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Evaluation of Efflux-Mediated Resistance and Biofilm Formation in Virulent Pseudomonas aeruginosa Associated with Healthcare Infections

Akinduti, Paul A. and George, Onome W. and Ohore, Hannah U. and Ariyo, Olusegun E. and Popoola, Samuel T. and Adeleye, Adenike I. and Akinwande, Kazeem S. and Popoola, J.O and Rotimi, S. O and Olufemi, Fredrick O. and Omonhinmin, Conrad A. and Olasehinde, G. I (2023) Evaluation of Efflux-Mediated Resistance and Biofilm Formation in Virulent Pseudomonas aeruginosa Associated with Healthcare Infections. antibiotics, 12.

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Abstract

Pseudomonas aeruginosa is a significant pathogen identified with healthcare-associated infections. The present study evaluates the role of biofilm and efflux pump activities in influencing high-level resistance in virulent P. aeruginosa strains in clinical infection. Phenotypic resistance in biotyped Pseudomonas aeruginosa (n = 147) from diagnosed disease conditions was classified based on multiple antibiotic resistance (MAR) indices and analysed with logistic regression for risk factors. Efflux pump activity, biofilm formation, and virulence factors were analysed for optimal association in Pseudomonas infection using receiver operation characteristics (ROC). Agespecificity (OR [CI] = 0.986 [0.946–1.027]), gender (OR [CI] = 1.44 [0.211–9.827]) and infection sources (OR [CI] = 0.860 [0.438–1.688]) were risk variables for multidrug resistance (MDR)-P. aeruginosa infection (p < 0.05). Biofilm formers caused 48.2% and 18.5% otorrhea and wound infections (95% CI = 0.820–1.032; p = 0.001) respectively and more than 30% multidrug resistance (MDR) strains demonstrated high-level efflux pump activity (95% CI = 0.762–1.016; p = 0.001), protease (95% CI = 0.112–0.480; p = 0.003), lipase (95% CI = 0.143–0.523; p = 0.001), and hemolysin (95% CI = 1.109–1.780; p = 0.001). Resistance relatedness of more than 80% and 60% to cell wall biosynthesis inhibitors (ceftazidime, ceffproxil, augumentin, ampicillin) and, DNA translational and transcriptional inhibitors (gentamicin, ciprofloxacin, ofloxacin, nitrofurantoin) were observed (p < 0.05). Strong efflux correlation (r = 0.85, p = 0.034) with MDR strains, with high predictive performances in efflux pump activity (ROC-AUC 0.78), biofilm formation (ROC-AUC 0.520), and virulence hierarchical-clustering. Combine activities of the expressed efflux pump and biofilm formation in MDR-P. aeruginosa pose risk to clinical management and infection control.

Item Type: Article
Uncontrolled Keywords: Pseudomonas aeruginosa; antibiotic resistance; biofilm; efflux pump; virulence factors
Subjects: Q Science > QH Natural history
Q Science > QH Natural history > QH301 Biology
Divisions: Faculty of Medicine, Health and Life Sciences > School of Biological Sciences
Depositing User: nwokealisi
Date Deposited: 24 Apr 2023 22:17
Last Modified: 24 Apr 2023 22:17
URI: http://eprints.covenantuniversity.edu.ng/id/eprint/16841

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