Phenotypic detection of Metallo Beta Lactamase Producing Pseudomonas aeruginosa among Clinical Isolates from the intensive care unit of a tertiary care centre

M. S. Deopa, R. Goyal, Mukesh Kumar, A. Kumar
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Abstract

Background: Pseudomonas aeruginosa is an opportunistic pathogenic bacterium responsible for both, acute and chronic infection, causing serious infections in patients who are mechanically ventilated individuals, who are immunocompromised, and patients with malignancies or HIV infection. Objectives: The phenotypic screening of metallo beta-lactamases (MBL) in strains of Pseudomonas aeruginosa resistant to imipenem. Material and Methods: The study was carried out in the department of Microbiology, in a medical hospital, Bareilly, over a period 18 months from January 2013 to June 2014. A total of 103 Pseudomonas aeruginosa isolated from sputum, broncho alveolar lavage (BAL), urine, pus and blood from critically ill patients admitted in the intensive care unit of a tertiary care centre. Strain of P. aeruginosa resistant to imipenem, were tested for metallo beta-lactamase production by phenotypic methods. Result: Out of 103 Pseudomonas aeruginosa, 48 strains were found imipenem resistant, of which 43(89.6%) were MBL positive by imipenem -EDTA combined disc test and the rest 35(72.9%) were by modified Hodge test. Conclusion: Imipenem – EDTA combined disc test found to be the best phenotypic method for detection of MBL. The appearance of the MBL and their spread among bacterial pathogens is a matter of concern with regard to the future of antimicrobial therapy. Both the methods are simple and one of these phenotypic methods can be easily incorporated in routine lab procedures to detect MBL.
某三级医疗中心重症监护室临床分离株中产生金属β -内酰胺酶的铜绿假单胞菌的表型检测
背景:铜绿假单胞菌是一种机会致病菌,可引起急性和慢性感染,在机械通气患者、免疫功能低下患者、恶性肿瘤患者或HIV感染患者中引起严重感染。目的:筛选耐亚胺培南铜绿假单胞菌金属内酰胺酶(MBL)的表型。材料与方法:本研究于2013年1月至2014年6月在巴雷利一家医院微生物科进行,为期18个月。从三级保健中心重症监护室收治的危重病人的痰液、支气管肺泡灌洗液(BAL)、尿液、脓液和血液中共分离出103株铜绿假单胞菌。采用表型法对耐亚胺培南铜绿假单胞菌的金属内酰胺酶产量进行了检测。结果:103株铜绿假单胞菌亚胺培南耐药48株,其中亚胺培南-EDTA联合圆盘试验MBL阳性43株(89.6%),改良霍奇试验35株(72.9%)。结论:亚胺培南- EDTA联合圆盘试验是检测MBL的最佳表型方法。MBL的出现及其在细菌病原体中的传播是一个值得关注的问题,涉及到未来的抗菌治疗。两种方法都很简单,其中一种表型方法可以很容易地纳入常规实验室程序来检测MBL。
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