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Knowledge of the prevalence of ESBL enzymes among P. aeruginosa strains compared to the Enterobacteraiceae family is limited. The phenotypic tests recommended by EUCAST for the detection of ESBL-producing Enterobacteriaceae are not always suited for P. aeruginosa strains. This is mainly due to the presence of other families of ESBLs in P. aeruginosa isolates more often than in Enterobacteriaceae, production of natural AmpC cephalosporinase and its overexpression, and co-production of metallo-β-lactamases. The aim of this study was to determine the occurrence of ESBLs in P. aeruginosa isolated from patients from hospitals in Warsaw, to evaluate the ESBL production of these isolates using currently available phenotypic tests, their modifications, multiplex PCR and molecular typing of ESBL-positive isolates by PFGE. Clinical isolates of P. aeruginosa were collected in 2000-2014 from four Warsaw hospitals. Based on the data obtained in this study, we suggest using three DDST methods with inhibitors, such as clavulanic acid, sulbactam and imipenem, to detect ESBL-producing P. aeruginosa strains. Depending on the appearance of the plates, we suggest a reduction in the distance between discs with antibiotics to 15 mm and the addition of boronic acid at 0.4 mg per disc. The analysed isolates carried genes encoding ESBL from the families VEB (69 isolates with VEB-9), GES (6 with GES-1, 1 GES-5, 5 GES-13 and 2 with GES-15), OXA-2 (12 with OXA-15, 1 OXA-141, 1 OXA-210, 1 OXA-543 and 1 with OXA-544) and OXA-10 (5 isolates with OXA-74 and one with OXA-142). The most important result of this study was the discovery of three new genes, blaGES-15, blaOXA-141 and blaOXA-142; their nucleotide sequences have been submitted to the NCBI GenBank. It is also very important to note that this is the first report on the epidemiological problem of VEB-9-producing bacterial strains, not only in Poland but also worldwide.

In our study the susceptibility (MIC) of chosen 21 strains of Gram-negative bacilli isolated in hospitals to disinfectant agents (glucoprotamine, sodium dichloroisocyanurate, potassium persulfate), the effectiveness of these disinfectants against selected bacteria and their effectiveness to biofilm forming bacteria was determined. It was found that glucoprotamine showed the highest activity to Gram-negative bacteria. Obtained MIC values for glucoprotamine (except 1 strain of S. marcescens) were 16-64 times lower that MICs for sodium dichloroisocyanurate and 4-32 times lower that MICs for potassium persulfate. The effectiveness of disinfectants containing potassium persulfate or sodium dichloroisocyanurate was 100% tested by carrier method. Glucoprotamine was ineffective against 2 out of 9 strains (18%): E. cloacae and S. marcescens. It was found that disinfectants were more effective against Gram-negative bacteria in carrier methods than for biofilm forming bacteria. 86% of bacteria growing 5 days on a catheter were resistant to working solution of disinfectant containing glucoprotamine (5200 mg/L) or potassium persulfate (4300 mg/L); 66.6% of tested bacteria were resistant to working solution of sodium dichloroisocyanurate (1795.2 mg/L). In our study the highest effectiveness to biofilm forming bacteria showed disinfectant with sodium dichloroisocyanurate, the lowest--with glucoprotamine.