blaIMP and blaVIM mediated carbapenem resistance in Pseudomonas and Acinetobacter species in India
blaIMP and blaVIM mediated carbapenem resistance in Pseudomonas and Acinetobacter species in India
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DOI：
10.3855/jidc.2268
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发表时间：
2012-11-01
影响因子：
1.9
通讯作者：
Balaraman, Sekar
中科院分区：
文献类型：
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作者：
Amudhan, M. Shanthi;Sekar, Uma;Balaraman, Sekar
简介：由于治疗选择有限，产生bla（IMP）和bla（Vim）金属β-内酰胺酶（MBL）的革兰氏阴性菌引起医院感染的出现和快速传播在全世界引起关注。共179例非重复、连续、碳青霉烯类耐药铜绿假单胞菌（61例）、鲍曼不动杆菌（116例），从住院48小时或更长时间的患者中分离出的鲁氏不动杆菌（1例）和施氏假单胞菌（1例）被纳入研究。根据临床实验室标准协会指南测定和解释对亚胺培南和美罗培南的最低抑菌浓度（MIC）。采用改良霍奇试验（MHT）和乙二胺四乙酸（EDTA）抑制剂增强纸片扩散试验分别对碳青霉烯酶和MBL生产进行筛选。采用聚合酶链反应（PCR）检测MBL（bla（Vim）和bla（IMP））基因。结果：169株MHT阳性率为94.4%（n = 169）。EDTA MBL筛查阳性率为80.4%（n = 144）。92株（51.4%）检出MBL基因bla（Vim）和bla（IMP）。在89株分离株中检测到单独的Bla（Vim），而2株分离株仅检测到bla（IMP）。1株分离株同时具有bla（Vim）和bla（IMP）。在铜绿假单胞菌中，有36株携带MBL基因。以.鲍曼不动杆菌，54携带MBL基因。Bla（Vim）存在于斯氏毕赤酵母和A.结论：铜绿假单胞菌和铜绿假单胞菌对碳青霉烯类抗生素耐药。鲍曼不动杆菌主要由MBL产生介导。常见的MBL基因是bla（Vim）。
Introduction: The emergence and rapid spread of bla(IMP) and bla(VIM) metallo-beta-lactamase (MBL) producing Gram-negative bacteria causing nosocomial infections are of concern worldwide due to limited treatment options.Methodology: A total of 179 nonreplicate, consecutive, carbapenem resistant Pseudomonas aeruginosa (61), Acinetobacter baumannii (116), Acinetobacter lwoffii (1) and Pseudomonas stutzeri (1) isolated from patients hospitalized for 48 hours or more were included in the study. The minimum inhibitory concentrations (MIC) to imipenem and meropenem were determined and interpreted according to Clinical Laboratory Standards Institute guidelines. The Modified Hodge Test (MHT) and inhibitor potentiated disk diffusion tests with ethylenediaminetetraacetic acid (EDTA) were used for screening of carbapenamases and MBL production respectively. Polymerase chain reaction (PCR) was performed for the detection of MBL (bla(VIM) and bla(IMP)) genes. Gene sequencing was performed for representative isolates.Results: MHT was positive in 94.4% (n = 169). MBL screening with EDTA was positive in 80.4% (n = 144). MBL genes bla(VIM) and bla(IMP) were detected in 92 (51.4%) isolates. Bla (VIM) alone was detected in 89 isolates while two isolates had bla (IMP) alone. One isolate had both bla (VIM) and bla (IMP). Among the P. aeruginosa, 36 carried the MBL gene. In A. baumannii, 54 carried the MBL gene. Bla (VIM) was found in P. stutzeri and A. lwoffii isolates.Conclusion: Carbapenem resistance in P. aeruginosa and A. baumannii is chiefly mediated by MBL production. The common MBL gene is the bla(VIM).