Prevalence of Metallo-b-lactamase Producing Gram Negative Bacteria in a Tertiary Care Hospital, Patiala
Keywords:
Modified Hodge test, imipenem, metallo-â-lactamases, non-fermenting bacilliAbstract
The metallo-â-lactamases (MBLs) in gram negative bacteria have emerged as a major cause of health care associated infections. They hydrolyze all beta-lactam antibiotics including extendedspectrum cephalosporins and carbapenems, not inhibited by serine beta-lactamase inhibitors like clavulinic acid, sulbactum, and tazobactum and are resistant to many antibiotics. This study was undertaken to ascertain the prevalence of MBL producing gram negative bacteria. Out of 1546 culture positive gram negative isolates, 398 isolateswere multi drug resistant. These isolates were screened for carbapenem resistance by modified hodge test. Isolates were also checked for metallo- -lacatmase (MBLs) production by the EDTA combined disk test (CDT). MBLs - activity was detected in 43 (10.8%) isolates by CDT. In Multidrug resistance isolates,colistin being the most active agent. Emergence of MBL- producing pathogens in our setting creates an important challenge for clinicians and hospital epidemiologists, because it is added to the already high burden of antimicrobial.
Downloads
References
Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-âlactamase gene, blaNDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae Sequence Type 14 from India. Antimicrob Agents Chemother. 2009; 53:5046–54.
Behera B, Mathur P, Das A, Kapil A, Sharma V. An evaluation of four different phenotypic techniques for detection of metallo-â-lactamase producing Pseudomonas aeruginosa. Indian J Med Microbiol. 2008; 26:233–7.
Walsh TR, Toleman MA, Poirel L, Nordmann P. Metallo-ß- lactamases: the quiet before the storm? ClinMicrobiol Rev. 2005; 18:306–25.
Peleg AY, Franklin C, Bell JM, Spelmann DW. Dissemination of the metallo-â lactamase gene bla IMP4among gram-negative pathogens in a clinical setting in Australia. Clin Infect Dis. 2005; 41:1549–56.
Nordmann P, Poirel L. Emerging carbapenemases in gram-negative aerobes. Clin Microbial Infect. 2002; 8:321–31.
Luzzaro F, Endimiani A, Docquier JD, Mugnaioli C, Bonsignori M, Amicosante G, et al. Prevalence and characterization of metallo-beta-lactamases in clinical isolates of Pseudomonas aeruginosa. DiagnMicrobiol Infect Dis. 2004; 48:131–5.
Senda K, Arakawa Y, Nakashima K, Ito H, Ichiyama S, Shimokata K, et al. Multifocal outbreaks of metallo-betalactamase producing Pseudomonas aeruginosa resistant to broad-spectrum beta lactams, including carbapenems. Antimicrob Agents Chemother. 1996; 40:349–53.
Yong D, Lee K, Yum JH, Shin HB, Rossolini GM, Chong Y. Imipenem-EDTA disk method for differentiation of metallo-â-lactamases producing clinical isolates of Pseudomonas spp and Acinetobacterspp. J ClinMicrobiol. 2002; 40:3798–801.
Clinical and Laboratory Standards Institute (CLSI). 2011. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. CLSI document M100-S21 (ISBN 1-56238- 742- 1). Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087 USA.
Livermore DM, Woodford N. The â-lactamase threat in Enterobacteriaceae, Pseudomonas and Acinetobacter. Trends Microbiol. 2006;14:413–20.
Attal RO, Basak S, Mallick SK, Bose S. Metallob etalactamase producing Pseudomonas aeruginosa: An emerging threat to clinicians. J ClinDiagn Res. 2010;4:2691-6.
Deshmukh DG, Damle AS, Bajaj JK, Bhakre JB, Patwardhan NS.Metallo-â-lactamase-producing clinical isolates from patients of a tertiary care hospital. J Lab Physician. 2011 Jul;3(2):93-7. doi: 10.4103/0974- 2727.86841.
Jaydev Pandya, MiteshKamothi , Sanjay Maheta , KunjanKikani, SwetaPrajapati. The prevalence of Metallo-beta-lactamase (MBL) in gram negative bacilli and their antimicrobial susceptibility pattern at tertiary care hospital, Surendranagar. Int J Res Med. 2016; 5(3); 78-83.
Behera B, Mathur P, Das A, Kapil A, Sharma V. An evaluation of four different phenotypic techniques for detection of Metallo-â-lactamase producing Pseudomonas aeruginosa. Ind J Med Microb 2008; 26(3):233-7.
Peshattiwar PD, Peerapur BV. ESBL and MBL Mediated Resistance in Pseudomonas aeruginosa: An Emerging Threat to Clinical Therapeutics. J Clino and Diagno Res2011; 5(8):1552-4.
Rajesh Joshi and AnkurPhatarpekar. Emergence of Metallo â-Lactamases and Carbapenem Resistance. Indian Pediatrics 166 Volume 48: February 17, 2011
Nandy S, Das AK, DudejaM.Prevalence of metallo beta lactamase in clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital.Int J Community Med Public Health. 2015 Nov; 2(4):566-9.
Hisaaki Nishio, Masaru Komatsu, Naohiro Shibata, KouichiShimakawa, Noriyuki Sueyoshi, Toshiro Ura, Kaori Satoh et al.Metallo-â-Lactamase-Producing GramNegative Bacilli: Laboratory-Based Surveillance in Cooperation with 13 Clinical Laboratories in the Kinki Region of Japan.JClinMicrobiol 2004 Nov; 42(11): 5256–5263.
Jesudason MV, Kandathil AJ, Balaji V. Comparison of two methods to detect carbapenemase&metallo-betalactamase production in clinical isolates. Indian J Med Res. 2005; 121:780–3.
