Volume 8, Issue 3 (7-2022)                   RABMS 2022, 8(3): 110-117 | Back to browse issues page


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Rouf M, Nazir A, Karnain O, Akhter S. Comparison of Various Phenotypic Methods in Detection of Carbapenemases and Metallo-Beta-Lactamases (MBL) in Carbapenem Resistant Clinlical Isolates of Acinetobacter Species at A Tertiary Care Centre. RABMS 2022; 8 (3) :110-117
URL: http://ijrabms.umsu.ac.ir/article-1-191-en.html
Senior Resident, Department of Microbiology, Government Medical college, Srinagar , drmariyaovais@gmail.com
Abstract:   (505 Views)
Background & Aims:  carbapenem-resistant strains of Acinetobacter baumannii (A. baumannii) have been reported worldwide over the last decade. Detection of the carbapenemases is crucial to determine the severity of the problem. The aim of our study was to detect Carbapenemase and MBL producing strains among Multidrug Resistant (MDR) Acinetobacter species isolated from clinical specimens in this geographical area by Modified Hodge test (MHT) and Imipenem-EDTA double disc synergy test and their evaluation.
Materials & Methods:  In this descriptive-prospective study, consecutive, non-duplicate, and resistant-to-carbapenems clinical strains of Acinetobacter species isolated from various clinical samples were included. Antimicrobial sensitivity of Acinetobacter isolates was performed on Mueller Hinton agar plates by Kirby-Bauer disk diffusion method. Carbapenemase production was confirmed by MHT. Confirmation of MBL production was done by subjecting all isolates with positive screen test to combined disc test using imipenem, meropenem, and EDTA. Data analysis was done using Epi Info 7.0. Categorical variables were summarized as frequency and percentage and continuous variables as Mean and SD.
Results:  A total of 312 non-duplicate strains of A. baumannii were isolated, out of which 224 (71.79%) strains were resistant and 88 (28.21%) were sensitive to carbapenem. There was 100% sensitivity to Colistin followed by Tigecycline (79%) whereas high degree of resistance was seen against 2nd and 3rd generation cephalosporins and quinolones (>90%). 82.6% were identified as carbapenemase producers on MHT and on Imipenem-EDTA combined disc test (CDT), 21.4% were found to be positive.
Conclusion:  Our study showed that tests like MHT are equally efficient to detect carbapenemase production, followed by Imipenem-EDTA combined disc test. These tests are cost-effective and easy to perform and may be used routinely to assess whether carbapenemase producers are present or not.
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Type of Study: orginal article | Subject: Special

