scholarly journals Identification, Speciation and Antibiogram along with Detection of Metallo Beta-lactamase Production in Acinetobacter Isolated from Clinical Samples in a Tertiary Care Hospital

Author(s):  
N Ashwin Chitrabanu ◽  
Shrikara Mallya

Acinetobacter species are gram negative non fermenters, which are important nosocomial pathogens involved in various outbreaks in hospitals due to widespread resistance to majority antibiotics. The aim of this study is to speciate Acinetobacter isolated from clinical samples, to assess the antibiotic sensitivity pattern and to detect the production of metallo-β-lactamase by double disc synergy test. The study was conducted in the department of microbiology, A. J Institute of Medical Sciences. All clinical samples were subjected to gram stain & cultured; the Acinetobacter isolates obtained were subjected to antibiogram. Those isolates that showed Imipenem resistant were further tested for production of metallo-β-lactamase by double disc synergy test. Out of 6625 culture positive isolates, 414 (36.1%) were identified biochemically to belong to Acinetobacter species. Of the 414 cases, 393 (94.9%) were further identified to be Acinetobacter baumannii and the remaining 21 (5.1%) to be Acinetobacter lwoffi. Acinetobacter lwoffii showed 100% sensitivity to all the drugs. Of the 393 Acinetobacter baumannii isolates 109 (27.7%) showed resistant to Imipenem. Out of these 109 isolates, 65 (59.63%) were positive for metallo-β-lactamase production by double disk synergy test. The speciation is highly demanding and laborious but it’s important to be demonstrated due to difference in the antibiotic susceptibility pattern. Carbapenem resistant Acinetobacter nosocomial strains in ICUs are detected to be more resistant to antibiotics. As shown in this study the metallo-β-lactamase producing A.baumannii isolates were 59.63% and therapeutic options were limited. Therefore early identification of metallo-β-lactamase producers is of great importance to start appropriate treatment and to control the spread.

Author(s):  
Kirti Hemwani ◽  
P. S. Nirwan ◽  
Preeti Shrivastava ◽  
Abhiraj Ramchandani

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords:  Nonfermenters,  Polymyxin-B, Pseudomonas, Acinetobacter.


Author(s):  
Vijayashree V. ◽  
Saikeerthana D. ◽  
Prabha P.

Background: The genus Klebsiella of Enterobacteriaceae family is ubiquitous in nature. They cause many nosocomial infections like pneumonia, urinary tract infections, wound infections, bacteremia and septicemia. Multidrug resistance is seen in Klebsiella which serves as the most common cause of increased morbidity and mortality. This study reveals the prevalence and antibiotic sensitivity pattern of Klebsiella species from various clinical samples. The primary objectives are as follows: To isolate and characterize Klebsiella species from various clinical samples. To study the antibiotic susceptibility pattern of Klebsiella isolates.Methods: This prospective study was conducted in our tertiary care hospital during the period from August 2019 to October 2019. A total of 3521 samples were tested during this period. The samples include blood, sputum, urine, and pus.Results: Out of the total samples tested,1106 samples were showing the growth of the organisms. Among this,351 were identified as Klebsiella species and the highest rate of isolation of Klebsiella species is from the sputum sample and also the same was reported high in medical wards. The study also shows that the isolation of Klebsiella species shows male preponderance when compared to females. The antibiotic sensitivity pattern was done by Kirby-Bauer's disc diffusion method and the sensitivity was noted to be higher to amikacin and ciprofloxacin.Conclusions: Thus, this study shows the prevalence rate of Klebsiella species and sensitivity pattern of Klebsiella, which may help select appropriate antibiotics and prevent overuse and misuse of antibiotics.


Author(s):  
Sumitra Kumari Sanju Pannu ◽  
Anjli Gupta Geeta Tinna ◽  
B.P. Sharma

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallo betalactamase (MBL) in Acinetobacter species. It was conducted in the Department of Microbiology, Sardar Patel Medical college, Bikaner from Feb 2018 to Feb.2019. in various clinical specimens including urine, pus, blood, vaginal swabs, respiratory samples, and various body fluids were processed Acinetobacter species isolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL and MBL positive isolates of Acinetobacter species were observed among E.T. tube samples. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against this organisms.


