Bright Ugochukwu NMESİRİONYE, Chukwudi Thomas UGWU, Kelechi Martins NWORİE

Antibiotic Susceptibility and Plasmid Profile of Multidrug resistant Uropathogenic Serratia marcescens

ABSTRACT Objectives: Genetic elements such as plasmids play a role in spreading multi-antibiotic resistance, a global threat. Therefore, the purpose of this study was to investigate the antibiotic susceptibility and plasmid profiles of multidrug-resistant (MDR) uropathogenic Serratia marcescens. Methods: Fifty Serratia marcescens isolates were obtained from urine samples of patients presenting with urinary tract infection (UTI) in Southeastern Nigeria. Bacteria samples were identified via their characteristic red pigmentation and other biochemical tests. The disc diffusion method was used for antibiotic susceptibility testing. Plasmids were extracted using the alkaline lysis method, and electrophoresis was done on a 1% agarose gel. Extracted DNA plasmids were visualized using the ultraviolet light illuminator and a photo documentation system. Plasmid curing was carried out using acridine orange. Results: Antibiotic susceptibility testing of isolates revealed 41 (82%) were resistant to one or more antibiotics tested, and 8 (16%) isolates exhibited resistance to three or more antibiotics (MDR). Of the eight MDR isolates, five (63%) had plasmids with molecular weights ranging from 33 kb to 58 kb. One isolate (S9) was cured and became sensitive to ceftriaxone, but not cefuroxime or ceftazidime. Notably, one isolate (S23), initially sensitive to ciprofloxacin, became resistant post-plasmid curing. Conclusion: The findings show that most resistant bacteria containing plasmids were immune to curing as they remained resistant to antibiotics after curing. This result confirms a concern about the growing presence of MDR plasmids of S. marcescens in healthcare facilities in Southeastern Nigeria. J Microbiol Infect Dis 2022; 12(1):12-18.

Keywords:

Antibiotic resistance Serratia marcescens, Plasmid profiling, Urinary tract infection,

