DETECTION OF MBL PRODUCTION IN PSEUDOMONAS AERUGINOSA IN KATIHAR DISTRICT, BIHAR
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 55
Abstract
BACKGROUND Pseudomonas aeruginosa is a leading cause of nosocomial infection due to its numerous intrinsic and acquired mechanisms of drug resistance. Although antibiotic resistance in P. aeruginosa is caused by multiple mechanisms, one major factor leading to resistance is the production of carbapenemases. Metallo-β-lactamases (MBLs) are carbapenemases which require zinc at the active site and are predominantly produced by P. aeruginosa. The selection criteria for confirmation of MBL producers are reduced susceptibility or resistance to carbapenems and/or ceftazidime. The aim of the study was to determine the efficacy of three antibiotics viz., meropenem, imipenem and ceftazidime as a screening and confirmatory agent for detection of MBL and to assess the diagnostic potential of DDST, DPT and MIC reduction test for detection of MBL. MATERIALS AND METHODS This study included 461 isolates of P. aeruginosa collected over a period of 2 years. Resistance to carbapenems and ceftazidime was used for screening of isolates. Positively screened isolates were further subjected to different MBL detecting tests- DDST (Double Disc Synergy Test), DPT (Disc Potential Test) and EPM/EPI Microdilution test. RESULTS A total of 12304 samples were processed during the study period of which 461 isolates were Pseudomonas aeruginosa. Out of 461 Pseudomonas aeruginosa, 45.78% were MBL producers. Majority of MBL strains were isolated from Department of Surgery (41.23%). MIC was positive in 211 isolates, being a gold standard test for MBL detection with 100% sensitivity. DPT was positive in 89.57% isolates and DDST was positive in 74.4% isolates. Most MBL strains (93.83%) were sensitive to Polymyxin B. CONCLUSION The present study gives us an indication regarding the occurrence of MBL production amongst Pseudomonas aeruginosa in Eastern Bihar which is very high at 45.78%. Early detection of MBL producing Pseudomonas aeruginosa may help in appropriate antimicrobial therapy and avoid the development and dissemination of these strains. The DPT was found to be a simple, reliable and reproducible test that showed 89.5% conformity. Therefore, we recommend incorporation of DPT in all laboratories as a part of routine.
Authors and Affiliations
Tarannum Yasmin, Krishan Nandan, Aninda Sen
Keywords
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- EP ID EP225892
- DOI 10.14260/Jemds/2017/896
- Views 71
- Downloads 0
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