Aspectos clínicos e caracterização de Pseudomonas aeruginosa isoladas de pacientes infectados com SARS-COV-2

Abstract

Objective: The objective of this work was to identify and characterize Pseudomonas aeruginosa isolated from patients at a university hospital and compare the genotypic and phenotypic profile of strains isolated from patients infected and not infected with SARS-CoV-2. Methods: P. aeruginosa isolates from patients aged between 18 and 85 years old were admitted to a University Hospital in Presidente Prudente-SP from January to December 2021. Demographic and clinical data were collected. The isolates were evaluated according to antimicrobial resistance, production of pyocyanin, lipase and phospholipase C and biofilm formation. The presence of genes for virulence factors (exoS, exo, toxA, akgO, pclH, plcN, aprA, lasB) and production of metallo-β-lactamases (blaIMP, blaVIM, blaSPM) was evaluated by means of the Polymerase Reaction in Chain. Statistical analyzes considered a significance level of 5%. Results: During the collection period, it was possible to obtain a total of 100 P. aeruginosa isolates, of which 58 were obtained from patients infected with SARS-CoV-2 and 42 were isolated from non-infected patients (p<0.05). The largest portion of P. aeruginosa isolated from SARS-CoV-2 positive patients was obtained in the UTI Covid (p<0.05). Mechanical ventilation was required in approximately 93% of patients infected with SARS-CoV-2 and P. aeruginosa. Thus, P. aeruginosa were more frequently obtained from tracheal secretion samples in patients infected with SARS-CoV-2 while in patients without SARS-CoV-2 the most common sample was urine (p<0.05). The frequency of co-infection with other bacterial species was similar in both groups, differing only in the presence of microorganisms from the Staphylococcus spp group. Which were in higher percentage in uninfected patients. Multidrug resistance was present in about 60% of the isolates, a similar value in both groups. Patients infected with SARS-CoV-2 had a higher rate of resistance to the antibiotic aztreonam and used a greater diversity of antibiotics (p<0.05). The isolates from patients infected with SARS-CoV-2 showed a higher production of phospholipase C and a higher number classified as strong biofilm formers (p<0.05). All genes linked to virulence factors in P. aeruginosa were present in at least 70% of isolates from both groups. Only three isolates obtained from patients infected with SARS-CoV-2 were observed with the presence of one gene each. Conclusion: The data from the present study demonstrated that the COVID-19 pandemic is a perfect scenario for the increase in co-infection with P. aeruginosa. Therefore, strategies based on epidemiological studies like this one become relevant so that goals can be set in order to reduce rates of infections by P. aeruginosa.