Occurrence of bla genes encoding carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii from Intensive Care Unit in a tertiary care hospital

Jayanthi Siva Subramaniyan; Jeya Meenakshi Sundaram

doi:10.4103/JLP.JLP_108_17

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2018; 10(02): 208-213
DOI: 10.4103/JLP.JLP_108_17

Original Article

Occurrence of bla genes encoding carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii from Intensive Care Unit in a tertiary care hospital

Jayanthi Siva Subramaniyan

Department of Microbiology, Chettinad Hospital and Research Institute, Kanchipuram, Tamil Nadu, India

,

Jeya Meenakshi Sundaram

Department of Microbiology, Chettinad Hospital and Research Institute, Kanchipuram, Tamil Nadu, India

› Author Affiliations

Abstract

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Abstract

CONTEXT: ICU shows increasing incidence of infection associated with the use of invasive procedures for the diagnostic purpose as well as the indiscriminate use of antibiotics. Pseudomonas aeruginosa and Acinetobacter species are "very successful" pathogen and the emergence of the Metallo-β-Lactamases (MBL) is becoming a therapeutic challenge.

AIMS: To isolate the Nonfermenting Gram negative bacilli from the ICU samples. To identify the metallo betalactamase producers and to detect the bla gene presence among the Pseudomonas aeruginosa and Acinetobacter baumannii.

SETTINGS AND DESIGN: The Nonfermenting Gram negative bacilli isolates from the ICU samples were taken over for 5 years (2009-2014) in a tertiary care hospital.

METHODS AND MATERIALS: The isolates of Pseudomonas species and Acinetobacter species were confirmed by API analyser and processed according to standard procedures. Detection of the MBL producers were done by E strip method and subjected for bla gene detection by PCR method.

RESULTS: In our study a total of 195 isolates of NFGNB were obtained from various ICU. Of these MBL producers, 26 % were Pseudomonas aeruginosa and 25 % were Acinetobacter baumannii. The subtypes of bla _VIMMBL producing P.aeruginosa were 26%.The predominant gene coding for MBL activity in A.baumannii were found to be bla _OXA gene 11.9%. The gene accession numbers were KF975367, KF975372.

CONCLUSIONS: We have to control the development and dissemination of these superbugs among the ICU's.

Keywords

Acinetobacter baumanni - bla genes - ICU - Metallo-β-lactamases - Pseudomonas aeruginosa

