Molecular detection of mexXY-oprM, mexPQ-opmE Efflux pumps in multi-drug resistant Pseudomonas aeruginosa isolates in patients referred to teaching hospitals in Babylon province, Iraq

Abstract

One of the global health issues is antibiotic resistance in Pseudomonas aeruginosa, a causative agent of bacterial infections due to multidrug resistance (MDR), which may be mediated by efflux pumps' overexpression. The present study investigated the prevalence of mexXY-oprM, mexPQ-opmE genes as encoding agents of efflux pumps and the determination of antibiotic resistance rate in clinical isolates of P. aeruginosa. Different clinical specimens of infectious patients, such as wounds, urine, blood, discharge, and abscesses except for stool, were examined. Identification of the isolates was performed using Pseudomo-nas chromogenic agar. A selective medium for the isolation of P. aeruginosa, used to screen 79 isolates. The results were vali-dated by Polymerase chain reaction (PCR) utilizing particular primer pairs for the 16S rDNA gene of Pseudomonas spp. for identification of the isolates after incubation at 37°C for 24 hours. According to Clinical and Laboratory Standards Institute (CLSI) (2021) recommendations, a microbial susceptibility test was performed using the Kirby–Bauer disk diffusion method. P. aeruginosa was extremely resistant to ceftazidime (93.6%) and cefepime (77.2 %). In contrast, imipenem (77.2%) and mero-penem (67%) showed high sensitivity. Finally, mexXY-oprM, mexPQ-opmE genes were investigated by PCR technique. Molecular investigation revealed mexX 43%, mexY 51.89%, oprM .481%, mexP 36.70% mexQ 46.83% and opmE 51.89%. The present study concluded that mexXY-oprM and mexPQ-opmE may have a role in P. aeruginosa resistance to various antibiot-ics. Identifying resistant isolates and antibiotic monitoring programs is essential to prevent the spread of MDR isolates.