Metallo-beta-lactamases (MBLS) Producing Pseudomonas aeruginosa in Hospitalized Patients: An Increasing Threat in Tertiary Care Hospitals | Chapter 7 | Research Advances in Microbiology and Biotechnology Vol. 9

 This chapter aimed to detect the prevalence of MBLs in isolates of imipenem resistant P. aeruginosa from various inpatient departments and to determine the best phenotypic test for detection of MBLs. Pseudomonas aeruginosa is a Gram-negative pathogen that has become an important cause of infection in humans and can be associated with significant morbidity and mortality. Infections acquired in connection with hospitalization can lead to significant morbidity and mortality, but preventive anti-infective measures can significantly affect these result.

It was a prospective observational study conducted at Department of Microbiology, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, UP, India. All the sample from June 2016-2017 of one year were processed for the study.

A total of 14700 samples were screened for P. aeruginosa by conventional culture and biochemical tests. All confirmed P. aeruginosa isolates were further subjected to Modified Kirby- Bauer disc diffusion test as per CLSI guidelines. All IPM resistant isolates were screened for MBL production by DDST, CDST, MHT and E-test MBL.

A total of 1423 were identified as P. aeruginosa. The isolation rate of P. aeruginosa at our hospital was 9.7%. Among these, 130(9.1%) isolates were IPM resistant. A total of 111 (85.4%) were MBL positive by CDST and E-test, 92 (70.5%) by DDST and 80 (61.5%) by MHT. Metallo-beta-lactamase producing Pseudomonas aeruginosa is an important nosocomial pathogen that shows resistance to all beta-lactam antibiotics except monobactams. Present study shows a quite alarming 85% MBL positive imipenem resistant Pseudomonas aeruginosa cases. This study found imipenem-EDTA combine disc test detected more MBLs isolates, than combined disc test, according to E-test for MBLs 111 out of 130 had ratio >8 and were confirmed as MBL-producing isolates.

Author(s) Details:

Amit Singh,
Department of Microbiology, UPUMS, Saifai, Etawah, Uttar Pradesh, India.

Sarita Sinha,
Department of Microbiology, UPUMS, Saifai, Etawah, Uttar Pradesh, India.

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Prevalence of Extended Spectrum Beta Lactamase (ESBL) Producing Gram Negative Isolates in Neonates | Chapter 3 | Innovations in Microbiology and Biotechnology Vol. 2

 The emergence of clinical isolates capable of manufacturing extended spectrum beta lactamase (ESBL) has posed treatment problems. As a result, ESBLs are becoming a growing clinical problem around the world because they transmit resistance to broad range -lactam antibiotics. Because neonates are more susceptible to infections, infections are a serious issue in Neonatal Intensive Care Units (NICUs). When newborns are treated with cephalosporins, it causes therapeutic failure and neonatal mortality; thus, its detection and awareness of the current prevalence scenario are critical for infection control. The current investigation looked into the prevalence of ESBL producers among the infected neonates who were included in the study.

Materials and Procedures: During a 25-month investigation, 1611 suspected instances of newborn infections were included (December 2010 to January 2013). 211 of the 342 positive cases were determined to be gramme negative by rigorous microbiological standards and tested for the generation of ESBLs. The double disc diffusion test was used to suspect ESBL production, and the double disc synergy test (DDST) and the phenotypic confirmatory disc diffusion test were utilised to confirm it (PCDDT).

The results showed that 39.34% of the 212 isolates tested positive for ESBLs. DDST affirmed 29.39 percent, while PCDDT confirmed 27.97 percent. The most common ESBL producers discovered were Escherichia coli and K. pneumoniae. Finally, because of the high incidence of ESBL producers in N.I.C.Us, it is critical to detect ESBL production on a regular basis with sensitivity reports that can help neonatologists meet the therapeutic challenge.

Author(S) Details

Manisha N. Shah
Department of Microbiology, Shree Ramakrishna Institute of Computer Education and Applied Sciences, Sarvajanik University, Surat, Gujarat, India.

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