Articles In Press
Back to the articles list |
Back to browse issues page
1- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran. , azeh9061@gmail.com
2- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran.
3- Department of Pediatric Pulmonary and Sleep Medicine, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran.
3- Department of Pediatric Pulmonary and Sleep Medicine, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Abstract: (91 Views)
Background and Aims: Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative bacterium that causes lung infections in cystic fibrosis (CF) patients by forming biofilms, which contribute to antibiotic resistance. The genetic diversity among strains could be important epidemiologically in the community of CF patients. This study investigated P. aeruginosa strains from CF patient sputum, focusing on their antibiotic resistance, biofilm production, and genetic diversity to understand their epidemiological relations.
Methods: Sixty-five strains of P. aeruginosa were isolated from CF patients with pulmonary infection symptoms (October 2023 to October 2024) at Imam Khomeini Children's Hospital in Tehran when the patients were admitted to the hospital. The antibiotic susceptibility patterns of these strains were examined using the disk diffusion method (Kirby-Bauer), based on the CLSI standard. Moreover, to evaluate colistin susceptibility, the broth microdilution (BMD) method was used. The strains' ability to produce biofilms was evaluated using a microtiter plate (MTP) assay. Finally, RAPD-PCR (Random Amplified Polymorphic DNA- Polymerase Chain Reaction) was employed for genetic analysis, using the short primer 272.
Results: 61.53% of P. aeruginosa strains exhibited MDR (Multidrug-Resistance), while 30.7% of the strains exhibited XDR (Extensively drug-resistant) characteristics. The highest levels of antibiotic resistance were found against amoxicillin, amikacin, and Cefepime. XDR and MDR strains exhibited a strong biofilm-forming ability. The 65 studied strains were classified into 19 groups based on RAPD-PCR patterns, with six strains sharing similar genetic traits divided into four categories.
Conclusion: The study showed a rise in antibiotic resistance in P. aeruginosa and established a strong connection between biofilm production and resistance. Some isolates exhibited similar genetic patterns, indicating possible cross-infection.
Type of Study: Original Research Article |
Subject:
Antibiotic Resistance
Received: 2025/05/16 | Accepted: 2025/08/4 | ePublished: 2025/08/18
Received: 2025/05/16 | Accepted: 2025/08/4 | ePublished: 2025/08/18
References
1. Pournajaf A, Razavi S, Irajian G, Ardebili A, Erfani Y, Solgi S, et al. Integron types, antimicrobial resistance genes, virulence gene profile, alginate production and biofilm formation in Iranian cystic fibrosis Pseudomonas aeruginosa isolates. Infez Med. 2018;26(3):226-36.
2. Alavi Foumani A, Yaghubi Kalurazi T, Mohammadzadeh Rostami F, Sedigh Ebrahim-Saraie H, Nazari-Alam A, Halaji M. Epidemiology of Pseudomonas aeruginosa in cystic fibrosis patients in Iran: A systematic review and meta-analysis. Infez Med. 2020;28(3):314-21.
3. Parisi GF, Mòllica F, Giallongo A, Papale M, Manti S, Leonardi S. Cystic fibrosis transmembrane conductance regulator (CFTR): beyond cystic fibrosis. Egypt J Med Hum Genet. 2022;23(1):94. [DOI:10.1186/s43042-022-00308-7]
4. Yıldız CA, Gökdemir Y, Erdem Eralp E, Ergenekon P, Karakoç F, Karadağ B. Cystic Fibrosis Treatment Landscape: Progress, Challenges, and Future Directions. Turk Arch Pediatr. 2025;60(2):117-25. [DOI:10.5152/TurkArchPediatr.2025.24257] [PMID] [PMCID]
5. Sellers ZM, Assis DN, Paranjape SM, Sathe M, Bodewes F, Bowen M, et al. Cystic fibrosis screening, evaluation, and management of hepatobiliary disease consensus recommendations. Hepatology. 2024;79(5):1220-38. [DOI:10.1097/HEP.0000000000000646] [PMID] [PMCID]
6. Bayfield KJ, Douglas TA, Rosenow T, Davies JC, Elborn SJ, Mall M, et al. Time to get serious about the detection and monitoring of early lung disease in cystic fibrosis. Thorax. 2021;76(12):1255-65. [DOI:10.1136/thoraxjnl-2020-216085] [PMID]