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References

References
1 Murray PR, Rosenthal KS, Pfaller MA, editors. Text Book of Medical Microbiology-Pseudomonas and Related Organisms. 5^th ed. Vol. 34. Elsevier; 2005. p. 357-65.
2 Towner KJ. Plasmid and transposon behaviour in Acinetobacter. In: Towner KJ, Bergogne-Berezin E, Fewson CA, editors. The Biology, Physiology, Industrial Relevance. New York: Plenum Press; 1991. p. 149-67.
3 Cisneros JM, Rodríguez-Baño J, Fernández-Cuenca F, Ribera A, Vila J, Pascual A, et al. Risk-factors for the acquisition of imipenem -Resistant Acinetobacter baumannii in Spain: A nationwide study. Clin Microbiol Infect 2005;11:874-9.
4 Corbella X, Pujol M, Ayats J, Sendra M, Ardanuy C, Domínguez MA, et al. Relevance of digestive tract colonization in the epidemiology of nosocomial infections due to multiresistant Acinetobacter baumannii. Clin Infect Dis 1996;23:329-34.
5 Afzal-Shah M, Livermore DM. Worldwide emergence of carbapenem-resistant Acinetobacter spp. J Antimicrob Chemother 1998;41:576-7.
6 Paramythiotou E, Lucet JC, Timsit JF. Acquistion of multidrug resistant Pseudomonas aeruginosa in patients in Intensive Care Units: Role of antibiotics with antipseudomonal activity. Clin Infect Dis 2003;38:676-7.
7 Lister PD, Wolter DJ, Hanson ND. Antibacterial-resistant Pseudomonas aeruginosa: Clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clin Microbiol Rev 2009;22:582-610.
8 Talbot GH, Bradley J, Edwards JE Jr., Gilbert D, Scheld M, Bartlett JG, et al. Bad Bugs need drugs: An update on the development pipeline from the antimicrobial availability task force of the infectious diseases society of America. Clin Infect Dis 2006;42:657-68.
9 Perez F, Hujer AM, Hujer KM, Decker BK, Rather PN, Bonomo RA, et al. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2007;51:3471-84.
10 Rice LB. Challenges in identifying new antimicrobial agents effective for treating infections with Acinetobacter baumannii and Pseudomonas aeruginosa. Clin Infect Dis 2006;43 Suppl 2:S100-5.
11 Garnacho-Montero J, Amaya-Villar R. Multi resistant Acinetobacter baumannii infections: Epidemiology and management. Curr Opin Infect Dis 2010;23:332-9.
12 Irfan S, Zafar A, Guhar D, Ahsan T, Hasan R. Metallo-beta-lactamase-producing clinical isolates of Acinetobacter species and Pseudomonas aeruginosa from intensive care unit patients of a tertiary care hospital. Indian J Med Microbiol 2008;26:243-5.
13 Oberoi L, Singh N, Sharma P, Aggarwal A. ESBL, MBL and ampc β lactamases producing superbugs - Havoc in the intensive care units of Punjab India. J Clin Diagn Res 2013;7:70-3.
14 Mohanasundaram KM. Retrospective analysis of the incidence of nosocomial infection in the ICU-associated risk factors and microbiological profile. J Clin Diagn Res 2010;4:33789-2.
15 Clinical and Laboratory Standards Institute. Performance Standards for the Antimicrobial Susceptibility Testing. CLSI Document M100-S20. Wayne, PA, USA: Clinical and Laboratory Standards Institute; 2010.
16 Segal H, Elisha BG. Use of E test MBL strips for the detection of carbapenemases in Acinetobacter baumannii. J Antimicrob Chemother 2005;56:598.
17 Giakkoupi P, Xanthaki A, Kanelopoulou M, Vlahaki A, Miriagou V, Kontou S, et al. VIM-1 metallo-beta-lactamase-producing Klebsiella pneumoniae strains in Greek hospitals. J Clin Microbiol 2003;41:3893-6.
18 Dong F, Xu XW, Song WQ, LüP, Yu SJ, Yang YH, et al. Characterization of multidrug-resistant and metallo-beta-lactamase-producing Pseudomonas aeruginosa isolates from a paediatric clinic in China. Chin Med J (Engl) 2008;121:1611-6.
19 Gutiérrez O, Juan C, Cercenado E, Navarro F, Bouza E, Coll P, et al. Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa isolates from Spanish hospitals. Antimicrob Agents Chemother 2007;51:4329-35.
20 Juan C, Beceiro A, Gutiérrez O, Albertí S, Garau M, Pérez JL, et al. Characterization of the new metallo-beta-lactamase VIM-13 and its integron-borne gene from a Pseudomonas aeruginosa clinical isolate in Spain. Antimicrob Agents Chemother 2008;52:3589-96.
21 Lauretti L, Riccio ML, Mazzariol A, Cornaglia G, Amicosante G, Fontana R, et al. Cloning and characterization of bla VIM, a new integron-borne metallo-beta-lactamase gene from a Pseudomonas aeruginosa clinical isolate. Antimicrob Agents Chemother 1999;43:1584-90.
