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Infectious Disorders - Drug Targets


ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

Molecular Study of Integrase Gene I and Integrase Gene II in Clinical Isolates of Pseudomonas aeruginosa

Author(s): Maysaa El Sayed Zaki*, Noha Mostafa Mahmoud and Mohamed Anies Rizk

Volume 22, Issue 7, 2022

Published on: 06 July, 2022

Article ID: e080422203300 Pages: 6

DOI: 10.2174/1871526522666220408111454

Price: $65


Background: The presence of the class I integron gene is associated with the emergence of multiple drug resistance (MDR) phenotype in Pseudomonas aeruginosa (P. aeruginosa) isolates.

Aim: The objectives of this research were to study the prevalence of integrase genes I (Intel I) and integrase genes II (Intel II) in clinical isolates of P. aeruginosa and its association with antibiotic resistance in these isolates.

Methods: The study was a retrograde cross-sectional study that was carried out on 150 clinical isolates of P. aeruginosa isolated from patients with healthcare-associated infections. The isolates were subjected to biochemical identification and antibiotic sensitivity study by discs diffusion test. Intel I & Intel II genes were detected by polymerase chain reaction (PCR).

Results: Intel I gene was present in 48% of the isolates, and Intel II was present in 1.3% of the isolates. Intel I gene was detected at a statistically significant high rate in MDR- P. aeruginosa (76.9%, P=0.001) compared to non-MDR- P. aeruginosa (3.4%), while intel II had a statistically insignificant increase in MDR- P. aeruginosa (1.1%, P=1.00) compared to non-MDR-P. aeruginosa (1.7%). Both Intl I/Intl II genes were detected in 2.2% of MDR-P. aeruginosa isolates and were absent in non- MDR-P. aeruginosa isolates with statistically insignificant difference (P=1.00). P. aeruginosa isolates with Intel I gene had an increase in antibiotic resistance pattern to the used antibiotics discs. However, this increase had statistically significant rates only for gentamicin (63.9%, P≤0.001), meropenem (47.2%, P=0.009), trimethoprim/sulfamethoxazole (37.5%, P=0.013) and imipenem (44.4%, P=0.025).

Conclusion: The present study highlights the high prevalence of the Intel I gene in clinical isolates of P. aeruginosa, while the Intel II gene was less prevalent in these isolates. There was a significant association between the prevalence of the Intel I gene and the MDR phenotype of P. aeruginosa and resistance to gentamicin, meropenem, trimethoprim/sulfamethoxazole, and imipenem. These findings need future evaluation in a higher number of clinical isolates of P. aeruginosa.

Keywords: P. aeruginosa, integrase I gene, integrase II gene, multiple drug resistance, gentamicin, integrons.

