Involvement of Pseudomonas aeruginosa in the occurrence of community and hospital acquired diarrhea, and its virulence diversity among the stool and the environmental samples

ABSTRACT

Transmission of Pseudomonas aeruginosa along the food chain could cause gastrointestinal infections. To show this involvement, the prevalence, putative virulence genotype, and antibiotic resistance phenotype of P. aeruginosa isolates from stool of 1482 patients with community and hospital acquired diarrhea were compared with 87 isolates from the environmental samples. The results showed infection with P. aeruginosa in 3.4% of the cases, while 57.4% of vegetable samples were contaminated. Significantly higher frequency of lasB (98%), aprA (98%), exoY (98%), and exoS (90%), but lower rate of exoT (39.2%), was detected among the stool isolates. Multi-drug resistance (MDR) phenotype was detected in 25.5% and 4% of the stool and vegetable isolates, respectively. A higher rate of studied virulence genes was detected among the MDR strains vs non-MDR strains. These results indicate P. aeruginosa as a causative agent of diarrhea either among the hospitalized patients and those with community-acquired diarrhea.

KEYWORDS:

• Pseudomonas aeruginosa
• virulence determinants
• antimicrobial resistance
• community-acquired diarrhea
• hospital-acquired diarrhea

Acknowledgments

Authors of this study like to thank all colleagues in National Institute for Medical Research Development, Islamic Republic of Iran; Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; The Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran; Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran; and all staff of Public Health offices of 11 Medical universities who kindly provided the patients’ samples and demographic data.

Additional information

Funding

This study was part of a MSc thesis that was directed cooperatively with department of Microbiology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran and Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.