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Study of metallo-β-lactamase production in clinical isolates of Pseudomonas aeruginosa  [cached]
Agrawal G,Lodhi R,Kamalakar U,Khadse R
Indian Journal of Medical Microbiology , 2008,
Abstract: A study of metallo-β-lactamase (MBL) production was done in clinical isolates of Pseudomonas aeruginosa . Isolates resistant to ceftazidime and imipenem were screened for MBL production by double disc synergy test (DDST) and minimum inhibitory concentration reduction test. There was complete correlation between two methods for imipenem. For ceftazidime, there was correlation between the two methods in all except four strains. In the screening test for MBL, ceftazidime - EDTA combination was better than imipenem - EDTA combination. 8.05% strains were MBL producers. Presence of MBL producer P. aeruginosa is a cause of concern. Simple DDST can be helpful for monitoring of these emerging resistant determinants.
Metallo-beta-lactamase producing Pseudomonas aeruginosa strains isolated in hospitals in Recife, PE, Brazil
Magalh?es, Vera;Lins, Ana Kelly;Magalh?es, Marcelo;
Brazilian Journal of Microbiology , 2005, DOI: 10.1590/S1517-83822005000200005
Abstract: out of 24 nosocomial strains of pseudomonas aeruginosa from recife, brazil, 15 (62%) were metallo-b-lactamase producers. such isolates were resistant to main antipseudomonas drugs, except polymixyn b and aztreonam. the enzyme responsible for the carbapenem-resistance belongs to spm-1 class, and the gene involved, blaspm-1, is likely plasmid located.
Metallo-β-lactamase and genetic diversity of Pseudomonas aeruginosa in intensive care units in Campo Grande, MS, Brazil
Rodrigues, Ana Claudia Souza;Chang, Marilene Rodrigues;Nóbrega, Gabriela Dorn;Rodrigues, Mayara Souza;Carvalho, Nadia Cristina Pereira;Gomes, Beatriz Garcia;Almeida, Dênio Lopes de;Carvalho, Karyne Rangel;Asensi, Marise Dutra;
Brazilian Journal of Infectious Diseases , 2011, DOI: 10.1590/S1413-86702011000300002
Abstract: infection by pseudomonas aeruginosa has spread worldwide, with limited options for treatment. the purpose of this study was to investigate metallo-β-lactamase-producing p. aeruginosa strains and compare their genetic profile using samples collected from patients in intensive care units. forty p. aeruginosa strains were isolated from two public hospitals in campo grande, mato grosso do sul state, from january 1st, 2007 to june 31st, 2008. profiles of antimicrobial susceptibility were determined using the agar diffusion method. metallo-β-lactamase was investigated using the double-disk diffusion test and pcr. molecular typing was performed by pulsed-field gel electrophoresis (pfge). respiratory and urinary tracts were the most common isolation sites. of the 40 samples tested, 72.5% (29/40) were resistant to ceftazidime and 92.5% (37/40) to imipenem, whereas 65% (26/40) were resistant to both antimicrobials. fifteen pan-resistant samples were found. five percent (2/40) of samples were positive for metallo-β-lactamase on the phenotype test. no metallo-β-lactamase subtype was detected by pcr. macrorestriction analysis revealed 14 distinct genetic patterns. based on the superior accuracy of pcr, it can be inferred that p. aeruginosa isolates from the investigated hospitals have alternative mechanisms of carbapenem resistance. the results also suggest clonal spread of p. aeruginosa between the studied hospitals.
Changing the epidemiology of carbapenem-resistant Pseudomonas aeruginosa in a Brazilian teaching hospital: the replacement of S?o Paulo metallo-β-lactamase-producing isolates
Cavalcanti, Felipe Lira de Sá;Almeida, Anna Carolina Soares;Vilela, Marinalda Anselmo;Morais, Marcia Maria Camargo de;Morais Junior, Marcos Antonio de;
Memórias do Instituto Oswaldo Cruz , 2012, DOI: 10.1590/S0074-02762012000300019
Abstract: in brazil, carbapenem-resistant pseudomonas aeruginosa isolates are closely related to the s?o paulo metallo-β-lactamase (spm) brazilian clone. in this study, imipenem-resistant isolates were divided in two sets, 2002/2003 and 2008/2009, analysed by pulsed field gel electrophoresis and tested for the ambler class b metallo-β-lactamase (mbl) genes blaspm-1, blaimp and blavim. the results show a prevalence of one clone related to the spm brazilian clone in 2002/2003. in 2008/2009, p. aeruginosa isolates were mostly mbl negative, genetically diverse and unrelated to those that had been detected earlier. these findings suggest that the resistance to carbapenems by these recent p. aeruginosa isolates was not due to the spread of mbl-positive spm-related clones, as often observed in brazilian hospitals.