Graphical Abstract
Mirahsani M, Khorshidi A, Moniri R, Gilasi HR. Prevalence of class 1 Integron, resistance gene cassettes and antimicrobial susceptibility profiles among Isolates of Pseudomonas aeruginosa in Iran. Open J Med Microbiol 2016; 6: 87-96.
Barrios CC, Ciancotti-Oliver L, Bautista-Rentero D, Adán-Tomás C, Zanón-Viguer V. A New treatment choice against multi-drug resistant Pseudomonas aeruginosa: Doripenem. J Bacteriol Parasitol 2014; 5: 199-203.
Livermore DM. Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: Our worst nightmare? Clin Infect Dis 2002; 34(5): 634-40.
[] [PMID: 11823954]
Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev 2010; 74(3): 417-33.
[] [PMID: 20805405]
Hosseini SMJ, Naeini NS, Khaledi A, Daymad SF, Esmaeili D. Evaluate the relationship between class 1 integrons and drug resistance genes in clinical isolates of Pseudomonas aeruginosa. Open Microbiol J 2016; 10: 188-96.
[] [PMID: 28077975]
Ranjbar R, Taghipour F, Afshar D, Farshad S. Distribution of class 1 and 2 integrons among Salmonella enterica serovars isolated from Iranian patients. Open Microbiol J 2019; 13: 63-6.
Koratzanis E, Souli M, Galani I, Chryssouli Z, Armaganidis A, Giamarellou H. Epidemiology and molecular characterisation of metallo-β-lactamase-producing Enterobacteriaceae in a university hospital Intensive Care Unit in Greece. Int J Antimicrob Agents 2011; 38(5): 390-7.
[] [PMID: 21873034]
Ke X, Gu B, Pan S, Tong M. Epidemiology and molecular mechanism of integron-mediated antibiotic resistance in Shigella. Arch Microbiol 2011; 193(11): 767-74.
[] [PMID: 21842348]
Sabbagh P, Rajabnia M, Maali A, Ferdosi-Shahandashti E. Integron and its role in antimicrobial resistance; a literature review on some bac-terial pathogens. Iran J Basic Med Sci 2021; 24(2): 136-42.
Kouchaksaraei MF, Shahandashti FE, Molana Z. et al. Molecular detection of integron genes and pattern of antibiotic resistance in Pseudo-monas aeruginosa strains isolated from intensive care unit, Shahid beheshti hospital, north of Iran. Int J Mol Cell Med 2012; 1(4): 209-17.
[PMID: 24551780]
Thungapathra M. Amita , Sinha KK, et al. Occurrence of antibiotic resistance gene cassettes aac(6′)-Ib, dfrA5, dfrA12, and ereA2 in class I integrons in non-O1, non-O139 Vibrio cholerae strains in India. Antimicrob Agents Chemother 2002; 46(9): 2948-55.
[] [PMID: 12183252]
Ghaly TM, Geoghegan JL, Tetu SG, Gillings MR. The peril and promise of integrons: Beyond antibiotic resistance. Trends Microbiol 2020; 28(6): 455-64.
[] [PMID: 31948729]
Nepali B, Bhattarai S, Shrestha J. Identification of Pseudomonas fluorescens using different biochemical tests. J Appl Biol 2020; 2(2): 28-32.
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; approved standard. 30th ed. Wayne, PA: Clinical and Laboratory Standards Institute 2020.
Naik P, Pandey S, Gagan S, Biswas S, Joseph J. Virulence factors in multidrug (MDR) and Pan-drug resistant (XDR) Pseudomonas aeru-ginosa: A cross-sectional study of isolates recovered from ocular infections in a high-incidence setting in southern India. J Ophthalmic Inflamm Infect 2021; 11(1): 36.
[] [PMID: 34585284]
Koeleman JG, Stoof J, Van Der Bijl MW, Vandenbroucke-Grauls CM, Savelkoul PH. Identification of epidemic strains of Acinetobacter baumannii by integrase gene PCR. J Clin Microbiol 2001; 39(1): 8-13.
[] [PMID: 11136740]
Pachori P, Gothalwal R, Gandhi P. Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit; a critical review. Genes Dis 2019; 6(2): 109-19.
European centre for disease prevention and control. Surveillance Report: Antimicrobial resistance surveillance in Europe. 2015. Available from:
Köck R, Becker K, Cookson B. et al. Methicillin-resistant Staphylococcus aureus (MRSA): Burden of disease and control challenges in Europe. Euro Surveill 2010; 15(41): 19688.
[] [PMID: 20961515]
Bassetti M, Vena A, Croxatto A, Righi E, Guery B. How to manage Pseudomonas aeruginosa infections. Drugs Context 2018; 7: 212527.
[] [PMID: 29872449]
Peng Y, Bi J, Shi J. et al. Multidrug-resistant Pseudomonas aeruginosa infections pose growing threat to health care-associated infection control in the hospitals of Southern China: A case-control surveillance study. Am J Infect Control 2014; 42(12): 1308-11.
[] [PMID: 25444305]
Sharifi H, Pouladfar G, Shakibaie MR, Pourabbas B, Mardaneh J, Mansouri S. Prevalence of β-lactamase genes, class 1 integrons, major virulence factors and clonal relationships of multidrug-resistant Pseudomonas aeruginosa isolated from hospitalized patients in southeast of Iran. Iran J Basic Med Sci 2019; 22(7): 806-12.
[] [PMID: 32373303]
Porto JP, Mantese OC, Arantes A, Freitas C, Gontijo Filho PP, Ribas RM. Nosocomial infections in a pediatric intensive care unit of a devel-oping country: NHSN surveillance. Rev Soc Bras Med Trop 2012; 45(4): 475-9.
[] [PMID: 22767099]
WHO. World Health Organization. Antimicrobial resistance. 2015. Available from:
Dantas RCC, Silva RTE, Ferreira ML, et al. Molecular epidemiological survey of bacteremia by multidrug resistant Pseudomonas aerugino-sa: The relevance of intrinsic resistance mechanisms. PLoS One 2017; 12(5): e0176774.
[] [PMID: 28481953]
Ebrahimpour M, Nikokar I, Ghasemi Y. et al. Antibiotic resistance and frequency of class 1 integrons among Pseudomonas aeruginosa isolates obtained from wastewaters of a burn center in Northern Iran. Ann Ig 2018; 30(2): 112-9.
[] [PMID: 29465148]
Khosravi AD, Motahar M, Abbasi Montazeri E. The frequency of class1and 2 integrons in Pseudomonas aeruginosa strains isolated from burn patients in a burn center of Ahvaz, Iran. PLoS One 2017; 12(8): e0183061.
Hosseini Pour P, Momtaz H, Serajyan AA, Tajbakhsh E. Investigating class I, II and III integrons in multidrug resistance in Pseudomonas aeruginosa isolated from hospital infections in Ahvaz. Int J Med Lab 2015; 2(3): 168-76.
Khorramrooz SS, Gharibpour F, Parhizgari N, Yazdanpanah M, Mohammadi R, Rahbari N. Prevalence of class 1 integron and antibiotic resistance among Pseudomonas aeruginosa isolated from patie admitted to the Burn Unit at Taleghani Hospital in Ahvaz. J Arak Univ Med Sci 2015; 18(3): 9-18.
Leverstein-van Hall MA. M Blok HE, T Donders AR, Paauw A, Fluit AC, Verhoef J. Multidrug resistance among Enterobacteriaceae is strongly associated with the presence of integrons and is independent of species or isolate origin. J Infect Dis 2003; 187(2): 251-9.
[] [PMID: 12552449]

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