Isolation and Characterisation of Microbial Pathogens From Cystic Fibrosis Patients in Southeastern Iran
Authors
-
Zakaria Bameri
Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran.
https://orcid.org/0000-0003-0786-3266
-
Abolfazl Parsi Moud
Student Research Committee, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
https://orcid.org/0000-0001-8156-2379
-
Mojgan Jahantigh
Department of Community Nursing, Nursing Research Center, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
https://orcid.org/0000-0002-9208-1404
-
Mojdeh Jahantigh
Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran.
https://orcid.org/0000-0001-7381-5882
DOI:
https://doi.org/10.22100/ijhs.v12i4.1285Keywords:
Cystic fibrosis, Pseudomonas aeruginosa, Staphylococcus aureus, BiofilmAbstract
Background: Cystic fibrosis (CF) is a genetic disorder that leads to severe respiratory complications primarily due to recurrent lung infections. This study aimed to isolate and identify microbial pathogens from the respiratory secretions of CF patients and investigate factors influencing their virulence and antibiotic resistance.
Methods: In this cross-sectional study conducted between 2021 and 2024, 45 confirmed CF samples were collected from throat samples at Aliebne Abitaleb Hospital in Zahedan, Iran. Following the identification of the strains, their antibiotic resistance was assessed by the disk diffusion method based on the Clinical Laboratory Standards Institute 2022. Also, the formation of biofilm was investigated by using a crystal violet assay, and relevant genes were identified by the PCR method.
Results: The results revealed a high prevalence of Pseudomonas aeruginosa and Staphylococcus aureus, 24.4% and 35.6%, respectively, with significant rates of multidrug resistance observed among these pathogens. Notably, biofilm formation was identified as a critical factor contributing to antibiotic resistance, complicating treatment options.
Conclusion: These findings underscore the need for tailored antibiotic strategies and highlight the importance of ongoing surveillance of microbial pathogens in CF patients to inform clinical practices.
References
Gentzsch M, Mall MA. Ion channel modulators in cystic fibrosis. Chest. 2018;154(2):383-93. doi: 10.1016/j.chest.2018.04.036
Erfanimanesh S, Emaneini M, Modaresi MR, Feizabadi MM, Halimi S, Beigverdi R, et al. Distribution and characteristics of bacteria isolated from cystic fibrosis patients with pulmonary exacerbation. Canadian Journal of Infectious Diseases and Medical Microbiology. 2022;2022:5831139. doi: 10.1155/2022/5831139
Ong T, Ramsey BW. Cystic fibrosis: a review. JAMA. 2023;329(21):1859-71. doi: 10.1001/jama.2023.8120
Turcios NL. Cystic fibrosis lung disease: an overview. Respiratory Care. 2020;65(2):233-51. doi: 10.4187/respcare.06697
Harvey C, Weldon S, Elborn S, Downey DG, Taggart C. The effect of CFTR modulators on airway infection in cystic fibrosis. International Journal of Molecular Sciences. 2022;23(7):3513. doi: 10.3390/ijms23073513
Perikleous EP, Gkentzi D, Bertzouanis A, Paraskakis E, Sovtic A, Fouzas S. Antibiotic resistance in patients with cystic fibrosis: past, present, and future. Antibiotics. 2023;12(2):217. doi: 10.3390/antibiotics12020217
VanDevanter DR, Kahle JS, O'Sullivan AK, Sikirica S, Hodgkins PS. Cystic fibrosis in young children: a review of disease manifestation, progression, and response to early treatment. Journal of Cystic Fibrosis. 2016;15(2):147-57. doi: 10.1016/j.jcf.2015.09.008
Dongarwar D, Garcia BY, Miller K, Salihu HM. Assessment of hospitalization rates, factors associated with hospitalization and in-patient mortality in pediatric patients with cystic fibrosis. Journal of the National Medical Association. 2022;113(6):683-92. doi: 10.1016/j.jnma.2021.08.038
Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. American Journal of Respiratory and Critical Care Medicine. 2003;168(8):918-51. doi: 10.1164/rccm.200304-505SO
