Prevalence of Metallo-β-Lactamase IMP and VIM Producing Gram Negative Bacteria in Different Hospitals of Lahore, Pakistan
Prevalence of Metallo-β-Lactamase IMP and VIM Producing Gram Negative Bacteria in Different Hospitals of Lahore, Pakistan
Junaid Akhtar1,2, Sidrah Saleem1, Naveed Shahzad3, Abdul Waheed1, Iqra Jameel1, Farhan Rasheed4 and Shah Jahan5,*
ABSTRACT
Gram negative rod (GNR) infections cause a substantial amount of morbidity and mortality among hospitalized patients across the globe. Currently, β-lactam ring containing antibiotics predominantly carbapenems, are considered as last treatment option against multi-drug resistance GNR infections. However, the emergence of carbapenemases particularly metallo β-lactamases (MBLs) in bacteria have severely mitigated the efficiency of carbapenems. MBLs producing gram-negative bacteria have been reported from various hospital settings, worldwide. However, data is lacking in Pakistan regarding their frequency particularly among GNRs. Therefore, the present study aimed at determining the frequency of carbapenemase and β-lactamase producing GNRs recovered from different tertiary care hospitals of Lahore during January-December 2015. Additionally, existence of blaIMP and blaVIM carbapenems resistance determinant genes in carbapenems resistant isolates was also evaluated. The carbapenemase and β-lactamases production were evaluated by Modified Hodge test (MHT) and combined disks diffusion (CDD) method, respectively. The MBL producing clinical isolates were further subjected to PCR for the existence of blaIMP and blaVIM genes. The carbapenem resistant A. baumannii (n=32), P.aeruginosa (n=26), K. pneumoniae (n=19), E. coli (n=16), C. ferundi (n=04), P. vulgaris (n=02) and E. cloacae (n=01), were isolated from clinical samples of hospitalized patients. Out of these 100 carbapenem resistant isolates, 93 and 89 isolates were positive for cabapenemase and β-lactamase production, respectively. Notably, 3 (3.3%) of MBL producing strains harbor blaIMP gene while 29 (32.5%) of MBL producing clinical strains were positive for blaVIM gene. In a nutshell, several species of MBL-positive gram-negative rods are distributed broadly in different hospitals of Lahore region of Pakistan. The findings of the present study should be considered for planning strategies to treat and prevent the further spread of MBL-producing gram-negative rods infections.
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December 2018
Vol. 50, Iss. 6, Pages 1999-2398
