scholarly journals Prevalence of metallo-beta-lactamases (MBLS) producing Pseudomonas aeruginosa in hospitalized patients in rural tertiary care hospital in Uttar Pradesh, India

Author(s):  
Sarita Sinha ◽  
Amit Singh ◽  
Rajesh Kumar Verma ◽  
Dharmendra Prasad Singh ◽  
Sunita Kumari

Background: Pseudomonas aeruginosa is a leading cause of nosocomial infections due to MBLs production with limited therapeutic options, higher rate of colonization is encountered in hospitalized patient streated with broad spectrum antibiotics. This study was conducted with an aim to know the prevalence of Carbapenem resistant MBLs producing strains of Pseudomonas aeruginosa in hospitalized patients.Methods: A total of 14700 samples were obtained from various wards during Jan 2016 to June 2017, were screened for P. aeruginosa by conventional culture and biochemical tests. All confirmed P. aeruginosa isolates were further subjected to Modified Kirby- Bauer disc diffusion test as per CLSI guidelines. All IPM resistant isolates were screened for MBL production by DDST, CDST, MHT and E-test MBL.Results: Atotal of 1423were identified as P. aeruginosa. The isolation rate of P. aeruginosa at our hospital was 9.7%. Among these, 130(9.1%) isolates were IPM resistant. A total of 111 (85.4%) were MBL positive by CDST and E-test, 92 (70.5%) by DDST and 80 (61.5%) by MHT. The prevalence of MBL producing P. aeruginosa was 111/1423(7.8%) while among IPM resistant P. aeruginosa, its prevalence was 111/130 (85.4%).Conclusions: The study documents presence of nosocomial MBL producing P. aeruginosa strains in our Institute. E-test and CDST were superior to DDST and MHT for detection of MBLs.

2011 ◽  
Vol 55 (12) ◽  
pp. 5597-5601 ◽  
Author(s):  
Paul P. Cook ◽  
Michael Gooch ◽  
Shemra Rizzo

ABSTRACTWe examined the effect of the addition of ertapenem to our hospital formulary on the resistance of nosocomialPseudomonas aeruginosato group 2 carbapenems (imipenem, meropenem, and doripenem). This was a retrospective, observational study conducted between 1 January 2000 and 31 January 2009 at a large, tertiary-care hospital. Autoregressive integrated moving average (ARIMA) regression models were used to evaluate the effect of ertapenem use on the susceptibility ofPseudomonas aeruginosato group 2 carbapenems as well as on the use of the group 2 carbapenems, ciprofloxacin, and other antipseudomonal drugs (i.e., tobramycin, cefepime, and piperacillin-tazobactam). Resistance was expressed as a percentage of total isolates as well as the number of carbapenem-resistant bacterial isolates per 10,000 patient days. Pearson correlation was used to assess the relationship between antibiotic use and carbapenem resistance. Following the addition of ertapenem to the formulary, there was a statistically significant decrease in the percentage ofPseudomonas aeruginosaisolates resistant to the group 2 carbapenems (P= 0.003). Group 2 carbapenem use and the number of carbapenem-resistantPseudomonas aeruginosaisolates per 10,000 patient days did not change significantly over the time period. There was a large decrease in the use of ciprofloxacin (P= 0.0033), and there was a correlation of ciprofloxacin use with the percentage of isolates resistant to the group 2 carbapenems (ρ = 0.47,P= 0.002). We suspect that the improvement in susceptibility ofPseudomonas aeruginosato group 2 carbapenems was related to a decrease in ciprofloxacin use.


2008 ◽  
Vol 52 (8) ◽  
pp. 2943-2946 ◽  
Author(s):  
U. Garza-Ramos ◽  
R. Morfin-Otero ◽  
H. S. Sader ◽  
R. N. Jones ◽  
E. Hernández ◽  
...  