LiPuma JJ. The changing microbial epidemiology in cystic fibrosis. Clinical Microbiology Reviews. 2010;23(2):299-323. doi: 10.1128/CMR.00068-09
Bevivino A, Bacci G, Drevinek P, Nelson MT, Hoffman L, Mengoni A. Deciphering the ecology of cystic fibrosis bacterial communities: towards systems-level integration. Trends in Molecular Medicine. 2019;25(12):1110-22. doi: 10.1016/j.molmed.2019.07.008
Rey MM, Bonk MP, Hadjiliadis D. Cystic fibrosis: emerging understanding and therapies. Annual Review of Medicine. 2019;70:197-210. doi: 10.1146/annurev-med-112717-094536
Kidd TJ, Canton R, Ekkelenkamp M, Johansen HK, Gilligan P, LiPuma JJ, et al. Defining antimicrobial resistance in cystic fibrosis. Journal of Cystic Fibrosis. 2018;17(6):696-704. doi: 10.1016/j.jcf.2018.08.014
Fainardi V, Neglia C, Muscarà M, Spaggiari C, Tornesello M, Grandinetti R, et al. Multidrug-resistant bacteria in children and adolescents with cystic fibrosis. Children. 2022;9(9):1330. doi: 10.3390/children9091330
Guss AM, Roeselers G, Newton IL, Young CR, Klepac-Ceraj V, Lory S, et al. Phylogenetic and metabolic diversity of bacteria associated with cystic fibrosis. The ISME Journal. 2011;5(1):20-9. doi: 10.1038/ismej.2010.88
Lamoureux C, Guilloux C-A, Beauruelle C, Gouriou S, Ramel S, Dirou A, et al. An observational study of anaerobic bacteria in cystic fibrosis lung using culture-dependent and independent approaches. Scientific Reports. 2021;11(1):6845. doi: 10.1038/s41598-021-85592-w
Ahmadi N, Salimizand H, Zomorodi AR, Abbas JE, Ramazanzadeh R, Haghi F, et al. Genomic diversity of β-lactamase-producing Pseudomonas aeruginosa in Iran; the impact of global high-risk clones. Annals of Clinical Microbiology and Antimicrobials 2024;23(1):5. doi: 10.1186/s12941-024-00668-5
Jahantigh M, Tahmasbi H, Bokaeiyan M. Antibiotic Resistance Pattern of Pseudomonas aeruginosa Strains Isolated from Burn Patients. Medical Journal of Mashhad University of Medical Sciences. 2019;62(5):1121-31.
Jahantigh M, Bameri Z. Determining the Antibiotic Resistance of Staphylococcus aureus Strains Isolated from Patients Hospitalized in Zahedan, Southeastern Iran. Journal of Advances in Medical and Biomedical Research. 2024;32(151):127-34. doi: 10.61186/jambr.32.151.127
Wood TL, Wood TK. The HigB/HigA toxin/antitoxin system of Pseudomonas aeruginosa influences the virulence factors pyochelin, pyocyanin, and biofilm formation. Microbiologyopen. 2016;5(3):499-511. doi: 10.1002/mbo3.346
Guo Y, Sun C, Li Y, Tang K, Ni S, Wang X. Antitoxin HigA inhibits virulence gene mvfR expression in Pseudomonas aeruginosa. Environmental Microbiology. 2019;21(8):2707-23. doi: 10.1111/1462-2920.14595
Cayci YT, Coban A, Gunaydin M. Investigation of plasmid-mediated quinolone resistance in Pseudomonas aeruginosa clinical isolates. Indian Journal of Medical Microbiology. 2014;32(3):285-9. doi: 10.4103/0255-0857.136567
Ali AA, Sweedan EG. Role of higB-higA Novel Genes in antibiotic resistance of Pseudomonas aeruginosa. International Journal of Drug Delivery Technology 13(2):605-609. doi: 10.25258/ijddt.13.2.22
Humphries R, Bobenchik AM, Hindler JA, Schuetz AN. Overview of changes to the clinical and laboratory standards institute performance standards for antimicrobial susceptibility testing, M100. Journal of Clinical Microbiology. 2021;59(12):10. doi: 10.1128/JCM.00213-21
Azeredo J, Azevedo NF, Briandet R, Cerca N, Coenye T, Costa AR, et al. Critical review on biofilm methods. Critical Reviews in Microbiology. 2017;43(3):313-51. doi: 10.1080/1040841X.2016.1208146
Zahedani SS, Tahmasebi H, Jahantigh M. Coexistence of virulence factors and efflux pump genes in clinical isolates of Pseudomonas aeruginosa: Analysis of biofilm-forming strains from Iran. International Journal of Microbiology. 2021;2021:1-8. doi: 10.1155/2021/5557361
Amini H, Jahantigh M, Galavi H, Abdollahi A, Pirouzi A, Afkari R. Evaluation of oxalate-degrading activity and molecular Recognition of oxc, frc genes in lactic acid bacterium of inhabit in Human colon. International Journal of Pharmacy and Technology. 2016;8(3):16055-66.
