Metallo�β�lactamase�mediated resistance among clinical carbapenem�resistant Pseudomonas aeruginosa isolates in northern Iran: A potential threat to clinical therapeutics

Dogonchi, A.A. and Ghaemi, E.A. and Ardebili, A. and Yazdansetad, S. and Pournajaf, A. (2018) Metallo�β�lactamase�mediated resistance among clinical carbapenem�resistant Pseudomonas aeruginosa isolates in northern Iran: A potential threat to clinical therapeutics. Tzu Chi Medical Journal, 30 (2). pp. 90-96.

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Metallo‑β‑lactamase‑mediated resistance among clinical carbapenem‑resistant Pseudomonas aeruginosa isolates in northern Iran A potential threat to clinical therapeutics.pdf

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Abstract

Objective: Carbapenems are effective agents to treat multidrug�resistant (MDR) strains of bacteria, including Pseudomonas aeruginosa. However, there is a potential threat of emergence of carbapenem�resistant P. aeruginosa (CRPA). The aim of this study was to determine antibiotic susceptibility patterns and metallo�beta�lactamase (MBL)�mediated resistance in clinical P. aeruginosa isolates. Materials and Methods: Different clinical specimens were subjected to conventional culture�based identification of P. aeruginosa. Antimicrobial susceptibility patterns and MBL production were evaluated using the Kirby�Bauer and combined double�disk synergy test methods, respectively. Multiplex polymerase chain reaction was performed to investigate the presence of the blaIMP, blaVIM, blaNDM, blaSPM, and blaSIM genes. Results: A total of 71 clinical P. aeruginosa isolates were recovered, of which 28.17 were identified as CRPA. The most active antibiotics were colistin and polymyxin B (92.96 susceptibility to each). A total of 35 and 50 of CRPA isolates were MDR and extensively drug�resistant (XDR), respectively. MBL activity was shown in 20 of CRPA. A total of 90, 40, and 5 of CRPA isolates harbored the blaIMP, blaVIM, and blaNDM genes, respectively. No correlation was found between the MBL�encoding genes of P. aeruginosa and patient characteristics. Conclusion: Although the prevalence of CRPA in our therapeutic centers was relatively low, this rate of carbapenem resistance reflects a threat limiting treatment choices. A high prevalence of MDR/XDR phenotypes among the MBL�producer isolates suggests the need for continuous assessment of antimicrobial susceptibility and surveillance of antibiotic prescription. In addition, infection control measures are needed to prevent further dissemination of these organisms. © 2018 Tzu Chi Medical Journal | Published by Wolters Kluwer - Medknow.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: amikacin; ceftazidime; ciprofloxacin; colistin; gentamicin; imipenem; levofloxacin; meropenem; metallo beta lactamase; piperacillin plus tazobactam; polymyxin B; tobramycin, adolescent; adult; age distribution; aged; antibiotic resistance; Article; bacterium isolate; blood; carbapenem resistant Pseudomonas aeruginosa; child; comparative study; controlled study; ear; female; hospital patient; human; Iran; major clinical study; male; multiplex polymerase chain reaction; nonhuman; preschool child; prevalence; Pseudomonas aeruginosa; respiratory system; school child; urine; very elderly; wound; young adult
Subjects: QV Pharmacology
Depositing User: eprints admin
Date Deposited: 04 Dec 2018 13:51
Last Modified: 11 Aug 2019 09:21
URI: http://eprints.iums.ac.ir/id/eprint/7148

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