university hospitals

ABSTRACT

This study was conducted to study the prevalence of class 1 integron carrying Enterobacteriacae spp. and P.aeruginosa isolated from ICU patients and to determine factors associated with integron presence as well to determine the association between integron carriage and multidrug resistance [MDR] expression. Fifty urine and 70 respiratory specimens were collected from 100 lCU patients and processed for microbiological examination. The isolated pathogens were identified by standard techniques thereafter tested for antibiotic susceptibility by disk diffusion and broth microdilution methods. Class 1 integron was detected by PCR targeting a specific fragment in intl1 gene. Twenty five Enterobacteriaceae spp. and 17 P.aerugmnosa isolates were recovered. About 79% [33/42] of the tested organisms were integron positive. The presence of class 1 integron in Enterobacteriaceae spp. was significantly associated with resistance to 14 from the 18 tested antibiotics, while in P. aeruginosa significance was confined to resistance to 5 from 11 tested antibiotics. There was a strong association between wide range resistance expression [resistant >/= 7 antibiotics] and the presence of integron. A significant association between production of new beta-lactamases [ESBLs, AmpC, Carbapenemases] and the presence of integron has been found where 72.7% [24/33] of integron positive isolates were beta-lactamase producers. Hospital-acquired infections, prolonged hospital stay, invasive procedures and non responsiveness to antimicrobial therapy were significantly associated with infections with integron positive organisms. Prevalence of integron positive organisms with wide range antibiotic resistance in our ICUs is high that mandates proper implementation of infection control measures and antibiotic policy to control their presence and dissemination