Authors

1 Associate Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc Student, Department of Biology, School of Postgraduates, Islamic Azad University, Boroujerd Branch, Boroujerd, Iran

3 Assistant Professor, Department of Biology, School of Postgraduates, Isalamic Azad University, Boroujerd Branch, Boroujerd, Iran

Abstract

Background & Aims: One of the main causes of nosocomial infection is pseudomonas aeruginosa and carbapenems is one of the most important classes of antibiotics used in the treatment of infections caused by this bacteria. Metallo-beta-lactamase (MBL) production is one of the most important mechanisms of resistance to carbapenems and their increased prevalence is a serious threat to treatment of infections caused by Pseudomonas aeruginosa. The goal of this study was the determination of MBL enzyme prevalence among clinical isolates of imipenem-resistant Pseudomonas aeruginosa. Methods: Antibiogram pattern of Pseudomonas aeruginosa isolates from different clinical infections of patients referred to Emam Reza and Emam Khomini Hospitals of Kermansha, Iran, was determined through disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Isolates that were resistant to more than 3 different antibiotics were identified as multi-drug-resistant organisms (MDROs). Then, MBL enzymes production rate was determined among imipenem-resistant isolates using Epsilometer test (Etest). Results: From among the 186 isolated strains from the two hospitals in Kermanshah, 165 (88.7%) isolates were MDROs, of which 67 (40.6%) isolates were imipenem-resistant. Through Etest, 33 )49.2%) strains were identified as MBL producing strains. Conclusion: Due to the increased prevalence of MDROs and MBL-producing Pseudomonas aeruginosa in hospitals, the use of phenotypic methods to detect MBL-producing isolates in hospital labs seems necessary.