References
1. Kempf M, Rolain JM. Emergence of resistance to carbapenems in Acinetobacter baumannii in Europe: clinical impact and therapeutic options. Int J Antimicrob Agents 2012;39(2):105-14. [DOI:10.1016/j.ijantimicag.2011.10.004] [PMID]
2. Sanjeev H, Swathi N, Asha P, Rekha R, Vimal K, Ganesh HR. Systematic review of Urinary tract infection caused by Acinetobacter species among hospitalised patients. J health Allied Sci 2013;3(04):007-9. [DOI:10.1055/s-0040-1703693]
3. Gaur A, Garg A, Prakash P, Anupurba S, Mohapatra TM. Observations on carbapenem resistance by minimum inhibitory concentration in nosocomial isolates of Acinetobacter species: An experience at a tertiary care hospital in north India. J Health Popul Nutr 2008;26(2):183-8. [PMID] [PMCID]
4. Prashanth K, Badrinath S. Nosocomial infections due to Acinetobacter species: Clinical findings, risk and prognostic factors. 2006;24(1):39-44. [DOI:10.1016/S0255-0857(21)02469-5] [PMID]
5. RU, Rao RS, Sahoo S, Shashikala P, Kanungo R, Jayachandran S, Prashanth K. Phenotypic and genotypic assays for detecting the prevalence of metallo-β-lactamases in clinical isolates of Acinetobacter baumannii from a South Indian tertiary care hospital. J Med Microbiol 2009;58(4):430-5. [DOI:10.1099/jmm.0.002105-0] [PMID]
6. Poirel L, Mansour W, Bouallegue O, Nordmann P. Carbapenem-resistant Acinetobacter baumannii isolates from Tunisia producing the OXA-58-like carbapenem-hydrolyzing oxacillinase OXA-97. Antimicrob Agents Chemother 2008;52(5):1613-7 [DOI:10.1128/AAC.00978-07] [PMID] [PMCID]
7. Clinical & Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. 19th ed; 2009. CLSI supplement M100-S28. [URL]
8. Yong D, Lee K, Yum JH, Shin HB, Rossolini GM, Chong Y. Imipenem-EDTA disc method for differentiation of metallo-beta-lactamase-producing clinical isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol 2002;40:3798-801. [DOI:10.1128/JCM.40.10.3798-3801.2002] [PMID] [PMCID]
9. Clinical & Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. 19th ed; 2009. CLSI supplement M100-S28. [URL]
10. Padmalakshmi Y, Shanthi M, Sekar U, Arunagiri K. Phenotypic and Molecular Characterisation of Carbapenemases in Acinetobacter Species in a Tertiary Care Centre in Tamil Nadu, India. Nat J Lab Med 2015;4(3):55-60. [URL]
11. Kumar SH, De Anuradha S, Baveja SM, Gore MA. Prevalence and risk factors of metallo β-lactamase producing Pseudomonas aeruginosa and Acinetobacter species in burns and surgical wards in a tertiary care hospital. J Lab Physician 2012;4(1):039-42. [DOI:10.4103/0974-2727.98670] [PMID] [PMCID]
12. Noori M, Karimi A, Fallah F, Hashemi A, Alimehr S, Goudarzi H, Aghamohammad S. High Prevalence of Metallo-beta-lactamase Producing Acinetobacter. Arch Pediatr 2014 ;2(3):e15439. [DOI:10.5812/pedinfect.15439]
13. Sung JY, Kwon KC, Park JW, Kim YS, Kim JM, Shin KS, et al. Dissemination of IMP-1 and OXA Type beta-Lactamase in Carbapenem resistant Acinetobacter baumannii. Korean J Lab Med 2008;28:16-23. [DOI:10.3343/kjlm.2008.28.1.16] [PMID]
14. Carvalho RM, Marques SG, Gonçalves LH, Abreu AG, Monteiro SG, Gonçalves AG. Phenotypic detection of metallo-β-lactamases in Pseudomonas aeruginosa and Acinetobacter baumannii isolated from hospitalized patients in São Luis, State of Maranhão, Brazil. Rev Soc Bras Med Trop 2013;46:506-9. [DOI:10.1590/0037-8682-1451-2013] [PMID]
15. García-Garmendia JL, Ortiz-Leyba C, Garnacho-Montero J, Jiménez-Jiménez FJ, Pérez-Paredes C, Barrero-Almodóvar AE, Miner MG. Risk factors for Acinetobacter baumannii nosocomial bacteremia in critically ill patients: a cohort study. Clin Infec Dis 2001 1;33(7):939-46. [DOI:10.1086/322584] [PMID]
16. Mindoli Pb, Salmani Mp, Vishwanath G, hanumanthapa Ar, identification and speciation of Acinetobacter and their antimicrobial susceptibility testing. Al Amen J Med Sci 2010;3:3459. [Google Scholar]
17. Gupta N, Gandham N, Jadhav S, Mishra RN. Isolation and identification of Acinetobacter species with special reference to antibiotic resistance. Journal of natural science, biology, and medicine. 2015 Jan;6(1):159-62. [DOI:10.4103/0976-9668.149116] [PMID] [PMCID]
18. Lone R, Shah A, Kadri SM, Lone S, Faisal S. Nosocomial multi-drug-resistant Acinetobacter infections - clinical findings, risk factors and demographic characteristics. Bangladesh J Med Microbiol 2009;3(1):34-8. [DOI:10.3329/bjmm.v3i1.2969]
19. Ahmed NH, Baba K, Clay C, Lekalakala R, Hoosen AA. In vitro activity of tigecycline against clinical isolates of carbapenem resistant Acinetobacter baumannii complex in Pretoria, South Africa. BMC Res Notes 2012;5(1):1-4. [DOI:10.1186/1756-0500-5-215] [PMID] [PMCID]
20. Ibrahim NH, Somily AM, Bassyouni RH, El-Aabedien AZ. Comparative study assessing the effect of tigecycline and moxifloxacin in prevention of Acinetobacter baumannii biofilm. Life Sci J 2012;9(3):1016-24 . [Google Scholar]
21. Fouad M, Attia AS, Tawakkol WM, Hashem AM. Emergence of carbapenem-resistant Acinetobacter baumannii harboring the OXA-23 carbapenemase in intensive care units of Egyptian hospitals. Int J Infect Dis 2013 1;17(12):e1252-4. [DOI:10.1016/j.ijid.2013.07.012] [PMID]
22. AL-Harmoosh A, Jarallah EM. First detection of the blaoxa-23 genes in a clinical isolates of acinetobacter baumannii in Hillah hospitals-IRAQ. J Pharm Biol Sci 2015;10:77-83. [URL]
23. Aziz RAR, Al-Jubori SS. Molecular analysis of genetic elements responsible for xdr in highly successful pathogen acinetobacter baumannii isolated from clinical samples of Iraqi patients. J Global Pharm Technol 2017;9:26-39. [Google Scholar]
24. Lee SO, Kim NJ, Choi SH, Kim TH, Chung JW, Woo JH et al. Risk factors for the acquisition of imipenem resistant Acinetobacter baumannii: a case-control study. Antimicrob Agents Chemother 2004;48:224-8. https://doi.org/10.1128/AAC.48.3.1070.2004 [DOI:10.1128/AAC.48.1.224-228.2004] [PMID]
25. Queenan A, Bush K. Carbapenemases: the versatile β-lactamases. Clin Microbiol Rev 2007;20:440-58. [DOI:10.1128/CMR.00001-07] [PMID] [PMCID]

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