DETECTION OF RESISTANT GENES AMONG MDR PSEUDOMONAS AERUGINOSA INFECTION IN CHILDREN UNDERGOING CHEMOTHERAPY
Main Article Content
Keywords
Cancer patients, drug resistance, antibiotics, AMR, antibiotic resistance
Abstract
A Cross- sectional study was conducted for the detection of nosocomial resistant Beta-lactamase gene (IMP, SPM, AIM and BIC) against Pseudomonas aeruginosa in children undergoing chemotherapy. These genes play a significant role in multi drug resistance. P. aeruginosa is known to cause disease in immunocompromised patients e.g., cancer, HIV patients and burn patients. Also known as “superbug” due to resistant mechanism against the antibiotics. 10-15% of nosocomial infections are being caused by P. aeruginosa worldwide. About 300 samples (blood, sputum, urine & nasal) of children suffering from cancer were collected from a tertiary care hospital and prevalence of antibiotic resistance genes were analysed. Resistance against 13 antibiotics were tested in laboratory with disc diffusion method followed by PCR for the detection of genes. The results showed that the P. aeruginosa isolates were resistant against ulfamethoxazole / Trimethoporim (SXT) 100%, Ciprofloxacin (CIP) 48%, and Ceftozane/Tezobactum (CT) 80%, Cefipime (FEP) 93%, Ceftazidime (CAZ) 40%, Amikacin (AK) 32%, Levofloxacin (LEV) 39% , Meropenem (MEM) 90%, Imipenem (IPM) 95%, Polymixin B (PB) 71%, Gentamicin (CN) 65%, Tobramycin (TOB) 28%, Tazobactum (TZP) 24%.The PCR results showed that 91% isolates were positive for the IMP and 78% was positive for AIM and 68% was positive with SPM and 60% was positive with BIC genes. The prevalence of resistant genes IMP, SPM, AIM, BIC in P. aeruginosa is also on the increase in isolates from cancer patient. These findings are considered beneficial in understanding the mechanism involved in development of antibiotic resistance in P. aeruginosa.
References
1. Ahmed, N.; Ali, Z.; Riaz, M.; Zeshan, B.; Wattoo, J.I.; Aslam, M.N. Evaluation of antibiotic resistance and virulence genes among clinical isolates of Pseudomonas aeruginosa from cancer patients. Asian Pacific journal of cancer prevention: APJCP 2020, 21, 1333.
2. Ahmed, N.; Habib, S.; Muzzammil, M.; Rabaan, A.A.; Turkistani, S.A.; Garout, M.; Halwani, M.A.; Aljeldah, M.; Al Shammari, B.R.; Sabour, A.A. Prevalence of Bacterial Pathogens among Symptomatic–SARS-CoV-2 PCR-Negative Patients. Microorganisms 2022, 10, 1978.
3. Rizvi, A.; Saeed, M.U.; Nadeem, A.; Yaqoob, A.; Rabaan, A.A.; Bakhrebah, M.A.; Al Mutair, A.; Alhumaid, S.; Aljeldah, M.; Al Shammari, B.R. Evaluation of Bi-Lateral Co-Infections and Antibiotic Resistance Rates among COVID-19 Patients in Lahore, Pakistan. Medicina 2022, 58, 904.
4. Zeb, S.; Mushtaq, M.; Ahmad, M.; Saleem, W.; Rabaan, A.A.; Naqvi, B.S.Z.; Garout, M.; Aljeldah, M.; Al Shammari, B.R.; Al Faraj, N.J. Self-Medication as an Important Risk Factor for Antibiotic Resistance: A Multi-Institutional Survey among Students. Antibiotics 2022, 11, 842.
5. Ahmed, N.; Khan, M.; Saleem, W.; Karobari, M.I.; Mohamed, R.N.; Heboyan, A.; Rabaan, A.A.; Mutair, A.A.; Alhumaid, S.; Alsadiq, S.A. Evaluation of bi-lateral co-infections and antibiotic resistance rates among COVID-19 patients. Antibiotics 2022, 11, 276.
6. Ahmed, N.; Zeshan, B.; Naveed, M.; Afzal, M.; Mohamed, M. Antibiotic resistance profile in relation to virulence genes fimH, hlyA and usp of uropathogenic E. coli isolates in Lahore, Pakistan. Trop. Biomed 2019, 36, 559-568.
