Prevalence of extended-spectrum beta-lactamases, AmpC beta-lactamase, and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii in an intensive care unit in a tertiary care hospital

Goel, Varun; Hogade, Sumati A; Karadesai, SG

doi:10.4103/0974-5009.109691

Cited by 40 publications

(36 citation statements)

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“…42.30% ESBL producer were observed in the study of VarunGoel et al, [14]. Lower ESBL producer were seen in the studies by Prashant et al, [15] and Agarwal et al, [16] which were 22.22% & 20.27% respectively.…”

Section: Discussionmentioning

confidence: 82%

Resistance Pattern of Pseudomonas aeruginosa in a Tertiary Care Hospital of Kanchipuram, Tamilnadu, India

2014

JCDR

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Purpose:This study was undertaken to analyze the extended spectrum of β lactamase (ESBL), metallo β lactamase (MBL) & AmpC production in Pseudomonas aeruginosa in various clinical samples. Materials & Methods:One hundred four non repetitive clinical specimens were inoculated onto nutrient agar, blood agar and incubated at 37 o C overnight. The colonies were tested for oxidase test and other biochemical tests and antibiogram. ESBL screening was done using 3 rd generation cephalosporins and confirmatory combined double disc test, imipenem-EDTA double disc synergy test for MBL enzyme and AmpC test using Cefoxitin disc. Results & Analysis:Out of 104 P.aeruginosa isolates, 42.30% were ESBL producer, 15.38 % MBL producer and none were AmpC producer. Imipenem, Ofloxacin, and aminoglycosides (amikacin (29.8%) tobramycin (29.8%) and netilmycin (13.46%) has got the better antipseudomonal activity in this study. 43 (41.35%) P.aeruginosa was found to be Multi Drug Resistant (MDR). Conclusion:This study highlights the prevalence of ESBL, MBL and MDR P.aeruginosa. Carbapenems and aminoglycosides are promising drugs with antipseudomonal activity in our study.

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Section: Discussionmentioning

confidence: 82%

Resistance Pattern of Pseudomonas aeruginosa in a Tertiary Care Hospital of Kanchipuram, Tamilnadu, India

2014

JCDR

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“…Rajini et al reported coproduction of these enzymes in 2 (20%) out of 10 isolates of Acinetobacter species which were studied [15]. Nagano et al studied three Acinetobacter isolates for the production of β-lactamases and they reported coproduction of both ESBL and AmpC enzymes in all three (100%) isolates [24].One study showed coproduction of metallo-β-lactamases and AmpC β-lactamases in 54% of the Acinetobacter isolates which were studied [25].Another study reported ESBL production in 17.95% isolates and production of AmpC β-lactamases in 56.67% of Acinetobacter isolates which had been studied, but this study did not highlight the prevalence of Acinetobacter isolates which had shown coproduction of β-lactamases [26].The major lacunae in past studies which showed coproduction, was the lesser number of Acinetobacter strains which were studied. Hence, these could not be considered as statistically significant.…”

Section: Ampc Detectionmentioning

confidence: 84%

Co-production of ESBL and AmpC β-Lactamases in Clinical Isolates of A. baumannii and A. lwoffii in a Tertiary Care Hospital From Northern India

Singla

Sikka

Deeep

et al. 2014

JCDR

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Background: Acinetobacter baumannii is an important cause of health care associated infections which are difficult to control and treat, because of widespread antimicrobial resistance which is possessed by this organism. Aims:The aim of the present study was to know the prevalence of ESBLs and AmpC β-lactamases in clinical isolates of Acinetobacter spp. which were cultured from various clinical specimens by using different phenotypic methods. Settings and Design:Study was conducted over a period of one year at the Microbiology Department of a tertiary care teaching hospital. A total of 100 consecutive, non-duplicate strains of Acinetobacter species which were isolated from various clinical samples were included. Materials and Methods:All the isolates were identified by standard microbiological procedures and antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion technique. Isolates which showed reduced susceptibilities to third generation cephalosporins were tested for ESBL production by CLSI double disc synergy method and also by using sulbactam as an inhibitory agent. Isolates which showed reduced susceptibilities to cefoxitin were tested for AmpC detection by doing AmpC disc test.Statistical Analysis: SPSS, version 17 was used to calculate p-value. If the p-value was <0.05, it was considered to be significant. Results:Out of 100 isolates, 82 were Acinetobacter baumannii and 18 were Acinetobacter lwoffii. ESBL were mentioned in 4% of the Acinetobacter isolates and in 77% of the isolates by using clavulanic acid and sulbactam as inhibitory agents respectively. AmpC β-lactamase production was detected in 60% isolates of Acinetobacter spp. Co-production of both ESBL and AmpC enzymes were seen in 29% of the Acinetobacter strains. Conclusion:Failure in detecting β-lactamases contributes to their uncontrolled spread and therapeutic failures. Hence, these β-lactamases should be detected routinely and they should be reported to clinicians in time, so that inappropriate use of antibiotics can be stopped in time.Pooja Singla 1 , Rama SiKKa 2 , antaRiKSh DeeeP 3 , DeeP gagneja 4 , Uma ChaUDhaRy 5 InTRODuCTIOnMembers of the genus Acinetobacter, in particular, Acinetobacter baumannii, are being reported increasingly as the causative agents of numerous hospital outbreaks which occur in several countries. They are responsible for causing a number of nosocomial infections like septicaemia, pneumonia, wound sepsis, endocarditis, meningitis and urinary tract infections (UTIs), especially in intensive care settings [1]. The infections caused by these organisms are often extremely difficult for clinicians to treat, because of the widespread resistance of these bacteria to the major groups of antibiotics like aminoglycosides, fluoroquinolones, ureidopenicillins and third generation cephalosporins. Moreover, the ability of resistant strains of A. baumannii to survive for prolonged periods in the hospital environment, contributes significantly to antimicrobial resistance, thereby posing a difficult chall...

