Abstract
Metallo-betalactamase producing pseudomonas aeruginosa have been reported to show resistance to carbepenem drugs. Detection of metallo-betalactamases producing pseudomonas is now important to prevent their spread as dissemination of these bacteria could be fatal to the patients. The present study was undertaken over period of six months from November-2010 to May-2011 in Kesar SAL Medical College & Research institute, Ahmedabad to study the incidence of MBL producing pseudomonas aeruginosa from various clinical specimens. 100 isolates were obtained from different clinical samples of patients. These isolates were subjected to susceptibility testing to antipseudomonal drugs as per CLSI guidelines they were further screened for production of MBL by two methods i.e. EDTA impregnated imipenem double disc synergy method and Imipenem – EDTA combined disc test. Out of hundred isolates 55 imipenem resistant isolates were screened for MBL production. 38 isolates showed MBL production. MBL production was found to be 9.09%. This presents therapeutic challenge to the clinicians and also needs proper selection of antibiotics especially carbapenems.
Highlights
The carbapenems have been drug of choice for treatment of infections caused by gram negative bacilli Infections 1
Routine antibiotic disc sensitivity testing was done with Ampicillin, Gentamicin, Amikacin, Ceftazidime, Cefepime, Cephotaxime, Ciprofloxacin, Chloramphenicol, Cefuroxime, Cefpodoxime, Norfloxacin, Nitrofurantoin, Tobramycin, Cephalexin, Cephazolin, Sparfloxacin, Pipercillin, Tazobactum, Colistin
The test organisms were inoculated on the plates of Muller Hinton agar as recommended by CLSI (Clinical Laboratory standard institute) an imipenem (10 Microgram) disc was placed 20 mm centre to centre from blank disc containing 10 micro litters of 0.5 Mg EDTA (750 microgram)
Summary
The carbapenems have been drug of choice for treatment of infections caused by gram negative bacilli Infections 1. Pseudomonas shows resistance to carbapenems due to decrease outer membrane permeability, increased efflux system, alteration penicillinbinding proteins and carbapenem hydrolyzing enzymes carbapenemase[2]. The emergence of MBLS in pseudomonas species is becoming a therapeutic challenge as these enzymes possess high hydrolytic activity that leads to degradation of higher cephalosporins[3]. Carbapenems available for use in India are imipenem and meropenem[4]. As treatment options are either not available or very expensive and may be toxic with poor outcomes[3]
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