22 Yum JH, Yi K, Lee H, Yong D, Lee K, Kim JM, et al. Molecular characterization of metallo-beta-lactamase-producing Acinetobacter baumannii and Acinetobacter genomospecies 3 from Korea: Identification of two new integrons carrying the bla (VIM-2) gene cassettes. J Antimicrob Chemother 2002;49:837-40.
23 Sundararaj T, Sundararaj A. Microbiology Laboratory Manual. 4^th ed. Vol. 1. A. Sundararaj; 2005. p. 39-40.
24 Alişkan H, Colakoğlu S, Turunç; T, Demiroğlu YZ, Erdoğan F, Akin S, et al. Four years of monitoring of antibiotic sensitivity rates of Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from patients in Intensive Care Unit and inpatient clinics. Mikrobiyol Bul 2008;42:321-9.
25 Jaggi N, Sissodia P, Sharma L. Acinetobacter baumannii isolates: The epidemiology, antibiogram and the nosocomial status which were studied over a 25 months period in a tertiary care hospital in India. BMC Proc 2011;5:291.
26 Orrett FA. Antimicrobial susceptibility survey of Pseudomonas aeruginosa strains isolated from clinical sources. J Natl Med Assoc 2004;96:1065-9.
27 Dash M, Padhi S, Pattnaik S, Mohanty I, Misra P. Frequency, risk factors, and antibiogram of Acinetobacter species isolated from various clinical samples in a tertiary care hospital in Odisha, India. Avicenna J Med 2013;3:97-102.
28 Rit K, Saha R. Multidrug-resistant Acinetobacter infection and their susceptibility patterns in a tertiary care hospital. Niger Med J 2012;53:126-8.
29 Joshi SG, Litake GM, Satpute MG, Telang NV, Ghole VS, Niphadkar KB, et al. Clinical and demographic features of infection caused by Acinetobacter species. Indian J Med Sci 2006;60:351-60.
30 Gautam V, Mewara A, Raj A, Gupta V, Singla N, Ray P, et al. High prevalence of New Delhi metallo-β-lactamase in Acinetobacter calcoaceticus-A. Baumannii complex at two tertiary care centres in North India. Indian J Med Microbiol 2014;32:455-6.
31 Abbo A, Navon-Venezia S, Hammer-Muntz O, Krichali T, Siegman-Igra Y, Carmeli Y, et al. Multidrug-resistant Acinetobacter baumannii. Emerg Infect Dis 2005;11:22-9.
32 Yan JJ, Ko WC, Tsai SH, Wu HM, Wu JJ. Outbreak of infection with multidrug resistant Klebsiella pneumonia carrying bla IMP -8 in a university medical centre in Taiwan. J Clin Microbiol 2001;39:4433-9.
33 Livermore DM. Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: Our worst nightmare? Clin Infect Dis 2002;34:634-40.
34 Lone R, Shah A, Kadri SM, Lone S, Shah F. Nosocomial multidrug resistant Acinetobacter infections-clinical findings, risk factors and demographic characteristics. Bangladesh J Med Microbiol 2009;3:34-8.
35 Tan TT. "Future" threat of Gram negative resistance in Singapore. Ann Acad Med Singapore 2008;37:884-90.
36 Hsu LY, Tan TY, Jureen R, Koh TH, Krishnan P, Tzer-Pin Lin R, et al. Antimicrobial drug resistance in Singapore hospitals. Emerg Infect Dis 2007;13:1944-7.
37 Lagatolla C, Tonin EA, Monti-Bragadin C, Dolzani L, Gombac F, Bearzi C, et al. Endemic carbapenem-resistant Pseudomonas aeruginosa with acquired metallo-beta-lactamase determinants in European hospital. Emerg Infect Dis 2004;10:535-8.
38 Kabbaj H, Seffar M, Belefquih B, Akka D, Handor N, Amor M, et al. Prevalence of Metallo betalactamases producing Acinetobacter baumannii in a Moroccan hospital. ISRN Infect Dis 2013;2013:154921.
39 Uma Karthika R, Srinivasa Rao R, Sahoo S, Shashikala P, Kanungo R, Jayachandran S, et al. Phenotypic and genotypic assays for detecting the prevalence of metallo-beta-lactamases in clinical isolates of Acinetobacter baumannii from a South Indian tertiary care hospital. J Med Microbiol 2009;58:430-5.
40 Anil VK, Vishnu SP, Kavitha R, Shamusul D. The phenotypic detection of carbapenemase in the meropenem resistant Acinetobacter calcoaceticus-baumannii complex in a tertiary care hospital in S. I. J Clin Diagn Res 2011;5:223-6.
41 Azim A, Dwivedi M, Rao PB, Baronia AK, Singh RK, Prasad KN, et al. Epidemiology of bacterial colonization at Intensive Care Unit admission with emphasis on extended-spectrum beta-lactamase-and metallo-beta-lactamase-producing Gram-negative bacteria – An Indian experience. J Med Microbiol 2010;59:955-60.