Keywords

  1. Polotto M, Casella T, de Lucca Oliveira MG, Rúbio FG, Nogueira ML, de Almeida MTG, et al. Detection of P. aeruginosa harboring bla CTX-M-2, bla GES-1 and bla GES-5, bla IMP-1 and bla SPM-1 causing infections in Brazilian tertiary-care hospital. BMC Infectious Diseases 2012; 12: 176.
  2. Fallah F, Shams Borhan R, Hashemi A. Detection of bla(IMP) and bla(VIM) metallo-β-lactamases genes among Pseudomonas aeruginosa strains. Int J Burns Trauma 2013; 3(2): 122-4.
  3. Kumar SH, De AS, Baveja SM, Gore MA. Prevalence and risk factors of Metallo beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter species in burns and surgical wards in a tertiary care hospital. J Lab Physicians 2012; 4(1): 39-42.
  4. Khosravi Y, Loke MF, Chua EG, Tay ST, Vadivelu J. Phenotypic detection of metallo-beta-lactamase in imipenem-resistant Pseudomonas aeruginosa. Scientific World Journal 2012; 2012: 654939.
  5. Wan Nor Amilah WA, Noor Izani NJ, Ng WK, Ashraful HJ. A simple screening test for the detection of metallo-beta-lactamase-producing Pseudomonas aeruginosa and Acinetobacter in a tertiary care hospital. Trop Biomed 2012; 29(4): 588-97.
  6. Irina Mereuta A, Corina Badescu A, Simona Dorneanu O, Smaranda Iancu L, Gabriela Tuchilus C. Spread of VIM-2 metallo-beta-lactamase in Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates from Iaşi, Romania. Romanian Review of Laboratory Medicine 2013; 21(4): 423-30.
  7. Sarhangi M, Motamedifar M, Sarvari J. Dissemination of Pseudomonas aeruginosa producing blaIMP1, blaVIM2, blaSIM1, blaSPM1 in Shiraz, Iran. Jundishapur J Microbiol 2013; 6(7): e6920.
  8. Khosravi AD, Mihani F. Detection of metallo-beta-lactamase-producing Pseudomonas aeruginosa strains isolated from burn patients in Ahwaz, Iran. Diagn Microbiol Infect Dis 2008; 60(1): 125-8.
  9. Rezaei Yazdi H, Behzadian Nejad G, Najar Peerayeh S, Mostafaei M. Prevalence and detection of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa strains from clinical isolates in Iran. Annals of Microbiology 2007; 57(2): 293-5.
  10. Mirsalehian A, Akbari Nakhjavani F, Bahador A, Jabalameli F, Bigverdi R, Goli H. prevalence of MBL-producing Pseudomonas aeruginosa isolated from burn patients. Tehran Univ Med J 2011; 68(10): 563-9. [In Persian].
  11. Shahcheraghi F, Nikbin V. Metallo- -Lactamase and resistance rate of P.aeruginosa isolates to ceftazidim and imipenem. Iran J Inf and Trop Dis 2007; 36: 19-22.
  12. Saderi H, Lotfalipour H, Owlia P, Salimi H. Detection of metallo-β-lactamase producing pseudomonas aeruginosa isolated from burn patients in Tehran, Iran. Lab Medicine 2010; 41: 609-12.
  13. Kalantar E, Torabi V, Salimizand H, Soheili F, Beiranvand S, Soltan Dallal MM. First survey of metallo-β-lactamase producers in clinical isolates of pseudomonas aeruginosa from a referral burn center in Kurdistan province. Jundishapur J Nat Pharm Prod 2012; 7(1): 23-6.
  14. Fazeli H, Fatahi Bafghi M., Faghri M, Akbari R. Molecular Study of PER and VEB Genes is Multidrug Resistant Pseudomonas aeroginosa Isolated from Clinical Specimens in Isfahan/Iran and their Antibiotic Resistance Patterns. J Kerman Univ Med Sci 2012; 19(4): 345-53. [In Persian].
  15. Salimi H, Owlia P, Yakhchali B, Rastegar Lari A. Drug Susceptibility and Molecular Epidemiology of Pseudomonas aeruginosa Isolated in a Burn Unit. American Journal of Infectious Diseases 2009; 5(4): 301-6.
  16. Tavajjohi Z, Moniri R, Khoeshidi A. Frequency of extended-spectrum beta-lactamase (ESBL) multidrug-resistance produced by Pseudomonas aeruginosa isolated from clinical and environmental specimens in Kashan Shahid Beheshti hospital during 2010-11. Feyz 2011; 15(2): 139-45. [In Persian].
  17. Amudhan MS, Sekar U, Kamalanathan A, Balaraman S. bla(IMP) and bla(VIM) mediated carbapenem resistance in Pseudomonas and Acinetobacter species in India. J Infect Dev Ctries 2012; 6(11): 757-62.
  18. Lagatolla C, Edalucci E, Dolzani L, Riccio ML, De LF, Medessi E, et al. Molecular evolution of metallo-beta-lactamase-producing Pseudomonas aeruginosa in a nosocomial setting of high-level endemicity. J Clin Microbiol 2006; 44(7): 2348-53.
  19. Varaiya A, Kulkarni M, Bhalekar P, Dogra J. Incidence of metallo-beta-lactamase-producing Pseudomonas aeruginosa in diabetes and cancer patients. Indian J Pathol Microbiol 2008; 51(2): 200-3.
  20. Sadeghi A, Rahimi B, Shojapour M. Molecular detection of metallo-?-lactamase genes blaVIM-1, blaVIM-2, blaIMP-1, blaIMP-2 and blaSPM-1 in Pseudomonas aeruginosa isolated from hospitalized patients in Markazi province by Duplex-PCR. African Journal of Microbiology Research 2012; 6(12): 2965-9.
  21. Cornaglia G, Mazzariol A, Lauretti L, Rossolini GM, Fontana R. Hospital outbreak of carbapenem-resistant Pseudomonas aeruginosa producing VIM-1, a novel transferable metallo-beta-lactamase. Clin Infect Dis 2000; 31(5): 1119-25.
  22. ElMasry SAS, Ammar RA, Saber SM. Phenotypic and molecular characterization of imipenem resistant pseudomonas isolates. Life Sci J 2012; 9(2): 377-83.
  23. Chakraborty D, Basu S, Das S. A study on infections caused by metallo beta lactamase producing gram negative bacteria in intensive care unit patients. Am J Infect Dis 2010; 6(2): 34-9.