Study on aminoglycoside antibiotics resistance of Pseudomonas aeruginosa isolated from diabetic foot infections / 天津医药

ABSTRACT

Objective To investigate the clinical features, phenotypes and genotypes of Pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infection (DFI) resisting to aminoglycosides antibiotics (AmAn). Methods The clinical profiles of 209 DFI patients hospitalized in the Tianjin Metabolic Diseases Hospital were collected and ana?lyzed. Forty-one PA strains were identified, and their antibiotic resistance profiles were obtained. The DNAs of PA isolates were extracted and applied to amplifications for several aminoglycosides modifying enzyme genes, including aac(3′)-Ⅰ, aac (3′)-Ⅱ, aac(6′)-Ⅰb, aac(6′)-Ⅱ, ant(2′′)-Ⅰand ant(3′′)-Ⅰby PCR method. Combining with the clinical features and the antibiotic resistance profiles, the relationship between genotypes and phenotypes of the PA strains was analyzed. Results Gram positive bacteria (G+) were the majority of the pathogen with 51.67%detection rate. The total detection rate of PA was 19.62%, listed as the top one pathogenic bacterium among gram negative bacteria (47.67%). There was significant difference in the ratio of ulcer area≥4 cm2 between PA group and non-PA group and G+group. There were significantly higher inci?dence rate of ischemic ulcer and osteomyelitis in PA group than those of G+group. There were higher clinical characteristics and ulcer depth (SAD) score, and increased hypersensitive C-reactive protein in PA group than those of G+ group. There were 30 strains of PA being resistant to AmAn (73.17%). The predominant drug resistance gene to AmAn was ant(3′′)-Ⅰ(65.85%), and aac(3′)-Ⅰgene was not found from all PA isolates. Conclusion The detection rate of PA isolated from DFI patients was higher, and patients were with the characteristics of larger, deeper and severe ischemia of ulcer area. The phe?nomenon of PA resistant to AmAn was more serious, and ant(3′′)-Ⅰgene identified from PA isolates was the most common resistance gene identified to AmAn.