Molecular Profiling of Antibiotic-resistant Pseudomonas aeruginosa Isolated from Patients with Urinary Tract Infections in Rivers State University Teaching Hospital

Abstract

Background: Antibiotic-resistant Pseudomonas aeruginosa poses a significant challenge in urinary tract infections (UTIs), particularly in hospital settings. Aim: The aim of this study was to analyze the molecular profile of antibiotic-resistant P. aeruginosa strains isolated from patients with urinary tract infections at the Rivers State University Teaching Hospital, Port Harcourt. Methods: As part of a cross-sectional study, 199 patients were interviewed, and urine samples were collected from subjects with symptoms of a urinary tract infection. A semiquantitative urine culture method was used to detect significant bacteriuria. Suspected uropathogenic P. aeruginosa isolates were then identified using conventional and molecular techniques for identification and gene detection. The data generated from this study was presented as frequencies and percentages using Microsoft Excel 365. Results: Of the 199 urine samples analyzed, P. aeruginosa was isolated in 17 cases, corresponding to a prevalence rate of 8.5%. Among the antimicrobial classes tested, aminoglycosides showed different resistance rates: amikacin (23.5%) and gentamicin (35.3%). Fluoroquinolones, including ofloxacin and ciprofloxacin, had resistance rates of 52.9%. Cephalosporins showed high resistance, particularly cefuroxime sodium (88.2%) and cefpodoxime (100%). Amoxicillin + clavulanic acid showed a resistance rate of 94.1%, while resistance to cefotaxime was 47.1%. Imipenem remained effective without resistance being observed. Several antimicrobial resistance indices (MAR) indices revealed complex resistance patterns across isolates, with the highest MAR index at 0.92. Genotypic analysis identified CTX-M as the most prevalent resistance gene (77.8%), followed by TEM (44.4%) and SHV (33.3%). Notably, no isolates harbored NDM or VIM genes, indicating the absence of carbapenem resistance genes among the studied isolates. Conclusion: This study highlights the prevalence of antibiotic-resistant P. aeruginosa in UTIs at Rivers State University Teaching Hospital, the study also evaluated the antimicrobial susceptibility of Pseudomonas isolates, and key finding is the high resistance rates of the Pseudomonas isolates to multiple antibiotics, especially within the fluoroquinolone and cephalosporin classes, while maintaining susceptibility to Imipenem.