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NJBMS - Volume 3, Issue 4, April - June 2013

Pages: 278-280

DETECTION OF METALLO BETALACTAMASE PRODUCING ENTEROBACTERIACEAE ISOLATES FROM CRITICAL CARE PATIENTS

Author: C.ANURADHA, R.INDRA PRIYADHARSINI, S. MATHAVI, K.S. SEETHA

Category: Microbiology

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Abstract:

Background : The production of Metallo beta lactamases(MBL) is one of the important mechanisms of bacterial drug resistance.The genes responsible for MBL production are horizontally transferable via plasmids or are chromosomally mediated facilitating rapid spread to other bacteria.This rapid spread of MBL genes is a matter of concern with regard to the antimicrobial chemotherapy. Aims and objectives : This study aims to provide early,rapid and effective phenotypic characterization of carbapenem resistant isolates from the family enterobacteriaceae for initiation of effective treatment especially in critically ill patients.

Materials and methods : A total of 98 enterobacteriaceae isolates obtained from ICU samples from october 2010 to September 2011 were included in the study.All the samples were screened for imipenem resistance by Kirby-Bauer disc diffusion method. 49 isolates that were resistant to imipenem were screened for MBL by the combined disc(IMP-EDTA) and the double disc synergy(DDST) tests.The Minimum Inhibitory Concentration(MIC) was determined using Estrips(Biomeriuex)

Results : Of the 49 imipenem resistant samples,12(24.48%) were positive for MBL production by both combined and double disc methods;37(75.51%) showed positivity by combined disc only and 16(32.65%)isolates by double disc method only.The positive samples showed a minimum inhibitory concentration ratio of >8 (imipenem/imipenem+EDTA).

Conclusion : The frequent use of carbapenems has lead to an increase in carbapenem-resistant strains due to selective pressure. It has to be made as a practice guideline to detect and control these resistant strains on a day to day basis in clinical microbiology as spread of MDR strains is by mobile genetic elements.To date there are no standard CLSI guidelines for MBL screening/detection.Most studies suggest more than one phenotypic method. In our study combined disc test is better than the disc synergy test for the early detection of metallobetalactamase producing enterobacteriaceae strains, thereby assisting in proper therapeutic interventions.

Keywords: Enterobacteriaceae, metallobetalactamases, combined disc, double disc synergy tests.

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Editor in Chief of NJBMS Dr.Deepti Shastri, Professor and Head, Department of Anatomy, Academic Co-ordinator for Pre and Paraclinical Sciences, VMKV Medical College & Hospital, Salem.


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