Isolation and Antimicrobial Susceptibility Paradigm of Carbapenem Resistant Metallo-Beta-Lactamase Producing Gram Negative Rods
Isolation and Antimicrobial Susceptibility Paradigm of Carbapenem Resistant Metallo-Beta-Lactamase Producing Gram Negative Rods
Muhammad Hidayat Rasool1,*, Muhammad Zaheer1, Muhammad Farooque Hassan2, Muhammad Shafique1 and Muhammad Usman Qamar1
ABSTRACT
Rapid spread of acquired Metallo-beta-lactamases (MBLs) among major Gram negative pathogens is an emerging threat and a matter of great concern worldwide. Especially increasing resistance to 3rd and 4th generation cephalosporin and carbapenems is an issue of high importance. Present study was aimed to determine the frequency and antimicrobial susceptibility patterns of MBL producing carbapenem-resistant Gram-negative rods (GNRs) isolated from clinical specimens. A clinical descriptive study was conducted in Faisalabad, Pakistan from June 2016 to January 2017. A total of 152 clinical samples were processed according to standard microbiological methods. Isolated GNRs were subjected to susceptibility testing against various antibiotics as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Carbapenem-resistant isolates were subjected to detection of Metallo-beta-lactamase production by Double Disc Diffusion test (DDDT) and Modified Hodge’s test. In 152 specimens, different species identified in order of their frequency were; Klebsiella pneumoniae (59; 38.8%), Pseudomonas aeruginosa (46; 30.3%), Escherichia coli (36; 23.7%), Klebsiella oxytoca (4; 2.6%), Serratia marcescens (3; 2%), Enterobacter agglomerans (2; 1.3%) and Enterobacter cloacae (2; 1.3%). Out of 103 carbapenem-resistant isolates, 58 (55.1%) were positive by DDDT and 49 (46.7%) by MHT. Most of the carbapenems MBL resistant isolates were resistant towards drugs such as cephalosporin, ceftazidime but majority of them were sensitive to polymyxins, tazocin and fusidic acid. Proper screening of MBLs producing GNRs should be done from clinical specimens along with antimicrobial susceptibility testing for developing an effective treatment strategy and thus better control of infections caused by these bugs in future.
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June 2019
Vol. 51, Iss. 3, Pages 801-1202