Author(s):  
Nageswari Gandham ◽  
Neetu Gupta ◽  
Chanda Vyawahare ◽  
Shahzad Beg Mirza ◽  
Rabindra Nath Misra

Abstract Background Evaluating the expression pattern of oxacillinases (OXA) carbapenemases is essential to understand the prevalence and spread of carbapenem resistance Acinetobacter baumannii. Objectives The aim of the study is to evaluate the presence of OXA carbapenemase genes and ISAba1 upstream to these genes in carbapenem-resistant A. baumannii clinical isolates. Material and Methods A. baumannii isolated from clinical samples were phenotypically identified and antibiotics sensitivity was performed. Multiplex polymerase chain reaction (PCR) was used to detect OXA51-like gene, OXA carbapenemases genes (OXA-23-like, OXA-24-like, and OXA-58-like), and ISAba1 in carbapenem-resistant isolates. Results Out of 55 Acinetobacter isolates, 54 were confirmed as A. baumannii by PCR. Bla OXA-23-like gene was observed in 51 isolates of A. baumannii and none of the isolates showed the presence of bla OXA-24-like and bla OXA-58-like genes. Presence of ISAba1 upstream to OXA-23-like gene, OXA-51-like gene, and both OXA-51-like/OXA-23-like genes was observed in 51, 7, and 4 A. baumannii isolates, respectively. Conclusion The genetic pattern of carbapenem-resistant A. baumannii isolated in this study was unique, which should be factored for clinical protocols to manage infections caused by emerging resistant strains of A. baumannii.


Author(s):  
Sulaiman A Mohammed ◽  
Dr. Suman P Singh

Background: Carbapenem resistance mediated by metallo beta lactamases (MBL) in Acinetobacter baumannii is a global challenge due to its rapid spread and limited therapeutic options. Objective: To determine the prevalence of MBL in A. baumannii isolates in hospitalized patients by both phenotypic and genotypic methods. Materials and Methods: The clinical samples were collected from inpatients and subcultured on routine culture media for growth. Identification of bacteria along with antimicrobial sensitivity testing was done by VITEK -2 Compact (bioMerieux). Antibiotics that were not tested by VITEK-2 were tested manually by Kirby-Bauer disk diffusion method according to CLSI 2017 and EUCAST 2016 guidelines. The isolates which were resistant to carbapenem (imipenem and/ or meropenem) were tested by phenotypic (imipenem-EDTA combined disk method) and genotypic method for presence of common metallo beta lactamases genes (blaIMP, blaNDM, blaGIM, blaVIM, blaSPM and blaSIM). Results: 84 non duplicate A.baumannii were isolated out of 947 pathogenic gram negative isolates. Majority (47.6%) of isolates were obtained from tracheostomy/endotracheal/bronchoalveolar lavage (TT/ET/BAL) followed by sputum (21.4%). None of the isolates were found to be resistant to colistin and tigecycline. 73 (86.9%) isolates were found to be carbapenem resistant, among these 60 (82.2%) were found to be MBL positive by phenotypic and 32 (43.2%) by genotypic method. MBL genes detected were blaNDM (39.7%), blaGIM (2.7%) and blaVIM (1.4%). None of the isolates were positive for blaIMP, blaSPM and blaSIM. Conclusion:  The prevalence of MBL in carbapenem resistant isolates of A.baumannii was 87.7%.  blaNDM was the most common gene detected. No significant difference was found in the ability of phenotypic and genotypic methods for MBL detection. The resistance rate of the A.baumannii is high for most antibiotics except for polymyxins (E&B) and tigecycline. Key words: Metallo beta Lactamases, Acinetobacter baumannii, Carbapenem.


2017 ◽  
Vol 4 (3) ◽  
pp. 263-268
Author(s):  
Tanu Arora ◽  
◽  
Shailpreet K Sidhu ◽  
Pushpa Devi ◽  
Sita Malhotra ◽  
...  

2021 ◽  
Vol 71 (11) ◽  
pp. 2576-2581
Author(s):  
Saima Ishtiaq ◽  
Sidrah Saleem ◽  
Abdul Waheed ◽  
Arslan Ahmed Alvi

Objective: To evaluate carbapenem resistance and to detect blaOXA-23 and blaOXA-51 genes in carbapenem-resistant acinetobacter baumanii isolates recovered from patients having pneumonia secondry to ventilation. Methods: The cross-sectional study was conducted from July 2017 to June 2018 at the Department of Microbiology, University of Health Sciences, Lahore, Pakistan, and comprised endotracheal aspirates / tracheobroncheal lavage samples from patients irrespective of age and gender who developed pneumonia after being on the ventilator for 48 hrs at the Combined Military Hospital, and Jinnah Hospital, Lahore.  The samples were inoculated on MacConkey and blood agar and aerobically incubated at a temperature of 370C for 18-24 hours. The isolated organisms were further assessed by standard morphological, cultural and biochemical profile. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method. Carbapenem-resistant acinetobacter baumannii were checked for carbapenemase production using Modified Hodge Test. Conventional polymerase chain reaction and agarose gel electrophoreses were performed to detect blaOXA-23 and blaOXA-51 genes. Data was analysed using SPSS 17. Results: Out of 157 samples, 92(58.6%) yielded growth of bacteria, and, among them, 39(42.4%) were identified as acinetobacter baumannii. All (100%) acinetobacter baumannii cases showed resistance to carbapenem, were producing carbapenemase enzyme, and were positive for blaOXA-51 gene. The blaOXA-23 gene was amplified in 38(97.4%) isolates. Conclusion: BlaOXA-23 gene appeared to be the major cause of carbapenem resistance. Continuous...


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