The frequency of AmpC overproduction, OprD downregulation and OprM efflux pump expression in Pseudomonas aeruginosa: A comprehensive meta-analysis.

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  • Additional Information
    • Source:
      Publisher: Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer Country of Publication: Netherlands NLM ID: 101622459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-7173 (Electronic) Linking ISSN: 22137165 NLM ISO Abbreviation: J Glob Antimicrob Resist Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam : Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer
    • Subject Terms:
      Anti-Bacterial Agents*/pharmacology ; Bacterial Outer Membrane Proteins*/genetics ; Bacterial Outer Membrane Proteins*/metabolism ; Bacterial Proteins*/genetics ; Bacterial Proteins*/metabolism ; beta-Lactamases*/genetics ; beta-Lactamases*/metabolism ; Drug Resistance, Multiple, Bacterial*/genetics ; Membrane Transport Proteins*/genetics ; Membrane Transport Proteins*/metabolism ; Pseudomonas aeruginosa*/genetics ; Pseudomonas aeruginosa*/drug effects ; Pseudomonas aeruginosa*/metabolism; Humans ; Down-Regulation ; Gene Expression Regulation, Bacterial ; Iran ; Microbial Sensitivity Tests ; Pseudomonas Infections/microbiology
    • Abstract:
      Objectives: Pseudomonas aeruginosa is a major opportunistic pathogen responsible for a wide range of infections. The emergence of antibiotic resistance in this pathogen poses a significant public health challenge. This study aims to conduct a comprehensive meta-analysis of studies conducted in Iran to determine the frequency of key antibiotic resistance mechanisms in Pseudomonas aeruginosa and their association with multidrug-resistant and extensively drug-resistant strains or pandrug-resistant strains.
      Methods: Systematic database searches encompassing literature up to June 2023 were undertaken. The selected studies centered on OprD downregulation, efflux pump (mexAB-OprM, mexXY-OprM) expression, and AmpC overproduction. Extracted data were synthesised in a meta-analysis for pooled frequency determination of each resistance mechanism.
      Results: In total, 24 studies were included. OprD downregulation exhibited a pooled frequency of 61%. Efflux pump component frequency ranged from 48% to 77.5%. AmpC overproduction was identified in 29.1% of isolates. Polymyxin B and colistin demonstrated lower antibiotic resistance rates, with pooled frequency of 1% and 1.6%, respectively. Conversely, resistance to other antibiotics ranged widely, with pooled frequency spanning 38.4% to 98.2%.
      Conclusions: This study underscores the concerning frequency of diverse antibiotic resistance mechanisms in Pseudomonas aeruginosa strains from Iran. Concurrent OprD downregulation, mexAB, mexXY, OprM expression, and AmpC overproduction highlight the urgent need for stringent infection control and prudent antibiotic usage to curb the dissemination of these resistant strains.
      Prospero: CRD42022379311.
      (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
    • Contributed Indexing:
      Keywords: AmpC; OprD; Pseudomonas aeruginosa; Pseudomonas aeruginosa antimicrobial resistance; RND multidrug efflux pump; mexAB-OprM; mexXY-OprM
    • Accession Number:
      EC 3.5.2.6 (AmpC beta-lactamases)
      0 (Anti-Bacterial Agents)
      0 (Bacterial Outer Membrane Proteins)
      0 (Bacterial Proteins)
      EC 3.5.2.6 (beta-Lactamases)
      0 (Membrane Transport Proteins)
      148412-32-2 (OprD protein, Pseudomonas aeruginosa)
      0 (OprM protein, Pseudomonas aeruginosa)
    • Publication Date:
      Date Created: 20240920 Date Completed: 20241222 Latest Revision: 20241226
    • Publication Date:
      20241227
    • Accession Number:
      10.1016/j.jgar.2024.08.014
    • Accession Number:
      39303871