The phenotypic detection of carbapenemase in meropenem resistant acinetobacter calcoaceticus-baumannii complex in a tertiary care hospital in South India
Publication Type:Journal Article
Source:Journal of Clinical and Diagnostic Research, Volume 5, Number 2, p.223-226 (2011)
Keywords:Acinetobacter, Acinetobacter baumannii, Acinetobacter calcoaceticus, amikacin, aminoglycoside antibiotic agent, antibiotic resistance, antibiotic sensitivity, article, aztreonam, bacterial strain, bacterium identification, bacterium isolate, carbapenem, carbapenemase, cefepime, cefoperazone, ceftazidime, cephalosporin derivative, ciprofloxacin, controlled study, disk diffusion, enzyme synthesis, gentamicin, imipenem, India, levofloxacin, meropenem, metallo beta lactamase, multidrug resistance, netilmicin, nonhuman, penicillin derivative, phenotype, piperacillin, piperacillin plus tazobactam, quinoline derived antiinfective agent, screening test, sulperazon, tertiary health care, tobramycin
Background and objectives: The predominant Acinetobacter spp. in clinical settings are the members of the Acinetobacter calcoaceticus- baumannii complex which are multi drug resistant and are responsible for causing outbreaks. Carbapenem resistance due to metallo-β-lactamase production in Acinetobacter spp. is on the rise. We investigated the production of carbapenemase among the meropenem resistant Acinetobacter spp. which were further screened for metallo-β-lacatmase production. The co-resistance to other classes of antibiotics was also investigated. materials and methods: Forty five non duplicate consecutive meropenem resistant Acinetobacter calcoaceticus- baumannii complex were investigated for carbapenemase production by the modified Hodge test. The carbapenemase producing isolates were further screened for metallo-β-lacatmase production by the combined disc diffusion test by using imipenem with EDTA as the chelator. The co-resistance to other classes of antibiotics was also investigated to identify the multi drug resistant isolates. results: Of the 45 non duplicate consecutive meropenem resistant Acinetobacter calcoaceticus- baumannii complex which were screened, 95% (43/45) of them were multi drug resistant and 71% (32/45) were found to be carbapenemase producers by the modified Hodge test, of which 21% (7/32) were found to be metallo-β-lacatmase producers phenotypically by the combined-disk test. Conclusion: Carbapenem resistance in Acinetobacter calcoaceticus-baumannii complex is very high and is predominantly due to carbapenemase production. However, metallo-β-lactamase production among these isolates is not very high but is gradually increasing. Only 21% of our isolates were metallo-β-lactamase phenotypes, thus suggesting that the production of carbapenem hydrolyzing oxacillinase is still the most common mechanism of resistance to carbapenems in this species.
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