Occurrence of New Delhi Metallobetalactamase mediated carbapenem resistance among Acinetobacter species in intensive care units
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 21, Issue 2
Abstract
Back ground: Carbapenems are the main stay of therapy in the treatment of serious infections caused by Acinetobacter species. Emergence and spread of resistance to carbapenems has resulted in limiting the therapeutic options. Carbapenem resistance is most commonly mediated by production of carbapenemase. The rapidly disseminating New Delhi Metallobetalactamases (NDM), a class B MBL is also being detected in Acinetobacter species. This study was done to detect the presence bla NDM-1 in Acinetobacter species in a tertiary care centre. Materials and Methods: One hundred and seventeen carbapenem resistant clinical isolates of a total of Acinetobacter species cultured during the study period were screened for the presence of NDM-1by PCR. Clinical characteristics of the NDM-1 positive isolates were studied and outcome was followed up. Results: Thirteen of 116 carbapenem resistant A. baumannii harboured the bla NDM gene. In 12 isolates, NDM was foundalong with either VIM or OXa Carbapenemase encoding genes. Only one isolate harboured bla NDM alone. All the 13 isolates exhibited a positive result with MHT and MBL screen test. Their MIC 90 to imipenem and meropenem were 32mg/l and 64 mg/l respectively. These NDM producers were isolated from specimens such as respiratory secretions (7), blood (5) and cerebrospinal fluid (1). The majority of the isolates were from the multidisciplinary ICU (9) of the hospital followed by 2 each in cardiothoracic and neurosurgery ICU. Of the 13 patients with NDM positive A. baumannii infections, 11 patients expired. The lone A. lwoffii harboured both bla VIM and bla NDM. Conclusion: With limited therapeutic options, NDM mediated resistance in Acinetobacter species is a cause for concern in critically ill patients with life threatening infections. Adequate detection of NDM producing Acinetobacter is crucial for infection control measures and appropriate choice of antimicrobial therapy.
Authors and Affiliations
Shanthi Mariappan, Uma Sekar, Arunagiri Kamalanathan, Balaraman Sekar
Keywords
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