Jahantigh M, Seyedzayi N. Dominant EAEC and Widespread Antibiotic Resistance among Diarrheagenic Escherichia coli in Children with Acute Diarrhea in Zahedan, Iran. Journal of Medical Microbiology and Infectious Diseases. 2024;12(1):59-66. doi: 10.61186/JoMMID.12.1.59
Emaneini M, Bigverdi R, Kalantar D, Soroush S, Jabalameli F, Khoshgnab BN, et al. Distribution of genes encoding tetracycline resistance and aminoglycoside modifying enzymes in Staphylococcus aureus strains isolated from a burn center. Annals of Burns and Fire Disasters. 2013;26(2):76.
Kwiecinski J, Peetermans M, Liesenborghs L, Na M, Björnsdottir H, Zhu X, et al. Staphylokinase control of Staphylococcus aureus biofilm formation and detachment through host plasminogen activation. The Journal of Infectious Diseases. 2016;213(1):139-48. doi: 10.1093/infdis/jiv360
Wong Fok Lung T, Chan LC, Prince A, Yeaman MR, Archer NK, Aman MJ, et al. Staphylococcus aureus adaptive evolution: recent insights on how immune evasion, immunometabolic subversion and host genetics impact vaccine development. Frontiers in Cellular and Infection Microbiology. 2022;12:1060810. doi: 10.3389/fcimb.2022.1060810
Fischer AJ, Singh SB, LaMarche MM, Maakestad LJ, Kienenberger ZE, Peña TA, et al. Sustained coinfections with Staphylococcus aureus and Pseudomonas aeruginosa in cystic fibrosis. American Journal of Respiratory and Critical Care Medicine. 2021;203(3):328-38. doi: 10.1164/rccm.202004-1322OC
Cunningham F, Caldwell E, Mayer-Hamblett N, Goss CH, Muhlebach MS. Eradication of early MRSA infection in cystic fibrosis: A novel study design for the STAR-ter trial. ERJ Open Research. 2022;8(4). doi: 10.1183/23120541.00190-2022
Singh J, Hunt S, Simonds S, Boyton C, Middleton A, Elias M, et al. The changing epidemiology of pulmonary infection in children and adolescents with cystic fibrosis: an 18-year experience. Scientific Reports. 2024;14(1):9056. doi: 10.1038/s41598-024-59658-4
Ren CL, Morgan WJ, Konstan MW, Schechter MS, Wagener JS, Fisher KA, et al. Presence of methicillin-resistant Staphylococcus aureus in respiratory cultures from cystic fibrosis patients is associated with lower lung function. Pediatric Pulmonology. 2007;42(6):513-8. doi: 10.1002/ppul.20604
Razvi S, Quittell L, Sewall A, Quinton H, Marshall B, Saiman L. Respiratory microbiology of patients with cystic fibrosis in the United States, 1995 to 2005. Chest. 2009;136(6):1554-60. doi: 10.1378/chest.09-0132
Published
Issue
Section
License
The Copyright Form should be downloaded and signed by corresponding author in the fourth step "upload supplementary files" during submission process.
After acceptance, copyright form should be downloaded and signed by all authors one by one ( "summery --> supp. file" part and click on "add a supplementary file" link).
