ESBL, MBL AND AMP C-Î² LACTAMASES PRODUCED BY SUPERBUGS: AN EMERGING THREAT TO CLINICAL THERAPEUTICS
Objectives: The present study was undertaken to determine the prevalence of multi drug resistant (MDR) and multiple Î²-lactamase producing Pseudomonas aeruginosa isolates in lower respiratory tract infection (LRTI) patients at a tertiary care hospital in India.
Methods: A total of 80 consecutive, non-duplicate isolates of P. aeruginosa were studied for the presence of class A or B Î²-lactamase. Antibiotic susceptibility tests and PCR amplification of genes encoding class A (PER-1 and CTX-M 1, 2, 9) and class B Î²-lactamases (blaVIM-2, blaIMP-1 and blaSIM-1) were performed.
Results: Out of 80 P. aeruginosa isolates, 65% (52/80) of the isolates were MDR with 34 being Metallo-Î²-lactamase (MBL) producers, 23 were extended spectrum Î²-lactamase (ESBL) producers and 21 were positive for AmpC production. The cross-class resistance rates to other antibiotics was significantly higher in class A and B Î²-lactamase producers than in non-producers (P<0.05 for fluoroquinolone, aztreonam, ceftazidime and meropenem). Combined disk test (CDT) for MBL highest sensitivity and specificity compared to PCR. Combined disk method (CDM) for ESBL co-related well with PCR (sensitivity and specificity).
Conclusion: This study reports the validation of a simple and accurate MBL and ESBL detection method which can be easily integrated into the daily routine of a clinical laboratory.
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