Folia Medica Indonesiana
Vol. 54 No. 2 (2018): June

Positivity of ExoU Gene of Type III Secretion System and Fluoroquinolone Resistance of Psedomonas aeruginosa from Sputum of Nosocomial Pneumonia Patients in Sanglah Hospital, Bali

I Wayan Agus Gede Manik Saputra (Bali Provincial Health Office, Bali, Clinical Microbiology Study Programme, Faculty of Medicine, Universitas Airlangga, Surabaya)
Ni Made Mertaniasih (Department of Medical Microbiology, Faculty of Medicine Universitas Airlangga, Soetomo Hospital, Surabaya Indonesia,)
Ni Nengah Dwi Fatmawati (Department of Clinical Microbiology, Faculty of Medicine and Health Science, Udayana University, Sanglah General Hospital, Bali)



Article Info

Publish Date
05 Jul 2018

Abstract

Pseudomonas aeruginosa is one of the Gram-negative rods bacteria that frequently cause nosocomial pneumonia. One of the main virulent effector proteins on Type III secretion system (TTSS) of P. aeruginosa is Exoenzyme U ( ExoU). ExoU works as a phospholipase A2 activity and exhibits lung tissue injury effect in pneumonia. As an antibiotic that has activity against P. aeruginosa, fluoroquinolone resistance has increased as many as three fold since the last decade. Infections caused by P. aeruginosa that are fluoroquinolone resistant and positive for ExoU gene show worse clinical outcome. The aim of this study was to determine the positivity of ExoU gene TTSS and fluoroquinolone resistance of P. aeruginosa that isolated from sputum of nosocomial pneumonia patients in Sanglah Hospital, Bali. P. aeruginosa isolated from sputum of patient that diagnosed as nosocomial pneumonia, isolates had been identified phenotypically by Vitek2 Compact system (bioMérieux, Inc., Marcy-l'Etoile - France), and then continued by genotypic detection by PCR. The susceptibility testing of P. aeruginosa isolates to Ciprofloxacin were conducted by Vitek2 Compact, whereas ExoU genes were detected by PCR. Fifty-three P. aeruginosa isolates were identified in this study, in which 35 isolates (66.1%) had ExoU gene and 22 isolates (41.5%) were resistant to Ciprofloxacin. Based on nosocomial pneumonia type, the highest proportion of isolates genotipically ExoU+ and phenotypically Ciprofloxacin were on VAP group accounted for 57.1% and 54.5%, respectively. Chi-square analysis showed significant correlation between Ciprofloxacin resistance and ExoU gene (p=0.001). As a conclusion, the positivity of ExoU+ isolates were more likely found in Ciprofloxacin resistant group.

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Journal Info

Abbrev

FMI

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Other

Description

Folia Medica Indonesiana publishes articles in the field of medical science in particular and health sciences in general, as well as a variety of other fields related to those two disciplines. Most of the articles are research article, and others are articles on case reports and literature review. ...