ABSTRACT During 2003, 40 carbapenem-resistant Pseudomonas aeruginosa clinical isolates collected in a Mexican tertiary-care hospital were screened for metallo-β-lactamase production. Thirteen isolates produced IMP-15, and 12 had a single pulsed-field gel electrophoresis pattern. The bla IMP-15 gene cassette was inserted in a plasmid-borne integron with a unique array of gene cassettes and was named In95.


2012 ◽  
Vol 4 (01) ◽  
pp. 039-042 ◽  
Author(s):  
Simit H Kumar ◽  
Anuradha S De ◽  
Sujata M Baveja ◽  
Madhuri A Gore

ABSTRACT Introduction: The production of Metallo-β-lactamases (MBLs) is one of the resistance mechanisms of Pseudomonas aeruginosa and Acinetobacter species. There is not much Indian data on the prevalence of MBLs in burns and surgical wards. Materials and Methods: A total of 145 non-duplicate isolates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species, isolated from pus/wound swabs and endotracheal secretions from burns and surgical wards, were tested for MBL production by modified ethylene diamine tetra acetic acid (EDTA) disc synergy and double disc synergy tests. Results: Prevalence of MBLs was 26.9% by both the above tests. All MBL-positive isolates were multidrug resistant. Only 6.06% (2/33) P.aeruginosa and 16.67% (1/06) Acinetobacter species were susceptible to piperacillin-tazobactam and netilmycin, respectively. These patients had multiple risk factors like >8 days hospital stay, catheterization, IV lines, previous antibiotic use, mechanical ventilation, etc. Graft application and surgical intervention were significant risk factors in MBL-positive patients. Overall mortality in MBL-positive patients was 34.21%. Conclusion: Emergence of MBL-producing Pseudomonas aeruginosa and Acinetobacter species in this hospital is alarming, which reflect excessive use of carbapenems and at the same time, pose a therapeutic challenge to clinicians as well as to microbiologists. Therefore, a strict antibiotic policy and implementation of proper infection control practices will go a long way to prevent further spread of MBLs. Detection of MBLs should also become mandatory in all hospitals.


2019 ◽  
Vol 11 (04) ◽  
pp. 287-291 ◽  
Author(s):  
Nishu Verma ◽  
Ashok Prahraj ◽  
Baijayantimala Mishra ◽  
Bijayini Behera ◽  
Kavita Gupta

Abstract BACKGROUND: Carbapenemase-producing Pseudomonas aeruginosa is a serious threat in hospital infection due to its multidrug resistance. AIM: The aim of the study was to determine the frequency of carbapenem resistance in clinical isolates of Pseudomonas aeruginosa and detect the presence of carbapenemase enzymes in carbapenem-resistant P. aeruginosa (CRPA) isolates by phenotypic and genotypic methods. MATERIAL AND METHODS: Double-disk synergy test [DDST] and combined disk synergy test [CDST]) was performed in CRPA isolates and the prevalence ofblaKPC,blaNDM-1,blaIMP,blaVIM,blaSIM,blaSPM,blaGIM, andblaOXA-48 was determined. RESULTS: Of 559 isolates included in the study, a total of 102 isolates were resistant to carbapenem that accounted for overall 18.24% (102/559) prevalence. Of these 102 isolates, 89 (87.25%) isolates were positive by DDST and 95 (93.17%) isolates were positive by CDST. Of 102 CRPA isolates,blaVIM was detected in 30 isolates (30/102, 29.1%), followed byblaNDM-1 in 29 (29/102, 28.4%) isolates andblaSIM andblaGIM in 6 isolates each (6/102, 5.8%). A combination of two carbapenemase genes was detected in 12 isolates, with six (6/102, 5.88%) CRPA isolates harboring with bothblaVIM andblaNDM-1 genes. Four isolates were found to harbor a combination of three carbapenem-resistant genes. CONCLUSION: A high rate of carbapenemase production was observed in P. aeruginosa. Coproducers of multiple carbapenemases are also a cause of concern. An in-depth understanding of molecular mechanisms of resistance will be helpful in optimizing patient management and hospital infection control.


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