Identification of multi-drug resistant Pseudomonas aeruginosa clinical isolates that are highly disruptive to the intestinal epithelial barrier

被引：52
作者：
Zaborina O. [1 ]
Kohler J.E. [1 ]
Wang Y. [2 ]
Bethel C. [3 ]
Shevchenko O. [1 ]
Wu L. [1 ]
Turner J.R. [2 ]
Alverdy J.C. [1 ]
机构：
[1] Department of Surgery, University of Chicago, Chicago, IL
[2] Department of Pathology, University of Chicago, Chicago, IL
[3] Clinical Microbiology Laboratories, University of Chicago, Chicago, IL
来源：
Annals of Clinical Microbiology and Antimicrobials | / 5卷 / 1期
关键词：
Clinical Isolate; Intestinal Epithelium; Transepithelial Resistance; Intestinal Epithelial Barrier; exoS Gene;
D O I：
10.1186/1476-0711-5-14
中图分类号：
学科分类号：
摘要：
Background: Multi-drug resistant Pseudomonas aeruginoso nosocomial infections are increasingly recognized worldwide. In this study, we focused on the virulence of multi-drug resistant clinical strains P. aeruginosa against the intestinal epithelial barrier, since P. aeruginosa can cause lethal sepsis from within the intestinal tract of critically ill and immuno-compromised patients via mechanisms involving disruption of epithelial barrier function. Methods: We screened consecutively isolated multi-drug resistant P. aeruginosa clinical strains for their ability to disrupt the integrity of human cultured intestinal epithelial cells (Caco-2) and correlated these finding to related virulence phenotypes such as adhesiveness, motility, biofilm formation, and cytotoxicity. Results: Results demonstrated that the majority of the multi-drug resistant P. aeruginosa clinical strains were attenuated in their ability to disrupt the barrier function of cultured intestinal epithelial cells. Three distinct genotypes were found that displayed an extreme epithelial barrier-disrupting phenotype. These strains were characterized and found to harbor the exoU gene and to display high swimming motility and adhesiveness. Conclusion: These data suggest that detailed phenotypic analysis of the behavior of multi-drug resistant P. aeruginosa against the intestinal epithelium has the potential to identify strains most likely to place patients at risk for lethal gut-derived sepsis. Surveillance of colonizing strains of P. aeruginosa in critically ill patients beyond antibiotic sensitivity is warranted. © 2006 Zaborina et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 45 条
  • [1] Aliaga L., Mediavilla J.D., Cobo F., A clinical index predicting mortality with Pseudomonas aeruginosa bacteraemia, J Med Microbiol, 51, pp. 615-619, (2002)
  • [2] Alverdy J.C., Aoys E., Moss G.S., Effect of commercially available chemically defined liquid diets on the intestinal microflora and bacterial translocation from the gut, Jpen: Journal of Parenteral & Enteral Nutrition, 14, pp. 1-6, (1990)
  • [3] Alverdy J.C., Aoys E., Moss G.S., Total parenteral nutrition promotes bacterial translocation from the gut, Surgery, 104, pp. 185-190, (1988)
  • [4] Marshall J.C., Christou N.V., Meakins J.L., The gastrointestinal tract. The "undrained abscess" of multiple organ failure, Ann Surg, 218, pp. 111-119, (1993)
  • [5] Osmon S., Ward S., Fraser V.J., Kollef M.H., Hospital mortality for patients with bacteremia due to Staphylococcus aureus or Pseudomonas aeruginosa, Chest, 125, pp. 607-616, (2004)
  • [6] Bertrand X., Thouverez M., Talon D., Boillot A., Capellier G., Floriot C., Helias J.P., Endemicity, molecular diversity and colonisation routes of Pseudomonas aeruginosa in intensive care units, Intensive Care Med, 27, pp. 1263-1268, (2001)
  • [7] Bertrand X., Blasco G., Belle E., Boillot A., Capellier G., Talon D., [Pseudomonas aeruginosa epidemiology in intensive care units: Importance of cross-transmission], Ann Fr Anesth Reanim, 22, pp. 505-509, (2003)
  • [8] Alverdy J., Holbrook C., Rocha F., Seiden L., Wu R.L., Musch M., Chang E., Ohman D., Suh S., Gut-derived sepsis occurs when the right pathogen with the right virulence genes meets the right host: Evidence for in vivo virulence expression in Pseudomonas aeruginosa, Ann Surg, 232, pp. 480-489, (2000)
  • [9] de Jonge E., Schultz M.J., Spanjaard L., Bossuyt P.M., Vroom M.B., Dankert J., Kesecioglu J., Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: A randomised controlled trial, Lancet, 362, pp. 1011-1016, (2003)
  • [10] Flamm R.K., Weaver M.K., Thornsberry C., Jones M.E., Karlowsky J.A., Sahm D.F., Factors associated with relative rates of antibiotic resistance in Pseudomonas aeruginosa isolates tested in clinical laboratories in the United States from 1999 to 2002, Anti-microb Agents Chemother, 48, pp. 2431-2436, (2004)
12345