Drug resistance profile and molecular characterization of extended spectrum beta-lactamase (ESβL)-producing Pseudomonas aeruginosa isolated from burn wound infections. Essential oils and their potential for utilization.

Objectives: Pseudomonas aeruginosa producing extended spectrum β-lactamase (ESβL) enzyme had the ability for antimicrobial resistance mechanisms and its multidrug-resistant (MDR) phenotype, has been increasingly reported as a major clinical concern worldwide. The aim of this study was to (i) characterize ESβL-producing MDR P. aeruginosa isolated from burn wound infections phenotypically and molecularly, (ii) evaluate the antibacterial activity of some essential oils (EOs) against selected ESβL-producing drug resistant P. aeruginosa and (iii) characterize a promising EO.
Methods: Identification and antibiotic susceptibility tests were performed for all isolates. ESβL production was detected phenotypically by an initial screening test (IST) and a phenotypic confirmatory test (PCT). Additionally, ESβL-producing isolates were also characterized molecularly. The antibacterial activity was detected using a disc diffusion method. Mechanisms of antibacterial action, the fatty acid profile, and functional groups characterization of the promising EO were analyzed using scanning and transmission electron microscopy (SEM & TEM), gas chromatography-mass spectrometry (GC-MS), and Fourier transform infrared (FTIR) spectroscopy, respectively.
Results: A total of 50 non duplicated P. aeruginosa isolates from the wound samples of burn patients were identified. Of these, MDR and pan-drug resistance (PDR) showed a high prevalence in 38 (76%) isolates obtained from 10 clusters, while 21 (42%) were identified as ESβL-producing MDR or PDR P. aeruginosa isolates. Phenotypic detection of ESβL production showed that 20% were considered positive ESβL-producing P. aeruginosa using the IST, and were increased to 56% by the PCT. The most prevalent ESβL-encoding gene was bla _OXA-2 (60.7%), followed by bla _IMP-7 (53.6%) and bla _OXA-50 (42.8%). Ginger oil is the most efficient antibacterial agent and its antibacterial action mechanism is attributed to the morphological changes in bacterial cells. The oil characterization revealed that 9,12-Octadecadienoic acid methyl ester is the major fatty acid (50.49%) identified.
Conclusion: The high incidence of drug-resistance in ESβL-producing P. aeruginosa isolated from burn wounds is alarming. As proven in vitro, EOs may represent promising natural alternatives against ESβL-producing PDR or MDR P. aeruginosa isolates.
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