7. Mateu-Borrás M, González-Alsina A, Doménech-Sánchez A, Querol-García J, Fernández FJ, Vega MC, et al. Pseudomonas aeruginosa adaptation in cystic fibrosis patients increases C5a levels and promotes neutrophil recruitment. Virulence. 2022;13(1):215-24. [DOI:10.1080/21505594.2022.2028484] [PMID] [PMCID]
8. Reyne N, McCarron A, Cmielewski P, Parsons D, Donnelley M. To bead or not to bead: A review of Pseudomonas aeruginosa lung infection models for cystic fibrosis. Front Physiol. 2023;14:1104856. [DOI:10.3389/fphys.2023.1104856] [PMID] [PMCID]
9. Vetrivel A, Ramasamy M, Vetrivel P, Natchimuthu S, Arunachalam S, Kim G-S, et al. Pseudomonas aeruginosa biofilm formation and its control. Biologics. 2021;1(3):312-36. [DOI:10.3390/biologics1030019]
10. Sahoo K, Meshram S. Biofilm Formation in Chronic Infections: A Comprehensive Review of Pathogenesis, Clinical Implications, and Novel Therapeutic Approaches. Cureus. 2024;16(10):e70629. [DOI:10.7759/cureus.70629]
11. Pang Z, Raudonis R, Glick BR, Lin TJ, Cheng Z. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies. Biotechnol Adv. 2019;37(1):177-92. [DOI:10.1016/j.biotechadv.2018.11.013] [PMID]
12. Bhagirath AY, Li Y, Somayajula D, Dadashi M, Badr S, Duan K. Cystic fibrosis lung environment and Pseudomonas aeruginosa infection. BMC Pulm Med. 2016;16(1):174. [DOI:10.1186/s12890-016-0339-5] [PMID] [PMCID]
13. Parsa P, Amirmozafari N, Nowruzi B, Bahar MA. Molecular characterization of polymorphisms among Pseudomonas aeruginosa strains isolated from burn patients' wounds. Heliyon. 2020;6(12):e05041. [DOI:10.1016/j.heliyon.2020.e05041] [PMID] [PMCID]
14. Nasirmoghadas P, Yadegari S, Moghim S, Esfahani BN, Fazeli H, Poursina F, et al. Evaluation of Biofilm Formation and Frequency of Multidrug-resistant and Extended Drug-resistant Strain in Pseudomonas aeruginosa Isolated from Burn Patients in Isfahan. Adv Biomed Res. 2018;7:61. [DOI:10.4103/abr.abr_37_17] [PMID] [PMCID]
15. Mahon CR, Lehman DC. Textbook of Diagnostic Microbiology-E-Book: Textbook of Diagnostic Microbiology-E-Book: Elsevier Health Sciences; 2022.
16. Levinson WE. Review of Medical Microbiology and Immunology. McGraw-Hill Education; 2018. Available from: [http://thuvienso.thanglong.edu.vn//handle/TLU/6101]
17. Sands KM, Twigg JA, Lewis MAO, Wise MP, Marchesi JR, Smith A, et al. Microbial profiling of dental plaque from mechanically ventilated patients. J Med Microbiol. 2016;65(2):147-59. [DOI:10.1099/jmm.0.000212] [PMID] [PMCID]
18. Wayne PA. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing. INFORM SUPPL. 2011;31(1):100-21.
19. Goudarzi M, Navidinia M. Overview perspective of bacterial strategies of resistance to biocides and antibiotics. Arch Clin Infect Dis. 2019;14(2):e65744. [DOI:10.5812/archcid.65744]
20. Saderi H, Owlia P. Detection of Multidrug Resistant (MDR) and Extremely Drug Resistant (XDR) P. Aeruginosa Isolated from Patients in Tehran, Iran. Iran J Pathol. 2015;10(4):265-71.
21. Hosseini MS, Navidinia M, Seyedjavadi SS, Goudarzi M, Rasouli H, Mahdavian AM, et al. Evaluation of the antagonistic effect of Pseudomonas aeruginosa toxins on azole antifungal resistance in Candida albicans species isolated from clinical samples in Iran. Iran J Microbiol. 2025;17(2):293-302. [DOI:10.18502/ijm.v17i2.18395] [PMID] [PMCID]
22. Satlin MJ, Lewis JS, Weinstein MP, Patel J, Humphries RM, Kahlmeter G, et al. Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing Position Statements on Polymyxin B and Colistin Clinical Breakpoints. Clin Infect Dis. 2020;71(9):e523-e9. [DOI:10.1093/cid/ciaa121] [PMID]
23. Hemmati J, Nazari M, Abolhasani FS, Ahmadi A, Asghari B. In vitro investigation of relationship between quorum-sensing system genes, biofilm forming ability, and drug resistance in clinical isolates of Pseudomonas aeruginosa. BMC Microbiol. 2024;24(1):99. [DOI:10.1186/s12866-024-03249-w] [PMID] [PMCID]
24. Ghazi M, Goudarzi H, Dadashi M, Maleki DT, Ilkhichi PA, Goudarzi M, et al. Antibiotic Resistance and RAPD-PCR Genotyping of Pseudomonas aeruginosa Clinical Strains Isolated from Intensive Care Unit Patients. Nov Biomed. 2021;9(2):52-7.