7. Ahmed, N.; Abusalah, M.A.H.A.; Farzand, A.; Absar, M.; Yusof, N.Y.; Rabaan, A.A.; AlSaihati, H.; Alshengeti, A.; Alwarthan, S.; Alsuwailem, H.S. Updates on Epstein–Barr Virus (EBV)-Associated Nasopharyngeal Carcinoma: Emphasis on the Latent Gene Products of EBV. Medicina 2022, 59, 2.
8. Al-Mhanna, S.B.; Ghazali, W.S.W.; Mohamed, M.; Rabaan, A.A.; Santali, E.Y.; Alestad, J.H.; Santali, E.Y.; Arshad, S.; Ahmed, N.; Afolabi, H.A. Effectiveness of physical activity on immunity markers and quality of life in cancer patient: a systematic review. PeerJ 2022, 10, e13664.
9. Mohd Salim, N.H.; Mussa, A.; Ahmed, N.; Ahmad, S.; Yean Yean, C.; Hassan, R.; Uskoković, V.; Mohamud, R.; Che Jalil, N.A. The Immunosuppressive Effect of TNFR2 Expression in the Colorectal Cancer Microenvironment. Biomedicines 2023, 11, 173.
10. Mussa, A.; Mohd Idris, R.A.; Ahmed, N.; Ahmad, S.; Murtadha, A.H.; Tengku Din, T.A.D.A.A.; Yean, C.Y.; Wan Abdul Rahman, W.F.; Mat Lazim, N.; Uskoković, V. High-dose vitamin C for cancer therapy. Pharmaceuticals 2022, 15, 711.
11. Parveen, S.; Saqib, S.; Ahmed, A.; Shahzad, A.; Ahmed, N. Prevalence of MRSA colonization among healthcare-workers and effectiveness of decolonization regimen in ICU of a Tertiary care Hospital, Lahore, Pakistan. Advancements in Life Sciences 2020, 8, 38-41.
12. Rasool, Z.; Noreen, H.; Anjum, A.; Rizvi, A.; Rabaan, A.A.; Halwani, M.A.; Sabour, A.A.; Aljeldah, M.; Shammari, B.R.A.; Alhajri, S.M. Genotypic and Phenotypic Characterization of Erythromycin-Resistant Staphylococcus aureus Isolated from Bovine Mastitis and Humans in Close Contact. Tropical Medicine and Infectious Disease 2022, 8, 26.
13. Sohail, M.; Muzzammil, M.; Ahmad, M.; Rehman, S.; Garout, M.; Khojah, T.M.; Al-Eisa, K.M.; Breagesh, S.A.; Hamdan, R.M.A.; Alibrahim, H.I. Molecular Characterization of Community-and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Isolates during COVID-19 Pandemic. Antibiotics 2023, 12, 157.
14. Mustafai, M.M.; Hafeez, M.; Munawar, S.; Basha, S.; Rabaan, A.A.; Halwani, M.A.; Alawfi, A.; Alshengeti, A.; Najim, M.A.; Alwarthan, S. Prevalence of Carbapenemase and Extended-Spectrum β-Lactamase Producing Enterobacteriaceae: A Cross-Sectional Study. Antibiotics 2023, 12, 148.
15. Rabaan, A.A.; Eljaaly, K.; Alhumaid, S.; Albayat, H.; Al-Adsani, W.; Sabour, A.A.; Alshiekheid, M.A.; Al-Jishi, J.M.; Khamis, F.; Alwarthan, S. An Overview on Phenotypic and Genotypic Characterisation of Carbapenem-Resistant Enterobacterales. Medicina 2022, 58, 1675.
16. Vakulenko, S.B.; Mobashery, S. Versatility of aminoglycosides and prospects for their future. Clinical microbiology reviews 2003, 16, 430-450.
17. Struelens, M.; Monnet, D.; Magiorakos, A.; O’Connor, F.S.; Giesecke, J. New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe. Eurosurveillance 2010.
18. Sutcliffe, J.; Grebe, T.; Tait-Kamradt, A.; Wondrack, L. Detection of erythromycin-resistant determinants by PCR. Antimicrobial agents and chemotherapy 1996, 40, 2562-2566.
19. Tam, V.H.; Chang, K.-T.; Abdelraouf, K.; Brioso, C.G.; Ameka, M.; McCaskey, L.A.; Weston, J.S.; Caeiro, J.-P.; Garey, K.W. Prevalence, resistance mechanisms, and susceptibility of multidrug-resistant bloodstream isolates of Pseudomonas aeruginosa. Antimicrobial agents and chemotherapy 2010, 54, 1160-1164.
