Pan-drug Resistance Tracing: Molecular Identification, Plasmid Profiling, and Curing of Bacteria Wound Isolates

Background: Resistance to all antimicrobial agent classes, also known as pan-drug resistance (PDR), is a serious health issue facing the whole world and makes the treatment of any wound infection more difficult. The plasmids are central in the horizontal transmission of resistance determinants that have been associated with the rapid spread of multidrug resistance among the pathogenic bacteria. Objective: This paper sought to establish the pan-drug resistance in wound isolates by using the characteristics of phenotypic separation, molecular recognition, plasmid profiling, and plasmid curing. Methods: 127 wound swab samples were gathered in patients of three hospitals in Ondo State, Nigeria, in November 2021-April 2022. The identification of bacterial isolates was performed using the standard microbiological methods and validated with the 16S rRNA gene sequencing. The testing of antibiotic susceptibility was done based on Clinical and Laboratory Standards Institute (CLSI) guidelines. The SPSS version 20.0 was used to perform a statistical analysis. Results: The percentage distribution of the isolates includes S. aureus (33%), P. aeruginosa (25%), P. mirabilis (23%), K. pneumoniae (14%), and E. coli (5%). Among the identified bacteria isolated from the patients' wound sources were Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus mirabilis with accession numbers NR_037007.2, NR_114471, and NR_114419.1, respectively. The sensitivity pattern of S. aureus and P. aeruginosa showed 0.00±0.00 zones to all the antibiotics used. The molecular weight of uncured plasmids of S. aureus and P. aeruginosa was about 9500 and 8500 base pairs, respectively, from the gel electrophoresis image of plasmid profiling, but S. aureus and P. aeruginosa showed an average of 1200 and 800 base pairs, respectively, after being cured. Conclusion: This research revealed the presence of multiple plasmids in the wound isolates responsible for pan-drug resistance. Furthermore, plasmid curing showed relevant implications in antibiotic resistance mitigation.