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Saudi Journal of Pathology and Microbiology (SJPM)
Volume-4 | Issue-07 | 550-554
Original Research Article
Study of Metallo-Beta-Lactamase Producing Gram Negative Bacteria in a Tertiary Care Hospital
Dr. Shilpa Rajesh Shah, Dr. Nisha Chaitanya Karanje
Published : July 30, 2019
DOI : 10.21276/sjpm.2019.4.7.14
Abstract
Resistant bacteria are emerging worldwide as a threat to the favorable outcome of common infection in community & hospital settings. Beta-lactams remain a cornerstone for antimicrobial chemotherapy of a large number of bacterial infections. The most common cause of bacterial resistance to β- lactam antibiotics is the production of β- lactamases, followed by ESBL’s and then the emergence of MBL activity which is one of the most feared resistance mechanism, because of its ability to hydrolyze virtually all β- lactams, including cabapenems. However MBL’s are unable to hydrolyze monobactams & are not inactivated by β- lactamase inhibitors like clavulinic acid, sulbactam and Tazobactam. In any nosocomial settings, carbapenems are used as the last resort for treatment of MDR gram negative bacterial infections. MBL producing gram negative bacteria often exhibit resistance to additional classes of drugs and behave as multidrug resistant bacteria. Hence the present study was undertaken for detection of MBL producing gram negative bacilli and to help treating physicians to select appropriate antibiotic in our hospital. It was a prospective study conducted from April 2018 to July 2018 after IEC clearance. The Gram Negative isolates were first screened for MBL production with ceftazidime disc, & were further tested by Combined Disc Test Method (CDT) and Modified Hodge Test (MHT). Total 300 gram negative isolates were studied. In these, the MBL producers were 43.6%, majority of the isolates were from pus (19.3%), followed by urine (14.3%). Amongst these, E. coli was the most common organism isolated (16.3%), followed by Klebsiella pneumoniae(11%) and Pseudomonas aeruginosa (6.6%).By combined disc test a total of 131 MBL producing strains were isolated and 126 strains were detected by MHT. The exposure of bacterial strains to a multitude of β- lactams has induced mutation of β- lactamase in many bacteria, expanding their activity even against carbapenems, by the production of MBL resulting into fewer therapeutic alternatives. Hence detection of MBL is very important in respect to the treatment plan and sparing use of antibiotics to avoid their spread in the hospitals.
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