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J Med Microbiol 56 (2007), 956-963; DOI: 10.1099/jmm.0.46986-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Problematic clinical isolates of Pseudomonas aeruginosa from the university hospitals in Sofia, Bulgaria: current status of antimicrobial resistance and prevailing resistance mechanisms

Tanya Strateva1, Vessela Ouzounova-Raykova1, Boyka Markova2, Albena Todorova3, Yulia Marteva-Proevska2 and Ivan Mitov1

1 Department of Microbiology, Medical University of Sofia, 2 Zdrave Street, 1431 Sofia, Bulgaria

2 Laboratory of Clinical Microbiology, Alexander University Hospital, Medical University of Sofia, 1 Georgi Sofiiski Blvd, 1431 Sofia, Bulgaria

3 Laboratory of Molecular Pathology, University Hospital of Obstetrics and Gynecology, Medical University of Sofia, 2 Zdrave Street, 1431 Sofia, Bulgaria

Correspondence
Tanya Strateva
dr.strateva{at}abv.bg

Received 4 October 2006
Accepted 13 March 2007

A total of 203 clinical isolates of Pseudomonas aeruginosa was collected during 2001–2006 from five university hospitals in Sofia, Bulgaria, to assess the current levels of antimicrobial susceptibility and to evaluate resistance mechanisms to antipseudomonal antimicrobial agents. The antibiotic resistance rates against the following antimicrobials were: carbenicillin 93.1 %, azlocillin 91.6 %, piperacillin 86.2 %, piperacillin/tazobactam 56.8 %, ceftazidime 45.8 %, cefepime 48.9 %, cefpirome 58.2 %, aztreonam 49.8 %, imipenem 42.3 %, meropenem 45.5 %, amikacin 59.1 %, gentamicin 79.7 %, tobramycin 89.6 %, netilmicin 69.6 % and ciprofloxacin 80.3 %. A total of 101 of the studied P. aeruginosa isolates (49.8 %) were multidrug resistant. Structural genes encoding class A and class D ß-lactamases showed the following frequencies: blaVEB-1 33.1 %, blaPSE-1 22.5 %, blaPER-1 0 %, blaOXA-groupI 41.3 % and blaOXA-groupII 8.8 %. IMP- and VIM-type carbapenemases were not detected. In conclusion, the studied clinical strains of P. aeruginosa were problematic nosocomial pathogens. VEB-1 extended-spectrum ß-lactamases appear to have a significant presence among clinical P. aeruginosa isolates from Sofia. Carbapenem resistance was related to non-enzymic mechanisms such as a deficiency of OprD proteins and active efflux.

Abbreviations: AAC, aminoglycoside acetyltransferase; ANT, aminoglycoside nucleotidyltransferase; ESBL, extended-spectrum ß-lactamase; ICU, intensive care unit; LRTI, lower respiratory tract infection; MBL, metallo-ß-lactamase; URTI, upper respiratory tract infection.

The GenBank/EMBL/DDBJ accession nos for the P. aeruginosa blaVEB-1 and blaPSE-1 gene sequences are DQ333895 and M69058, respectively.




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