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“…The percentage of MBL production in Pseudomonas aeruginosa is similar to studies conducted by Manoharan et al (42.6%) and Saderi H et al (39.06%). [18,19] CONCLUSION This study has given us the knowledge about SSIs and their incidence in our hospital, it also emphasised on the fact that SSIs are more common in clean-contaminated than in clean surgeries. It also showed that there was increased rate of SSIs in patients who underwent emergency surgeries.…”

Section: Discussionmentioning

confidence: 89%

Methicillin-Resistant Staphylococcus Aureus, Extended Spectrum Betalactamase and Metallobetalactamase Production Among Organisms Causing Surgical Site Infections at a Tertiary Care Hospital in Bangalore

Jain¹,

Gopi²,

Samreen³

et al. 2017

jemds

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BACKGROUNDInfection at or near surgical incisions within 30 days of an operative procedure, or within 1 year of an operation if a foreign body is implanted as part of the surgery is defined as a surgical site infection (SSI). They are the 2 nd most common cause of nosocomial infections. It has been estimated that SSI develops in at least 2% of hospitalised patients undergoing operative procedures. The incidence of Methicillin-Resistant Staphylococcus aureus (MRSA), extended spectrum betalactamase (ESBL) and metallobetalactamase (MBL) producing organisms have been steadily increasing over the past few years resulting in limitation of therapeutic options. MATERIALS AND METHODSIt is a descriptive study conducted from December 2014 to June 2016 at a tertiary care hospital, Bangalore. Samples were collected aseptically from the wound using sterile cotton swabs. Isolates were identified by conventional methods and their antibiogram pattern was studied by Kirby Bauer's disc diffusion method. Staphylococcus aureus when isolated was studied for MRSA using oxacillin and cefoxitin disc diffusion test. Gram-negative isolates resistant to cephalosporins and carbapenems during antibiotic susceptibility testing were studied for ESBL production using ceftazidime and cefotaxime disc diffusion test and MBL production using imipenem-EDTA combined disc test respectively using standard CLSI guidelines. All the statistical analysis was done by chisquare test using SPSS software. RESULTSOf 100 clinically diagnosed cases, 68 samples yielded growth of various bacterial isolates. 47 out of 56 cases (83.9%) from emergency surgeries and 21 out of 44 cases (47.7%) from elective surgeries were infected. Staphylococcus aureus was the most common organism isolated (32.9%) followed by Klebsiella pneumoniae (26.3%). MRSA was observed in 24% of Staphylococcus aureus isolates. ESBL production was observed in 23% of all Gram-negative isolates and MBL production was observed in 57% of all nil-fermenting Gram-negative isolates. CONCLUSIONSSIs are menacing problem for healthcare providers. The rise of MRSA, ESBL and MBL producing organisms and continuous change in the resistance pattern has made SSI a therapeutic challenge. Management of SSI involves lot of skill and treatment should be judiciously based on risk stratification. KEYWORDS SSI, MRSA, ESBL and MBL.HOW TO CITE THIS ARTICLE: Jain S, Gopi A, Samreen F, et al. Methicillin-resistant Staphylococcus aureus, extended spectrum betalactamase and metallobetalactamase production among organisms causing surgical site infections at a tertiary care hospital in Bangalore.

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Prevalence of extended-spectrum beta-lactamases, AmpC beta-lactamase, and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii in an intensive care unit in a tertiary care hospital

Cited by 40 publications

References 1 publication

Resistance Pattern of Pseudomonas aeruginosa in a Tertiary Care Hospital of Kanchipuram, Tamilnadu, India

Resistance Pattern of Pseudomonas aeruginosa in a Tertiary Care Hospital of Kanchipuram, Tamilnadu, India

Co-production of ESBL and AmpC β-Lactamases in Clinical Isolates of A. baumannii and A. lwoffii in a Tertiary Care Hospital From Northern India

Methicillin-Resistant Staphylococcus Aureus, Extended Spectrum Betalactamase and Metallobetalactamase Production Among Organisms Causing Surgical Site Infections at a Tertiary Care Hospital in Bangalore

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