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1. Esimone CO, Nworu SC, Harrison GT. Antibiogram and plasmid profile of some multi-antibiotics resistant uropathogens obtained from local communities of Southeastern Nigeria. Ibnosina J Med Biomed Sci 2010; 2:152-159.
2. Paryani JP, Memon SR, Rajpar ZH, Shah SA. Pattern and Sensitivity of Microorganisms Causing Urinary Tract Infection at Teaching Hospital JLUMHS 2012; 11:97–100.
3. Roos V, Klemm P. Global gene expression profiling of the asymptomatic bacteriuria Escherichia coli strain 83972 in the human urinary tract. Infect Immun 2006; 74:3565-3575.
4. Iosifidis E, Farmaki E, Nedelkopoulou N, et al. Outbreak of bloodstream infections because of Serratia marcescens in a pediatric department. Am J Infect Control 2012; 40:11-15.
5. Moges F, Genetu A, Mengstu G. Antibiotics Sensitivity of Common Bacterial Pathogens in Urinary Tract Infections at Gondar Hospital, Ethiopia. East Afr Med J 2002; 79:140–142.
6. Iguchi A, Nagaya Y, Pradel E, et al. Genome evolution and plasticity of Serratia marcescens, an important multidrug-resistant nosocomial pathogen. Genome Biol Evol 2014; 6:2096–2110.
7. Khanna A, Khanna M, Aggarwal A. Serratia marcescens- a rare opportunistic nosocomial pathogen and measures to limit its spread in hospitalized patients. J Clin Diagn Res 2013; 7:243-246.
8. Chung WC, Chen LL, Lo WS, Kuo PA, Tu J, Kuo CH. Complete genome sequence of Serratia marcescens WW4. Genome Announc 2013; 1:e0012613. DOI: 10.1128/genomeA.00126-13
9. Liu P Y, Huang Y T, et al, (2013). Draft genome sequence of the Serratia marcescens strain VGH107, a Taiwanese clinical isolate. Genome Announc 1(3):e00249-13.
10. Wan Y, Gorrie CL, Jenney A, Mirceta M, Holt KE. Draft genome sequence of a clinical isolate of Serratia marcescens, Strain AH0650_Sm1. Genome Announc 2015; 3:e01007-15.
11. Redondo-Bravo L, Gutiérrez-González, E, San Juan-Sanz et al. Serratia marcescens outbreak in a neonatology unit of a Spanish tertiary hospital: risk factors and control measures. Am J Infect Control 2019; 47:271-279.
12. Liou BH, Duh RW, Lin YT, Lauderdale TL, Fung CP. Taiwan Surveillance of Antimicrobial Resistance (TSAR) Hospitals. A multicenter surveillance of antimicrobial resistance in Serratia marcescens in Taiwan. J Microbiol Immunol Infect 2014; 47:387-393.
13. Buttinelli E, Ardoino I, Domeniconi G, et al. Epidemiology of Serratia marcescens infections in NICU of a teaching and research hospital in northern Italy. Minerva Pediatr 2017. doi: 10.23736/S0026-4946.17.04856-3
14. Bennett PM. Plasmid encoded antibiotic resistance: acquisition and transfer of antibiotic resistance genes in bacteria. Br J Pharmacol. 2008; 153 Suppl 1:S347-S357. doi:10.1038/sj.bjp.0707607
15. Kamruzzaman M, Shoma S, Thomas CM, Partridge SR, Iredell JR. Plasmid interference for curing antibiotic resistance plasmids in vivo. PLoS ONE 2017; 12:e0172913
16. Van Hal SJ, Wiklendt A, Espedido B, Ginn A, Iredell JR. Immediate appearance of plasmid-mediated resistance to multiple antibiotics upon antibiotic selection: An argument for systematic resistance epidemiology. J Clin Microbiol 2009; 47:2325-2327.
17. Cheesbrough M. District laboratory practice in tropical countries, 2nd edn. Cambridge: Cambridge University Press, 2005. DOI: https://doi.org/10.1017/CBO9780511581304
18. Qin X, Weissman SJ, Chesnut MF, Zhang B, Shen L. Kirby-Bauer disc approximation to detect inducible third-generation cephalosporin resistance in Enterobacteriaceae. Ann Clin Microbiol Antimicrob 2004; 3:13. DOI: 10.1186/1476-0711-3-13
19. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2020.
20. Delaney S, Murphy R, Walsh F. A comparison of methods for the extraction of plasmids capable of conferring antibiotic resistance in a human pathogen from complex broiler cecal samples. Front Microbiol 2018; 9:1731. DOI: 10.3389/fmicb.2018.01731
21. Bikandi J, San Millán R, Rementeria A, Garaizar J. In silico analysis of complete bacterial genomes: PCR AFLP-PCR and endonuclease restriction. Bioinformatics 2004; 20:798-799.
22. Akingbade O, Balogun S, Ojo D et al. Resistant plasmid profile analysis of multidrug resistant Escherichia coli isolated from urinary tract infections in Abeokuta, Nigeria. Afr Health Sci 2014; 14:821-828.
23. Salisbury V, Hedges RW, Datta N. Two modes of “curing” transmissible bacterial plasmids. J Gen Microbiol 1972; 70:443-452.
24. Cilli F, Nazli-Zeka A, Arda B, et al. Serratia marcescens sepsis outbreak caused by contaminated propofol. Am J Infect Control 2019; 47:582-584.
25. Yah SC, Eghafona NO, Forbi JC. Plasmid-borne antibiotics resistant marker of Serrati marcescens: an increased prevalence in HIV/AIDS patients. Sci Res Essays 2008; 3:28-34.
26. Simsek M. Determination of the antibiotic resistance rates of Serratia marcescens isolates obtained from various clinical specimens. N J Clin Pract 2019; 22:125-130.
27. Stock I, Gruegar T, Wiedemann B. Natural antibiotics susceptibility of Serratia marcescens and the S. liquefaciens complex: S. liquefaciens sensu strict, S. proteamaculans and S. grimesii. Int J Antimicrob Agents 2003; 22:35-47.
28. Ineta BEL, Madu EP, Abdulhadi ASA, Ibrahim HIM. Antibiotic susceptibility and plasmid profile of clinical isolates of Escherichia coli. Biomed Res 2018; 29:3303-3310.
29. Letchumanan V, Chan K-G, Lee L-H. An insight of traditional plasmid curing in Vibrio species. Front Microbiol 2015; 6:735.
30. Pérez-Viso B, Hernández-García M, Ponce-Alonso M et al. Characterization of carbapenamase-producing Serratia marcescens and whole genome sequencing for plasmid typing in a hospital in Madrid, Spain (2016-2018). J Antimicrob Chemother 2021; 76:110-116.
31. Reboucas RH, Viana de Sousa O, Sousa LA, Roger FV, Carvalho PB, Fernandes RHV. Antimicrobial resistance profile of Vibrio species isolated from marine shrimp farming environments (Litopenaeus vannamei) at Cear’a, Brazil. Environ Res 2011; 111:21-24. DOI: 10.1016/j.envres.2010.09.012