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Molecular epidemiology of Pseudomonas aeruginosa isolated from infected ICU patients: a French multicenter 2012–2013 study

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Abstract

Although Pseudomonas aeruginosa has a non-clonal epidemic population structure, recent studies have provided evidence of the existence of epidemic high-risk clones. The aim of this study was to assess the molecular epidemiology of P. aeruginosa isolates responsible for infections in French ICUs, regardless of resistance patterns. For a 1-year period, all non-duplicate P. aeruginosa isolated from bacteremia and pulmonary infections in ten adult ICUs of six French university hospitals were characterized by antimicrobial susceptibility testing and genotyping (MLST and PFGE). We identified β-lactamases with an extended spectrum phenotypically and by sequencing. The 104 isolates tested were distributed in 46 STs, of which 7 epidemic high-risk (EHR) clones over-represented: ST111, ST175, ST235, ST244, ST253, ST308, and ST395. Multidrug-resistant (MDR) isolates mostly clustered in these EHR clones, which frequently spread within hospitals. Only one ST233 isolate produced the carbapenemase VIM-2. PFGE analysis suggests frequent intra-hospital cross-transmission involving EHR clones. For ST395 and ST308, we also observed the progression from wild-type to MDR resistance pattern within the same PFGE pattern. Molecular epidemiology of P. aeruginosa in French ICUs is characterized by high clonal diversity notably among antimicrobial susceptible isolates and the over-representation of EHR clones, particularly within MDR isolates, even though multidrug resistance is not a constant inherent trait of EHR clones.

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Abbreviations

EHR:

epidemic high-risk

ESBL:

extended-spectrum β-lactamase

ES-OXA:

extended-spectrum oxacillinase

ICU:

intensive care unit

MBL:

metallo-β-lactamase

MDR:

multidrug resistant

MLST:

multilocus sequence typing

PFGE:

pulsed-field gel electrophoresis

PT:

pulsotype

ST:

sequence type

WT:

wild type

XDR:

extensive drug resistant

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Acknowledgments

We thank the ICUs (Gilles Capellier, Emmanuel Samain, Christian Auboyer, Fabrice Zéni, Christophe Mariat, Anne-Charlotte Tellier, Martine Ferandière, François Lagarrigue, Charlotte Arbelot, Corinne Vezinet), microbiology laboratories (Anne Carricajo, Florence Grattard, Julie Gagnaire, Hanaa Benmansour), and infection control teams of the six participating centers.

Financial support

This work was supported by the French Ministry of Health (PHRC national 2011).

Author information

Authors and Affiliations

  1. Hygiène Hospitalière, Centre Hospitalier Régional Universitaire, Besançon, France

    Céline Slekovec, Pascal Cholley, Michelle Thouverez, Didier Hocquet & Xavier Bertrand

  2. UMR 6249 Chrono-environnement, Université de Bourgogne-Franche-Comté, Besançon, France

    Céline Slekovec, Pascal Cholley, Michelle Thouverez, Didier Hocquet & Xavier Bertrand

  3. Centre d’immunologie et des maladies infectieuses-Paris, Cimi-Paris, INSERM, Laboratoire de Bactériologie-Hygiène, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière – Charles Foix, Sorbonne Université, F-75013, Paris, France

    Jérôme Robert & Didier Hocquet

  4. Service de Bactériologie, Virologie et Hygiène, Centre Hospitalier Régional Universitaire, Tours, France

    Nathalie van der Mee-Marquet

  5. Hygiène hospitalière et maladies infectieuses, Centre Hospitalier Universitaire, Saint-Etienne, France

    Philippe Berthelot

  6. Hygiène hospitalière, Centre Hospitalier Universitaire, INSERM U657, Université de Bordeaux, Bordeaux, France

    Anne-Marie Rogues

  7. Bactériologie-Hygiène, AP-HP, Hôpitaux Universitaires Paris Sud- Clamart, Le Kremlin-Bicêtre, France

    Véronique Derouin

Authors
  1. Céline Slekovec
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  2. Jérôme Robert
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  3. Nathalie van der Mee-Marquet
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  4. Philippe Berthelot
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  5. Anne-Marie Rogues
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  6. Véronique Derouin
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  7. Pascal Cholley
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  8. Michelle Thouverez
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  9. Didier Hocquet
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  10. Xavier Bertrand
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Contributions

CS participated in the design of the study, acquisition of data, coordinated the study and in the article redaction. JR, NvdMM, PB, AMR, and VD participated in the acquisition of data and in the article redaction. PC and MT carried out the bacterial typing. DH coordinated the bacteriology study and participated in the redaction. XB conceived the study, participated in the acquisition of data in its design, and wrote the article.

Corresponding author

Correspondence to Xavier Bertrand.

Ethics declarations

Approval and written informed consent from all subjects or their legally authorized representatives were obtained before study initiation. The study was approved by the ethical committee “Comité d’Etude Clinique” of the Besançon University Hospital, Besançon, France, references: 2011-A01013-38.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Slekovec, C., Robert, J., van der Mee-Marquet, N. et al. Molecular epidemiology of Pseudomonas aeruginosa isolated from infected ICU patients: a French multicenter 2012–2013 study. Eur J Clin Microbiol Infect Dis 38, 921–926 (2019). https://doi.org/10.1007/s10096-019-03519-w

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  • DOI: https://doi.org/10.1007/s10096-019-03519-w

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