Prevalence and Antibiotic Resistance Pattern of Metallo-β-Lactamase-Producing Pseudomonas aeruginosa From Burn Patients—Experience of an Indian Tertiary Care Hospital

Abstract

The objective of the study is to determine the prevalence of Pseudomonas aeruginosa from burn patients, antibiotic resistance pattern and occurrence of acquired MBL-producing P. aeruginosa among isolates collected from burn patients. In this study, two phenotypic methods were used for the detection of MBL-producing P. aeruginosa: zone enhancement with EDTA-impregnated imipenem and ceftazidime discs, and modified Hodge test. One hundred fifty-four isolates of P. aeruginosa were obtained from July 2007 to July 2008. Infection was increased up to 95% in hospitalized patients for >50 days. Highest infection of 39% was found in patients, who had 41 to 50% of burn area followed by 19% in patients with 31 to 40% of burn area. The most common bacteria isolated were P. aeruginosa (55.0%), followed by Staphylococcus aureus (19.29%) and Klebsiella spp. (11.43%). Sixteen percent isolates of P. aeruginosa were positive for metallo-beta-lactamase production by both methods. Antibiotic resistance pattern of MBL-positive strains showed the highest resistance to ceftazidime (70%) followed by chloramphenicol (68%) and gentamicin (62.5%). Routine detection of MBLs ensuring optimal patient care and careful in vitro testing before antibiotic use may help in the prevention and treatment of burn patients infected with metallo-beta- lactamase-producing P. aeruginosa.

Pseudomonas aeruginosa infection in burn patients in Sulaimaniyah, Iraq: risk factors and antibiotic resistance rates

“…This is similar to the 28% reported by a previous study from the same city [8]. A higher prevalence has been reported by studies elsewhere, such as 57% in Iran [10], 55% in India [11] and 51% in Palestine [12]. This may be due the type inclusion criteria for the microorganisms accounted for and cultured.…”

Could chloramphenicol be used against ESKAPE pathogens? A review ofin vitrodata in the literature from the 21st century

“…As shown in TABLE 5, 16 studies that investigated the activity of chloramphenicol against P. aeruginosa met our research criteria, with a mean susceptibility rate of 13% [101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116]. Eighty-seven percent of the studies were performed in developed countries.…”

“…Agar dilution 23% meropenem-R 14 [108] 2008 UK 52 BSAC-DD -0 [109] 2009 India 20 KB -0 [110] 2009 Malaysia 48 KB 69% MDR (R ‡2 ATB) 40 [111] 2009 Australia 14 --0 [112] 2009 Brazil 10 KB -30 [113] 2010 India 25 -100% MBL 32 [114] 2011 Nigeria 15 KB -20 [115] 2012 China 14 --0 Antagonism [122] Inhibition of early (6 h) and late (20 h) bactericidal activity of ampicillin by chloramphenicol Ampicillin -21 enteric organisms, including Salmonella spp. and other Gram-negative bacilli…”

DETECTION OF ANTIBIOTIC RESISTANCE IN Pseudomonas aeruginosa ISOLATES WITH SPECIAL REFERENCE TO METALLO Β-LACTAMASES FROM A TERTIARY CARE HOSPITAL IN WESTERN INDIA

“…Varsha Gupta, et al reported MBL production (84%), Bhale Rao, et al (67%) and 72% by Fereshteh shaheheraghi, et al [31,27,32]. 16% of the Imipenem resistant isolates were positive for MBL production in Rajput Anuradha, et al study [33]. MBL production was seen in 50% of Ps.…”