Clinical trial NCT05642767: Molecular Detection Of Efflux Pump and Virulence Factors Genes in Pseudomonas Aeruginosa
Official title: Molecular Detection Of Efflux Pump and Virulence Factors Genes in Pseudomonas Aeruginosa
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Pseudomonas Aeruginosa
Keywords: Efflux genes, Pseudomonas , virulence, PCR
Lead sponsor: Sohag University
Sponsor class: OTHER
First posted: 2022-12-08
Enrollment: 75
Sex: ALL
Minimum age (years): 4
Maximum age (years): 80
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: This study will be carried out on all patients suffering from infections that can be caused by pseudomonas aeruginosa.

Samples (pus, urine, blood, sputum, ear discharge) will be collected from different departments at sohag university hospital.

Clinical Data will be obtained as:

- Data about clinical manifestations including fever, expectoration, pus from wounds, urinary symptoms, symptoms of upper respiratory tract infections, and symptoms of otitis externa.

Brief summary: Pseudomonas aeruginosa (PA) is a ubiquitous aerobic, non-fermentative Gram-negative rod that is widely associated with nosocomial pneumonia and can lead to severe illness with poor outcomes, particularly in critically ill people due to the ability of some strains to cause lung epithelial injury and spread into the circulation. 2 In the intensive care unit, PA infection is ranked among the top five causes of the bloodstream, pulmonary, surgical site, urinary tract, and soft tissue infections.

Detailed description: The pathogenesis of PA infections is multifactorial, and it is frequently complicated by the bacteria's intrinsic resistance to some antimicrobial agents such as sulfonamides, tetracyclines, and trimethoprim, as well as its ability to acquire or quickly develop resistance to major classes of antibiotics such as aminoglycosides, quinolones, B-lactams, and polymyxins (Bassetti et al., 2018).

The efflux systems, which mediate the expulsion of antibiotics out of the cell shortly after entry, the production of enzymes to inactivate antibiotics, and the decrease in permeability across the cell wall are some mechanisms used by PA to develop antimicrobial resistance (Meletis \& Bagkeri, 2013).

PA possesses a large number of virulence factors that play a significant role in pathogenesis and the determination of infection severity. These virulence factors act alone or in synergy with each other to cause tissue damage, necrosis, and cell death. Among the virulence factors of PA, the major determinants of virulence are the type III secretion system (T3SS) and quorum sensing (cell-to-cell signaling system). The T3SS is a needle-like complex, also known as the injectisome, that enables a bacterium to deliver different effector proteins such as ExoS, ExoT, ExoU, and ExoY across the membrane into a host cell, altering host cell functions and increasing bacterial survival rates ( Horna G and, Ruiz J, 2021). In this study, we aimed to evaluate the prevalence of antibiotic resistance caused by the presence of Efflux genes and some virulence factors in Pseudomonas aeruginosa from clinical isolates.

Eligibility criteria: Inclusion Criteria:

* All patients suffering from infections that can be caused by pseudomonas aeruginosa

Exclusion Criteria:

* Samples diagnosed to have organisms other than pseudomonas aeruginosa.

Primary outcomes:
measure: Isolation and identification of pseudomonas aeruginosa using culture and automated system techniques
timeFrame: 1 December 2022 to 1 February 2023
measure: Identification of recent antibiotic sensitivity pattern using Modified Kerby -Disc Diffusion method
timeFrame: 1 December 2022 to 1 February 2023
measure: Molecular Identification of some virulence factors and efflux genes using PCR
timeFrame: 1 February 2023 to 30 March 2023
Secondary outcomes:
Other outcomes:
Locations:
city: Sohag
country: Egypt
facility: Sohag University
Study officials:
affiliation: Faculty of medicine, Sohag university
name: Mohamed H Alrawy
role: STUDY_CHAIR
affiliation: Faculty Of Medicine, Sohag university
name: Ebtisam M Gad
role: STUDY_CHAIR
References: