Phenotypic characterization and PCR-Ribotypic profile of Pseudomonas aeruginosa isolated from cystic fibrosis patients in Iran


1 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Bacteriology and Virology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Pseudomonas aeruginosa, is the most common pathogen in patients with cystic fibrosis (CF) that shows various resistance to antibiotics, acquires mucoidity and multiple genotypes. This survey was performed to study phenotypic and genotypic variations among P. aeruginosa isolates in CF patients at Alzahra Hospital in Isfahan, Iran.
Materials and Methods: The isolates of Pseudomonas aeruginosa from CF patients at Alzahra Hospital was identified by appropriate biochemical and microscopic tests, then performed antibiotic resistance tests and mucoid colony morphotyping. The genum of isolates extracted and confirmed on 16S rDNA-based PCR assay and typed on 16S rDNA-23SrDNA spacer, restricted with Hinf1 restriction enzyme.
Results: P. aeruginosa was isolated from 21 of the 59 CF patients (35.5%), Out of 21 isolates 9 (42.8%) strains were revealed mucoid morphotype. 81.8% isolates of mucoid strains were resistance to at least one of four antibiotics (GM, AN, PIP and CP). Most of the isolates (86%) showed resistance to ceftazidime. Ribotyping revealed two patterns (P1, P5).
Conclusion: The isolates of P. aeruginosa showed meaningful difference between drug resistance to antibiotics. The majority of P. aeruginosa isolated from CF patients showed pattern1 of PCR-Ribotyping.


1. Johansen HK, Aanaes K, Pressler T, Nielsen KG, Fisker J, Skov M, et al. Colonisation and infection of the paranasal sinuses in cystic fibrosis patients is accompanied by a reduced PMN response. J Cyst Fibros 2012:10: 1-7.  Back to cited text no. 1
2. Igbinosa EO, Odjadjare EE, Igbinosa IH, Orhue PO, Omoigberale MN, Amhanre NI. Antibiotic synergy interaction against multidrug-resistant Pseudomonas aeruginosa isolated from an abattoir effluent environment. Scientific World Journal 2012;2012:308034.  Back to cited text no. 2
3. Hayes D Jr, West SE, Rock MJ, Li Z, Splaingard ML, Farrell PM. Pseudomonas aeruginosa in children with cystic fibrosis diagnosed through newborn screening: Assessment of clinic exposures and microbial genotypes. Pediatr Pulmonol 2010;45:708-16.  Back to cited text no. 3
4. Agarwal G, Kapil A, Kabra SK, Das BK, Dwivedi SN. Characterization of Pseudomonas aeruginosa isolated from chronically infected children with cystic fibrosis in India. BMC Microbiol 2005;5:43.  Back to cited text no. 4
5. Agarwal G, Kapil A, Kabra SK, Chandra R, Das B, Diwedi SN. Phenotypic and genotypic variants of Pseudomonas aeruginosa isolated from children with cystic fibrosis in India. Indian J Med Res 2002;116:73-81.  Back to cited text no. 5
6. Hogardt M, Heesemann J. Adaptation of Pseudomonas aeruginosa during persistence in the cystic fibrosis lung. Int J Med Microbiol 2010;300:557-62.  Back to cited text no. 6
7. Koch C. Early infection and progression of cystic fibrosis lung disease. Pediatr Pulmonol 2002;34:232-6.  Back to cited text no. 7
8. Spencker FB, HauptS, Claros MC, Walter S, Lietz T, Schille R. Epidemiologic characterization of Pseudomonas aeruginosa in patients with cystic fibrosis. Clin Microbiol Infect 2000;6:600-7.  Back to cited text no. 8
9. Van Daele SG, Franckx H, Verhelst R, Schelstraete P, Haerynck F, Van SL. Epidemiology of Pseudomonas aeruginosa in a cystic fibrosis rehabilitation centre. Eur Respir J 2005;25:474-81.  Back to cited text no. 9
10. Vosahlikova S, Drevinek P, Cinek O, Pohunek P, Maixnerova M, Urbaskova P. High genotypic diversity of Pseudomonas aeruginosa strains isolated from patients with cystic fibrosis in the Czech Republic. Res Microbiol 2007;158:324-9.  Back to cited text no. 10
11. Juan C, Gutiérrez O, Oliver A, Ayerstarán JI, Borrell N, Pérez JL. Contribution of clonal dissemination and selection of mutants during therapy to Pseudomonas aeruginosa antimicrobial resistance in an intensive care unit setting. Clin Microbiol Infect 2005;11:887-92.  Back to cited text no. 11
12. Fazzeli H, Akbari R, Moghim Sh, Narimani T, Arabestani MR, Ghoddousi AR. Pseudomonas aeruginosa infections in patients, hospital means, and personnel's specimens. J Res Med Sci 2012:17:332-7.  Back to cited text no. 12
13. Fazeli H, Akbari R, Moghim S, Asadian A, Faghihinia J, Saneeyan H, et al. Detection of morphotyping characteristics identification antibiotic resistance of Pseudomonas aeruginosa isolated from patients with cystic fibrosis. JIMS 2012;29:1-12.  Back to cited text no. 13
14. Burns JL, Gibson RL, McNamara S, Yim D, Emerson J, Rosenfeld M. Longitudinal assessment of Pseudomonas aeruginosa in young children with cystic fibrosis. J Infect Dis 2001;183:444-52.  Back to cited text no. 14
15. Currie AJ, Speert DP, Davidson DJ. Pseudomonas aeruginosa: Role in the pathogenesis of the CF lung: Host determinants of pseudomonas aeruginosa lung infection. Semin Respir Crit Care Med 2003;24:671-80.  Back to cited text no. 15
16. Hart CA, Winstanley C. Persistent and aggressive bacteria in the lungs of cystic fibrosis children. Br Med Bull 2002;61:81-96.  Back to cited text no. 16
17. Anthony M, Rose B, Pegler MB, Elkins M, Service H, Thamotharampillai K. Genetic analysis of Pseudomonas aeruginosa isolates from the sputa of Australian adult cystic fibrosis patients. J Clin Microbiol 2002;40:2772-8.  Back to cited text no. 17
18. Spilker T, Coenye T, Vandamme P, LiPuma JJ. PCR-based assay for differentiation of Pseudomonas aeruginosa from other Pseudomonas species recovered from cystic fibrosis patients. J Clin Microbiol 2004;42:2074-9.  Back to cited text no. 18
19. Jelsbak L, Johansen HK, Frost AL, Thogersen R, Thomsen LE, Ciofu O. Molecular epidemiology and dynamics of Pseudomonas aeruginosa populations in lungs of cystic fibrosis patients. Infect Immun 2007;75:2214-24.  Back to cited text no. 19
20. Ratjen F, Doring G, Nikolazik WH. Effect of inhaled tobramycin on early Pseudomonas aeruginosa colonization in patients with cystic fibrosis. Lancet 2001;358:983-4.  Back to cited text no. 20
21. Trust CF. Pseudomonas aeruginosa infection in people with cystic fibrosis. In: Report of the CF Trust's Control of Infection Group. London, UK: CF Trust; 2000. p. 1-21.  Back to cited text no. 21
22. Li Z, Kosorok MR, Farrell PM, Laxova A, West SE, Green CG. Longitudinal development of mucoid Pseudomonas aeruginosa infection and lung disease progression in children with cystic fibrosis. JAMA 2005;293:581-8.  Back to cited text no. 22
23. Griese M, Muller I, Reinhardt D. Eradication of initial Pseudomonas aeruginosa colonization in patients with cystic fibrosis. Eur J Med Res 2002;7:79-80.  Back to cited text no. 23
24. Jamil M, Bashir S, Mohsin M, Tariq A, Bashir A, Haque A. Differentiation of common gram negative pathogens by PCR-Ribotyping. Pak J Med Sci 2007;23:233-7.  Back to cited text no. 24
25. Sener B, Köseoðlu O, Ozcelik U, Kocagöz T, Günalp A. Epidemiology of chronic Pseudomonas aeruginosa infections in cystic fibrosis. Int J Med Microbiol 2001;291:387-93.  Back to cited text no. 25
26. West SE, Zeng L, Lee BL, Kosorok MR, Laxova A, Rock MJ, et al. Respiratory infections with Pseudomonas aeruginosa in children with cystic fibrosis: Early detection by serology and assessment of risk factor. JAMA 2002;287:2958-67.  Back to cited text no. 26
27. Leone I, Chirillo MG, Raso T, Zucca M, Savoia D. Phenotypic and genotypic characterization of Pseudomonas aeruginosa from cystic fibrosis patients. Eur J Clin Microbiol Infect Dis 2008;27:1093-9.  Back to cited text no. 27
28. O'Carroll MR, Syrmis MW, Wainwright CE, Greer RM, Mitchell P, Coulter C, et al. Clonal strains of Pseudomonas aeruginusa in paediatric and adult cystic fibrosis units. Eur Respir J 2004;24:101-6.  Back to cited text no. 28
29. Baoleri L, Janus AJ, Oana C, Jens B, Niels H, Soren M. Heterogeneity of biofilms formed by nonmucoid pseudomonas aeruginosa isolates from patients with cystic fibrosis. J Clin Microbiol 2005;43:5247-55.  Back to cited text no. 29