IDENTIFICATION AND DISTRIBUTION OF THE CLINICAL ISOLATES OF PSEUDOMONAS AERUGINOSA CARRYING METALLOBETALACTAMASE GENES IN A TERTIARY CARE CENTRE
Atul Khajuria* and Ashok K. Praharaj
ABSTRACT
Objective: The aim of this study is to evaluate the expression of metallobetalactamase genes in Pseudomonas aeruginosa recovered from hospitalized patients in a tertiary care hospital. Materials and Methods: A prospective study was conducted in an 1800 bedded tertiary care centre in Pune, India from October 2013 to October 2017. Carbapenem resistant strains were isolated and presence of the metallo carbapenemase enzyme was confirmed by Polymerase chain reaction (PCR) assays and sequencing. Transferability of genes was determined by conjugation experiments. REP PCR, ERIC PCR and RAPD PCR assays carried out to check Isolate relatedness. Results: Out of 525 isolates, MHT for carbapenemase production was positive for 68(13%), DDST in 126(24%), CDST in 130(24.8%) isolates, MBL (IP/IPI) E-test was positive for 157(30%) and 88(16.8%) isolates were Non MBL. MHT, DDST and CDST assay for P.aeruginosa showed sensitivity of 43.31%, 80.25% and 82.80 %, Specificity of 100%, its PPV was 100% and its NPV was 80.53%, 92.23% and 93.16% respectively. In the present study, blaNDM-1was detected in 36 P.aeruginosa isolates, while blaVIM in 121 isolates. Furthermore, blaIMP, blaSIM, blaSPM and blaGIM were not detected in any of the study isolates. Among ESBLs genes, blaCTX-M was present in 162 isolates, followed by blaTEM-1 in 154, and blaSHV in 151 isolates. Conclusion: The results of this study, highlights prevalence of blaVIM, and blaNDM-1, producing Pseudomonas aeruginosa along with other β-lactamases genes carried on a single or multiple plasmids that serve as a driving force for the horizontal spread of carbapenem resistance especially metallobetalactamase resistance in patients that suffer nosocomial infections.
Keywords: P.aeruginosa, blaNDM-1, blaVIM-2, blaVIM-6, blaSHV-5, blaSHV-11, blaSHV-12, blaSHV-28, blaCTX-M-15, blaCTX-M-14, REP PCR, and RAPD PCR.
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