20. Poirel, L.; Revathi, G.; Bernabeu, S.; Nordmann, P. Detection of NDM-1-producing Klebsiella pneumoniae in Kenya. Antimicrobial agents and chemotherapy 2011, 55, 934-936.
21. Rubin, J.; Victor, L.Y. Malignant external otitis: insights into pathogenesis, clinical manifestations, diagnosis, and therapy. The American journal of medicine 1988, 85, 391-398.
22. Silby, M.W.; Winstanley, C.; Godfrey, S.A.; Levy, S.B.; Jackson, R.W. Pseudomonas genomes: diverse and adaptable. FEMS microbiology reviews 2011, 35, 652-680.
23. Mittal, R.; Aggarwal, S.; Sharma, S.; Chhibber, S.; Harjai, K. Urinary tract infections caused by Pseudomonas aeruginosa: a minireview. Journal of infection and public health 2009, 2, 101-111.
24. Nixon, G.M.; Armstrong, D.S.; Carzino, R.; Carlin, J.B.; Olinsky, A.; Robertson, C.F.; Grimwood, K. Clinical outcome after early Pseudomonas aeruginosa infection in cystic fibrosis. The Journal of pediatrics 2001, 138, 699-704.
25. Poirel, L.; Lambert, T.; Türkoglü, S.; Ronco, E.; Gaillard, J.-L.; Nordmann, P. Characterization of Class 1 Integrons from Pseudomonas aeruginosa That Contain the bla VIM-2Carbapenem-Hydrolyzing β-Lactamase Gene and of Two Novel Aminoglycoside Resistance Gene Cassettes. Antimicrobial agents and chemotherapy 2001, 45, 546-552.
26. Pizarro-Cerdá, J.; Cossart, P. Bacterial adhesion and entry into host cells. Cell 2006, 124, 715-727.
27. Rátkai, C. Characterization of medically important Pseudomonas aeruginosa isolates. szte, 2011.
28. Rodríguez-Martínez, J.-M.; Poirel, L.; Nordmann, P. Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa. Antimicrobial agents and chemotherapy 2009, 53, 4783-4788.
29. Shakil, S.; Khan, R.; Zarrilli, R.; Khan, A.U. Aminoglycosides versus bacteria–a description of the action, resistance mechanism, and nosocomial battleground. Journal of biomedical science 2008, 15, 5-14.
30. Rossolini, G.; Mantengoli, E. Treatment and control of severe infections caused by multiresistant Pseudomonas aeruginosa. Clinical Microbiology and Infection 2005, 11, 17-32.
31. Lister, P.D.; Wolter, D.J.; Hanson, N.D. Antibacterial-resistant Pseudomonas aeruginosa: clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clinical microbiology reviews 2009, 22, 582-610.
32. Livermore, D.M. beta-Lactamases in laboratory and clinical resistance. Clinical microbiology reviews 1995, 8, 557-584.
33. Meenakumari, S.; Verma, S.; Absar, A.; Chaudhary, A. Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa in an Indian cardiac hospital. Int J Engineering Sci Tech 2011, 3, 7117-7124.
34. Mesaros, N.; Glupczynski, Y.; Avrain, L.; Caceres, N.E.; Tulkens, P.M.; Van Bambeke, F. A combined phenotypic and genotypic method for the detection of Mex efflux pumps in Pseudomonas aeruginosa. Journal of antimicrobial chemotherapy 2007, 59, 378-386.
35. Maki, D.G.; Tambyah, P.A. Engineering out the risk for infection with urinary catheters. Emerging infectious diseases 2001, 7, 342.
36. Janice, Y. Laboratory diagnosis of NDM-1 and other carbapenem-resistant Enterobacteriaceae. Medical Bulletin 2011, 16.
37. Navon-Venezia, S.; Leavitt, A.; Schwaber, M.J.; Rasheed, J.K.; Srinivasan, A.; Patel, J.B.; Carmeli, Y.; Group, I.K.K.S. First report on a hyperepidemic clone of KPC-3-producing Klebsiella pneumoniae in Israel genetically related to a strain causing outbreaks in the United States. Antimicrobial agents and chemotherapy 2009, 53, 818-820.
38. Poirel, L.; Héritier, C.; Tolün, V.; Nordmann, P. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrobial agents and chemotherapy 2004, 48, 15-22.
39. Noyal, M.; Menezes, G.; Harish, B.; Sujatha, S.; Parija, S. Simple screening tests for detection of carbapenemases in clinical isolates of nonfermentative Gram-negative bacteria. Indian Journal of Medical Research 2009, 129, 707.
40. Ranjan, K.P.; Ranjan, N.; Bansal, S.K.; Arora, D. Prevalence of Pseudomonas aeruginosa in post-operative wound infection in a referral hospital in Haryana, India. Journal of laboratory physicians 2010, 2, 74.
2. Ahmed, N.; Habib, S.; Muzzammil, M.; Rabaan, A.A.; Turkistani, S.A.; Garout, M.; Halwani, M.A.; Aljeldah, M.; Al Shammari, B.R.; Sabour, A.A. Prevalence of Bacterial Pathogens among Symptomatic–SARS-CoV-2 PCR-Negative Patients. Microorganisms 2022, 10, 1978.
3. Rizvi, A.; Saeed, M.U.; Nadeem, A.; Yaqoob, A.; Rabaan, A.A.; Bakhrebah, M.A.; Al Mutair, A.; Alhumaid, S.; Aljeldah, M.; Al Shammari, B.R. Evaluation of Bi-Lateral Co-Infections and Antibiotic Resistance Rates among COVID-19 Patients in Lahore, Pakistan. Medicina 2022, 58, 904.
4. Zeb, S.; Mushtaq, M.; Ahmad, M.; Saleem, W.; Rabaan, A.A.; Naqvi, B.S.Z.; Garout, M.; Aljeldah, M.; Al Shammari, B.R.; Al Faraj, N.J. Self-Medication as an Important Risk Factor for Antibiotic Resistance: A Multi-Institutional Survey among Students. Antibiotics 2022, 11, 842.
5. Ahmed, N.; Khan, M.; Saleem, W.; Karobari, M.I.; Mohamed, R.N.; Heboyan, A.; Rabaan, A.A.; Mutair, A.A.; Alhumaid, S.; Alsadiq, S.A. Evaluation of bi-lateral co-infections and antibiotic resistance rates among COVID-19 patients. Antibiotics 2022, 11, 276.
6. Ahmed, N.; Zeshan, B.; Naveed, M.; Afzal, M.; Mohamed, M. Antibiotic resistance profile in relation to virulence genes fimH, hlyA and usp of uropathogenic E. coli isolates in Lahore, Pakistan. Trop. Biomed 2019, 36, 559-568.
7. Ahmed, N.; Abusalah, M.A.H.A.; Farzand, A.; Absar, M.; Yusof, N.Y.; Rabaan, A.A.; AlSaihati, H.; Alshengeti, A.; Alwarthan, S.; Alsuwailem, H.S. Updates on Epstein–Barr Virus (EBV)-Associated Nasopharyngeal Carcinoma: Emphasis on the Latent Gene Products of EBV. Medicina 2022, 59, 2.
8. Al-Mhanna, S.B.; Ghazali, W.S.W.; Mohamed, M.; Rabaan, A.A.; Santali, E.Y.; Alestad, J.H.; Santali, E.Y.; Arshad, S.; Ahmed, N.; Afolabi, H.A. Effectiveness of physical activity on immunity markers and quality of life in cancer patient: a systematic review. PeerJ 2022, 10, e13664.
9. Mohd Salim, N.H.; Mussa, A.; Ahmed, N.; Ahmad, S.; Yean Yean, C.; Hassan, R.; Uskoković, V.; Mohamud, R.; Che Jalil, N.A. The Immunosuppressive Effect of TNFR2 Expression in the Colorectal Cancer Microenvironment. Biomedicines 2023, 11, 173.
10. Mussa, A.; Mohd Idris, R.A.; Ahmed, N.; Ahmad, S.; Murtadha, A.H.; Tengku Din, T.A.D.A.A.; Yean, C.Y.; Wan Abdul Rahman, W.F.; Mat Lazim, N.; Uskoković, V. High-dose vitamin C for cancer therapy. Pharmaceuticals 2022, 15, 711.
11. Parveen, S.; Saqib, S.; Ahmed, A.; Shahzad, A.; Ahmed, N. Prevalence of MRSA colonization among healthcare-workers and effectiveness of decolonization regimen in ICU of a Tertiary care Hospital, Lahore, Pakistan. Advancements in Life Sciences 2020, 8, 38-41.