First Survey of Metallo-β–Lactamase Producers in Clinical Isolates of Pseudomonas aeruginosa From a Referral Burn Center in Kurdistan Province  [cached]
Enayatollah Kalantar,Vahideh Torabi,Heiman Salimizand,Fariborz Soheili
Jundishapur Journal of Natural Pharmaceutical Products , 2012,
Abstract: Background: Treatment of infectious diseases is becoming more challenging with each passing year. This is especially true for infections caused by Pseudomonas aeruginosa, an opportunistic pathogen with the ability to rapidly develop resistance to multiple classes of antibiotics..Objectives: This study was conducted to determine the prevalence of metallo-β-lactamase (MBL)–producing strains among multidrug-resistant P. aeruginosa strains isolated from burn patients..Materials and Methods: The isolates were identified, tested for susceptibility to various antimicrobial agents, and screened for the presence of MβLs by using the double-disk synergy test. The minimal inhibitory concentration of imipenem was determined by microplate broth dilution method on Mueller-Hinton agar. To detect VIM, SIM, and GIM MBLs, the isolates were subjected to polymerase chain reaction..Results: In this study, we identified 100 P. aeruginosa isolates from 176 clinical specimens obtained from burn patients. The isolates showed maximum resistance to ampicillin (100%), ceftazidime (94%), and ceftriaxone (89%). The CLSI-MBL phenotypic test showed that of the 100 P. aeruginosa isolates, 22 (22%) were positive for MBL production in the double-disk synergy test. Of the 22 MBL-positive P. aeruginosa isolates, 8 were resistant to imipenem. PCR analysis showed that 8 isolates were positive for blaVIM1. The other genes blaSIM1 and blaGIM1 were not detected..Conclusions: The study results demonstrate the serious therapeutic threat of the spread of MBL producers among P. aeruginosa populations. Metallo-β-lactamases were detected in 22% of imipenem-resistant P. aeruginosa isolates. Early detection and infection-control practices are the best antimicrobial strategies for this organism; therefore, systematic surveillance to detect MBL producers is necessary.
Metallo-β-lactamase-producing clinical isolates of Acinetobacter species and Pseudomonas aeruginosa from intensive care unit patients of a tertiary care hospital  [cached]
Irfan S,Zafar A,Guhar D,Ahsan T
Indian Journal of Medical Microbiology , 2008,
Abstract: Prompt detection of metallo-β-lactamase (MBL) producing isolates is necessary to prevent their dissemination. Frequency of MBLs producing strains among multidrug resistant (MDR) Acinetobacter species and Pseudomonas aeruginosa was evaluated in critical care patients using imipenem-EDTA disk method. One hundred MDR Acinetobacter spp. and 42 Pseudomonas aeruginosa were checked for MBL production, from January to June 2001. MBL was produced by 96.6 % of imipenem-resistant Acinetobacter isolates, whereas 100% imipenem-resistant Pseudomonas aeroginosa isolates were MBL producers. Carbapenem resistance in MDR Acinetobacter spp. and Pseudomonas aeruginosa isolates in this study was due to MBLs. This calls for strict infection control measures to prevent further dissemination.
Metallo-β-lactamase-producing Pseudomonas aeruginosa in two hospitals from southern Brazil
Wirth, Fernanda W.;Picoli, Simone U.;Cantarelli, Vlademir V.;Gon?alves, Ana L.S.;Brust, Flávia R.;Santos, Liege M.O.;Barreto, Michelle F.;
Brazilian Journal of Infectious Diseases , 2009, DOI: 10.1590/S1413-86702009000300003
Abstract: this study determined the prevalence of metallo-β-lactamase (mbl)-producing pseudomonas aeruginosa in two hospitals located in the southern part of brazil and compare the performance of two different phenotypic tests. thirty-one non-repetitive pseudomonas aeruginosa isolates from various clinical samples from patients admitted to two hospitals located in rio grande do sul, brazil (twenty-three from a hospital in porto alegre city and eight isolates from a hospital in vale dos sinos region). all strains suggestive of possessing mbls by phenotypic methods were included in this study. phenotypic detection of mbls was carried out simultaneously by using both the mbl etest? and disk approximation test using 2-mercaptopropionic acid close to a ceftazidime disk. strains positive were further confirmed using molecular techniques for blavim, blaimp and blaspm-1. the prevalence of mbls from samplesof inpatients from the hospital located in porto alegre was 30.4% and that of inpatients from vale dos sinos hospital was only 3.1%. only mbl type spm-1 was detected in these samples by molecular analysis and all were detected by the etest? mbl strips. the prevalence of p. aeruginosa that produce mbls can be markedly different in distinct geographical areas, even among different hospitals in the same area. in our study, the edta-based method was the only method able to detect all strains harboring the spm-1 enzyme.
