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T3SS virulence factors and antimicrobial resistance of Pseudomonas aeruginosa isolated from medical devices of Peruvian inpatients in critical care units
* 1 , 1 , 2 , 3 , 4 , 5
1  Programa de Doctorado en Ciencias de la Salud, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.
2  Hospital Daniel Alcides Carrión – Callao, Perú.
3  Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos—‘One Health’, Universidad Científica del Sur, Lima, Perú.
4  Universidad Nacional Mayor de San Marcos, Facultad de Farmacia y Bioquímica, Lima, Perú.
5  Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Perú.
Academic Editor: Jordi Vila

Abstract:

Pseudomonas aeruginosa is an opportunistic Gram-negative bacteria identified as the main cause of serious nosocomial infections in Peru, especially in vulnerable patients, such as those hospitalized in critical care units (CCUs). Often, these infections are difficult to treat due to high antimicrobial resistance, enhanced virulence causing greater damage to the host, a tendency towards chronicity, and increases the risk of mortality. Thus, surveillance of this species in the aforementioned wards is encouraged.

Between July and September 2025, we collected the following medical devices, vascular catheters (VCs), urinary catheters (UCs), and endotracheal tubes (ETTs), from adult patients hospitalized in the CCU of a level-III reference hospital. Forty-two Pseudomonas aeruginosa isolates from different devices were recovered from MacConkey Agar and confirmed by PCR. Antimicrobial susceptibility was performed by disk diffusion using CLSI 2025 guidelines. Type 3 Secretion system virulence factor genes (T3SS) were detected by PCR, as well as carbapenemase genes blaVIM, blaIMP, blaNDM and blaKPC.

Out of 42 strains of P. aeruginosa from medical devices, 76% (32/42) were carbapenem-resistant; blaIMP was identified in 12/32 isolates and blaVIM in 5/32, the latter being VIM/IMP co-producers. The blaKPC gene was found in 6/32 isolates and none carried blaNDM. Regarding T3SS, we found the presence of exoU (15/42) and exoS (30/42), with three isolates being exoU+/exoS+. Most isolates also carried exoY (42/42) and exoT (39/42).

These results showed high carbapenem resistance in P. aeruginosa isolated from medical devices at a III-level Peruvian hospital and shed light on its T3SS virulence factors.Similar molecular epidemiology studies should be replicated.

Keywords: Pseudomonas aeruginosa; Resistance; Virulence; critical care

 
 
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