12. Rasool, Z.; Noreen, H.; Anjum, A.; Rizvi, A.; Rabaan, A.A.; Halwani, M.A.; Sabour, A.A.; Aljeldah, M.; Shammari, B.R.A.; Alhajri, S.M. Genotypic and Phenotypic Characterization of Erythromycin-Resistant Staphylococcus aureus Isolated from Bovine Mastitis and Humans in Close Contact. Tropical Medicine and Infectious Disease 2022, 8, 26.
13. Sohail, M.; Muzzammil, M.; Ahmad, M.; Rehman, S.; Garout, M.; Khojah, T.M.; Al-Eisa, K.M.; Breagesh, S.A.; Hamdan, R.M.A.; Alibrahim, H.I. Molecular Characterization of Community-and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Isolates during COVID-19 Pandemic. Antibiotics 2023, 12, 157.
14. Mustafai, M.M.; Hafeez, M.; Munawar, S.; Basha, S.; Rabaan, A.A.; Halwani, M.A.; Alawfi, A.; Alshengeti, A.; Najim, M.A.; Alwarthan, S. Prevalence of Carbapenemase and Extended-Spectrum β-Lactamase Producing Enterobacteriaceae: A Cross-Sectional Study. Antibiotics 2023, 12, 148.
15. Rabaan, A.A.; Eljaaly, K.; Alhumaid, S.; Albayat, H.; Al-Adsani, W.; Sabour, A.A.; Alshiekheid, M.A.; Al-Jishi, J.M.; Khamis, F.; Alwarthan, S. An Overview on Phenotypic and Genotypic Characterisation of Carbapenem-Resistant Enterobacterales. Medicina 2022, 58, 1675.
16. Vakulenko, S.B.; Mobashery, S. Versatility of aminoglycosides and prospects for their future. Clinical microbiology reviews 2003, 16, 430-450.
17. Struelens, M.; Monnet, D.; Magiorakos, A.; O’Connor, F.S.; Giesecke, J. New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe. Eurosurveillance 2010.
18. Sutcliffe, J.; Grebe, T.; Tait-Kamradt, A.; Wondrack, L. Detection of erythromycin-resistant determinants by PCR. Antimicrobial agents and chemotherapy 1996, 40, 2562-2566.
19. Tam, V.H.; Chang, K.-T.; Abdelraouf, K.; Brioso, C.G.; Ameka, M.; McCaskey, L.A.; Weston, J.S.; Caeiro, J.-P.; Garey, K.W. Prevalence, resistance mechanisms, and susceptibility of multidrug-resistant bloodstream isolates of Pseudomonas aeruginosa. Antimicrobial agents and chemotherapy 2010, 54, 1160-1164.
20. Poirel, L.; Revathi, G.; Bernabeu, S.; Nordmann, P. Detection of NDM-1-producing Klebsiella pneumoniae in Kenya. Antimicrobial agents and chemotherapy 2011, 55, 934-936.
21. Rubin, J.; Victor, L.Y. Malignant external otitis: insights into pathogenesis, clinical manifestations, diagnosis, and therapy. The American journal of medicine 1988, 85, 391-398.
22. Silby, M.W.; Winstanley, C.; Godfrey, S.A.; Levy, S.B.; Jackson, R.W. Pseudomonas genomes: diverse and adaptable. FEMS microbiology reviews 2011, 35, 652-680.
23. Mittal, R.; Aggarwal, S.; Sharma, S.; Chhibber, S.; Harjai, K. Urinary tract infections caused by Pseudomonas aeruginosa: a minireview. Journal of infection and public health 2009, 2, 101-111.
24. Nixon, G.M.; Armstrong, D.S.; Carzino, R.; Carlin, J.B.; Olinsky, A.; Robertson, C.F.; Grimwood, K. Clinical outcome after early Pseudomonas aeruginosa infection in cystic fibrosis. The Journal of pediatrics 2001, 138, 699-704.
25. Poirel, L.; Lambert, T.; Türkoglü, S.; Ronco, E.; Gaillard, J.-L.; Nordmann, P. Characterization of Class 1 Integrons from Pseudomonas aeruginosa That Contain the bla VIM-2Carbapenem-Hydrolyzing β-Lactamase Gene and of Two Novel Aminoglycoside Resistance Gene Cassettes. Antimicrobial agents and chemotherapy 2001, 45, 546-552.
26. Pizarro-Cerdá, J.; Cossart, P. Bacterial adhesion and entry into host cells. Cell 2006, 124, 715-727.
27. Rátkai, C. Characterization of medically important Pseudomonas aeruginosa isolates. szte, 2011.
28. Rodríguez-Martínez, J.-M.; Poirel, L.; Nordmann, P. Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa. Antimicrobial agents and chemotherapy 2009, 53, 4783-4788.
29. Shakil, S.; Khan, R.; Zarrilli, R.; Khan, A.U. Aminoglycosides versus bacteria–a description of the action, resistance mechanism, and nosocomial battleground. Journal of biomedical science 2008, 15, 5-14.
30. Rossolini, G.; Mantengoli, E. Treatment and control of severe infections caused by multiresistant Pseudomonas aeruginosa. Clinical Microbiology and Infection 2005, 11, 17-32.
31. Lister, P.D.; Wolter, D.J.; Hanson, N.D. Antibacterial-resistant Pseudomonas aeruginosa: clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clinical microbiology reviews 2009, 22, 582-610.
32. Livermore, D.M. beta-Lactamases in laboratory and clinical resistance. Clinical microbiology reviews 1995, 8, 557-584.
33. Meenakumari, S.; Verma, S.; Absar, A.; Chaudhary, A. Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa in an Indian cardiac hospital. Int J Engineering Sci Tech 2011, 3, 7117-7124.
34. Mesaros, N.; Glupczynski, Y.; Avrain, L.; Caceres, N.E.; Tulkens, P.M.; Van Bambeke, F. A combined phenotypic and genotypic method for the detection of Mex efflux pumps in Pseudomonas aeruginosa. Journal of antimicrobial chemotherapy 2007, 59, 378-386.
35. Maki, D.G.; Tambyah, P.A. Engineering out the risk for infection with urinary catheters. Emerging infectious diseases 2001, 7, 342.
36. Janice, Y. Laboratory diagnosis of NDM-1 and other carbapenem-resistant Enterobacteriaceae. Medical Bulletin 2011, 16.
37. Navon-Venezia, S.; Leavitt, A.; Schwaber, M.J.; Rasheed, J.K.; Srinivasan, A.; Patel, J.B.; Carmeli, Y.; Group, I.K.K.S. First report on a hyperepidemic clone of KPC-3-producing Klebsiella pneumoniae in Israel genetically related to a strain causing outbreaks in the United States. Antimicrobial agents and chemotherapy 2009, 53, 818-820.
38. Poirel, L.; Héritier, C.; Tolün, V.; Nordmann, P. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrobial agents and chemotherapy 2004, 48, 15-22.
39. Noyal, M.; Menezes, G.; Harish, B.; Sujatha, S.; Parija, S. Simple screening tests for detection of carbapenemases in clinical isolates of nonfermentative Gram-negative bacteria. Indian Journal of Medical Research 2009, 129, 707.
40. Ranjan, K.P.; Ranjan, N.; Bansal, S.K.; Arora, D. Prevalence of Pseudomonas aeruginosa in post-operative wound infection in a referral hospital in Haryana, India. Journal of laboratory physicians 2010, 2, 74.
Article Sidebar
Published
Oct 28, 2023
Article Details
How to Cite
Muhammad Naveed Aslam, Hussna Khan, Jamshaid Ahmad, Awais Abid, & Javed Iqbal Watto. (2023). DETECTION OF RESISTANT GENES AMONG MDR PSEUDOMONAS AERUGINOSA INFECTION IN CHILDREN UNDERGOING CHEMOTHERAPY. Journal of Population Therapeutics and Clinical Pharmacology, 30(18), 1218-1229. https://doi.org/10.53555/jptcp.v30i18.3261
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Muhammad Naveed Aslam
Department of Microbiology, Faculty of Science and Technology, University of Central Punjab, Lahore - Pakistan
Hussna Khan
Lahore School of Nursing, The University of Lahore, Lahore - Pakistan
Jamshaid Ahmad
Department of Medical Education, Sharif Medical and Dental College, Lahore - Pakistan
Awais Abid
Department of Medical Education, Sharif Medical and Dental College, Lahore - Pakistan
Javed Iqbal Watto
Department of Microbiology, Faculty of Science and Technology, University of Central Punjab, Lahore - Pakistan
How to Cite
Muhammad Naveed Aslam, Hussna Khan, Jamshaid Ahmad, Awais Abid, & Javed Iqbal Watto. (2023). DETECTION OF RESISTANT GENES AMONG MDR PSEUDOMONAS AERUGINOSA INFECTION IN CHILDREN UNDERGOING CHEMOTHERAPY. Journal of Population Therapeutics and Clinical Pharmacology, 30(18), 1218-1229. https://doi.org/10.53555/jptcp.v30i18.3261