Incidence of metallo-beta-lactamase-producing Pseudomonas aeruginosa in diabetes and cancer patients  [cached]
Varaiya Ami,Kulkarni Manasi,Bhalekar Pallavi,Dogra Jyotsana
Indian Journal of Pathology and Microbiology , 2008,
Abstract: Metallo-beta-lactamase (MBL)-producing Pseudomonas aeruginosa strains have been reported to be an important cause of nosocomial infections. There is not enough information from India regarding their prevalence in diabetic and cancer patients. The present study was undertaken over a period of one year from January to December 2006 to study the incidence of MBL P. aeruginosa and the clinical outcome in diabetes and cancer patients admitted to S.L. Raheja Hospital, Mumbai. Two hundred and thirty isolates of P. aeruginosa were obtained from different samples of patients. These isolates were subjected to susceptibility testing to anti-pseudomonal drugs as per CLSI guidelines. They were further screened for the production of MBL by disc potentiation testing using EDTA-impregnated imipenem and meropenem discs. Of the 230 isolates of P. aeruginosa, 60 (26%) isolates were found resistant to carbapenems (both imipenem and meropenem) and 33 (14.3%) were found to be MBL producers. Of the 33 MBL-producing isolates, 24 (72.7%) were diabetic patients, six (18.1%) were cancer patients and three (9%) patients had both diabetes and cancer. Five (15.1%) patients responded to the combination therapy of colistin, piperacillin with tazobactam and amikacin, while 28 (84.8%) patients responded to the combination therapy of amikacin, piperacillin with tazobactam and gatifloxacin. Thus, the rapid dissemination of MBL producers is worrisome and necessitates the implementation of not just surveillance studies but also proper and judicious selection of antibiotics, especially carbapenems.
WITHDRAWN:Incidence and Susceptibility Pattern of Metallo-Beta-Lactamase Producers Among Pseudomonas aeruginosa Isolated From Burn Patients at Kurdistan Province  [cached]
Enayatollah Kalantar,Vahideh Torabi,Himen Salimizand,Fariborz Soheili
Jundishapur Journal of Microbiology , 2012,
Abstract: This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Kowsar Policy on Article Withdrawal can be found at.http://jjmicrobiol.com/?page=public_pages&name=ms__kowsar_withdrawal_regulations. . . .Background: Infection with metallo-beta-lactamase (MBL)-producing organisms, particularly Pseudomonas aeruginosa, is associated with higher mortality and morbidity rates and health care costs.Objective: In this study, we aimed to determine the etiology of burns and the incidence and susceptibility patterns of metallo-beta-lactamase producers among P. aeruginosa samples that were isolated from burn patients in Kurdistan province.Patients and Methods: A total of 176 clinical specimens were received for P. aeruginosa testing. Antimicrobial susceptibility testing, determination of MIC, and detection of MBL-producing P. aeruginosa strains were performed per CLSI guidelines.Results: During the study period, 145 burn patients were admitted to the burn unit of Tohid Hospital. Their mean age and total body surface area (TBSA) were 29 years and 37.7 %, respectively. The mean length of hospital stay was 10 days. Kerosene was the most common cause of burns (60 %), followed by gas (30 %). In the 176 clinical specimens from burn patients, 100 P. aeruginosa isolates were identified. The antibiotic to which most bacteria were resistant was ampicillin (100 %), and the most effective antibiotic was meropenem. Of the 100 P. aeruginosa isolates, 22 (22 %) were positive for MBL production, of which 8 were resistant to imipenem.Conclusions: Of all burn injuries, 87 (60 %) patients were caused by kerosene, which is used primarily by people in low-income groups to light lamps. Our results demonstrate the serious threat of the spread of metallo-beta-lactamase producers; thus, systematic surveillance for detecting MBL producers is necessary..--------------------------------------------------------------------------------Implication for health policy/practice/research/medical education:An infection among burn patients with MBL resistant P. aeruginosa is associated with significantly higher morbidity, mortality and cost of care.Please cite this paper as:Kalantar E, Torabi V, Salimizand H, Soheili F, Ramezanzadeh R. Incidence and Susceptibility Pattern of Metallo-Beta-Lactamase Producers Among Pseudomonas aeruginosa Isolated From Burn Patients at Kurdistan Province. Jundishapur J Microbiol; 5(3):507-10. DOI: 10.5812/jjm.3664.
An evaluation of four different phenotypic techniques for detection of metallo-β-lactamase producing Pseudomonas aeruginosa  [cached]
Behera B,Mathur P,Das A,Kapil A
Indian Journal of Medical Microbiology , 2008,
Abstract: Purpose: The present study was undertaken to detect metallo-β-lactamase (MBL) in nosocomial isolates of Pseudomonas aeruginosa by four different phenotypic methods. Methods: Ninety-one consecutive P. aeruginosa isolates were subjected to susceptibility testing by disc-diffusion assay and Vitek 2. Imipenem resistance was determined by three different methods (disc-diffusion, Vitek 2 and E test). Screening for MBL production was done by imipenem-EDTA combined disc test, imipenem-EDTA double-disc synergy test, imipenem-EDTA MBL E test and EDTA disc potentiation using four cephalosporins. Results: Of 63 imipenem resistant isolates, MBL screening could be done in 56 isolates, of which 48 were MBL positive by combined disc test and 36 by the double disc synergy test. For confirmation of MBL production, MBL E test was done in 30 isolates. All the 30 isolates were confirmed to be MBL positive by the MBL E test method. EDTA disc potentiation using four cephalosporins was not very useful for MBL detection. Conclusions: Imipenem-EDTA combined disc test and imipenem-EDTA MBL E test are equally effective for MBL detection, but given the cost-constraints, combined disc test can be used as a convenient screening method in the clinical microbiology laboratory.
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