25. Rastegar-Kashkouli A, Khaledi A, Moammer F, Sanani MG, Heidari MM, Eghbal AF. Systematic review and meta-analysis on the prevalence and antibiotic susceptibility pattern in Pseudomonas aeruginosa isolated from cystic fibrosis patients. Eurasian J Med. 2024;56(3):189. [DOI:10.5152/eurasianjmed.2024.23302] [PMID] [PMCID]
26. Al-Awsi GRL, Alsudani AA, Jabir SM, Al-Mudhaffar M, editors. Genetic Diversity among Pseudomonas aeruginosa Isolated From Different Sources in Al-Diwaniyah City, Iraq Using RAPD-PCR Technique2019: IOP Publishing.
27. Elahi G, Goli HR, Shafiei M, Nikbin VS, Gholami M. Antimicrobial resistance, virulence gene profiling, and genetic diversity of multidrug-resistant Pseudomonas aeruginosa isolates in Mazandaran, Iran. BMC Microbiol. 2024;24(1):546. [DOI:10.1186/s12866-024-03707-5] [PMID] [PMCID]
28. Raoofi A, Zare Karizi S, Honarmand Jahromi S. Evaluation of antibiotic resistance patterns and biofilm formation potential in clinical strains of Pseudomonas aeruginosa Quarterly Scientific. J Anim Ecol. 2018;22:483-8.
29. Ramazani R, Izadi Amoli R, Taghizadeh Armaki M, Pournajaf A, Kaboosi H. A molecular New Update on the Biofilm Production and Carbapenem Resistance Mechanisms in Clinical Pseudomonas aeruginosa Isolates. Iran J Med Microbiol. 2022;16(6):557-65. [DOI:10.30699/ijmm.16.6.557]
30. Karamollahi S, Nikravan M, Asadollahi P, Ghafourian S, Maleki A, Heidari H, et al. Assessment of the Correlation Between Biofilm Formation and Resistance to Various Classes of Beta-Lactam Antibiotics. J Ilam Univ Med Sci. 2023;31(5):109-20.
31. Hassanzad M, Sadati E, Ghorbani F, Ghaffaripour H, Farnia P, Porabdollah M, et al. Evaluation of Antibiotic Resistance Trend among Cystic Fibrosis Patients: A Single Center Study from 2014-2019. J Pediatr Perspect. 2020;8(1):10719-29.
32. Emaneini M, Kalantar-Neyestanaki D, Jabalameli L, Hashemi M, Beigverdi R, Jabalameli F. Molecular analysis and antimicrobial resistance pattern of distinct strains of Pseudomonas aeruginosa isolated from cystic fibrosis patients in Iran. Iran J Microbiol. 2019;11(2):98-107. [DOI:10.18502/ijm.v11i2.1068] [PMID] [PMCID]
33. Kabir RB, Ahsan T, Rahman MF, Jobayer M, Shamsuzzaman SM. Biofilm-producing and specific antibiotic resistance genes in Pseudomonas aeruginosa isolated from patients admitted to a tertiary care hospital, Bangladesh. IJID Reg. 2024;11:100369. [DOI:10.1016/j.ijregi.2024.100369] [PMID] [PMCID]
34. Haidar A, Muazzam A, Nadeem A, Atique R, Saeed HA, Naveed A, et al. Biofilm formation and antibiotic resistance in Pseudomonas aeruginosa. Microbe. 2024;3:100078. [DOI:10.1016/j.microb.2024.100078]
35. Heidari R, Farajzadeh Sheikh A, Hashemzadeh M, Farshadzadeh Z, Salmanzadeh S, Saki M. Antibiotic resistance, biofilm production ability and genetic diversity of carbapenem-resistant Pseudomonas aeruginosa strains isolated from nosocomial infections in southwestern Iran. Mol Biol Rep. 2022;49(5):3811-22. [DOI:10.1007/s11033-022-07225-3] [PMID] [PMCID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Copyright Policy
Iranian Journal of Medical Microbiology by Farname is licensed under CC BY-NC 4.0
