Detecting NDM-1 Gene in MBL-Producing Pseudomonas aeruginosa | InformativeBD

K. Archana Rao, S. Sangeetha and SA. Lakshminarayana from the different institute of the india, wrote a research article about Detecting NDM-1 Gene in MBL-Producing Pseudomonas aeruginosa, entitled, "NDM-1 gene detection from Metallobeta lactamase (MBL) producing Pseudomonas aeruginosa: A pilot study from a teritiary care centre". This research paper published by the International Journal of Microbiology and Micology | IJMM, an open access scholarly research journal on Microbiology, under the affiliation of the International Network For Natural Sciences |INNSpub, an open access multidisciplinary research journal publisher.

Abstract

Multidrug resistant bacteria always remain a great challenge. The latest threat being New Delhi Metallobetalactamase-1 (NDM-1) a superbug has brought notoriety to Indian Health care. NDM-1 refers to the transmissible genetic element encoding multiple resistant genes, first isolated from a strain of Klebsiella spp. in New Delhi, India, which has the ability to hydrolyse beta lactams and carbapenams. Detection of NDM-1 gene in multidrug resistant Pseudomonas isolates from various clinical samples. 200 Pseudomonas species were isolated in Microbiology laboratory during one year period were included in the study. Samples were processed as per Standard operating procedures. Antibiotic sensitivity testing was done by Kirby-Bauer disc diffusion method. The results were interpreted as per CLSI guidelines. MBL detection was done, by using EDTA Double Disc Synergy Test and Imipenem [I]-EDTA Combined Disc Test. MBL positive isolates were subjected to conventional PCR for genotyping & detection of NDM-1. A cross sectional descriptive study. Out of 12545 samples that were received in microbiology laboratory, 299 Non-Fermenting Gram Negative Bacilli [NFGNB] were isolated of which 200 were speciated as Pseudomonas aeruginosa. 20/200 [10%] were resistant to imipenem and 24/200 [12%] to meropenem. 10% of isolates showed MBL positive. NDM-1 gene was not detected in any of the 20 MBL positive isolates. NDM-1 gene since its origin has caused chaos in the health care facility with its ability to cause various infections. Detection is possible only with molecular methods. Thus gene detection plays a pivotal role in patient treatment and reduction of hospital stay. (Pseudomonas, multidrug resistant, New Delhi Metallobetalactamase-1, super bugs).

 

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Introduction

Pseudomonas aeruginosa a gram-negative bacterium is one of the leading causes of health care associated infections. Multi-drug-resistant Pseudomonas aeruginosa is a growing concern. Multi drug resistant bacteria are defined as isolates that show intermediate or resistance to at least three drugs in the following classes: beta-lactams, carbapenems, aminoglycosides, and fluoroquinolones.(1) Reported rates of multi drug resistant Pseudomonas aeruginosa varies from 0.6-32% based on geographic location and type of surveillance study.(2) Pseudomonas aeruginosa is intrinsically resistant to a wide range of antibiotics like ampicillin, cefuroxime and cefotaxim which is attributed to its production of ß-lactamases.(3) Indiscriminate use of antibiotics, heavy antibiotic pressure further accentuates the mutations in genes coding for ß-lactamase enzymes. This results in the fabrication of new ß-lactamases with wider ranges of activity. The emergence of New Delhi Metallobetalactamase-1 (NDM-1) Pseudomonas aeruginosa, a superbug, is a potential threat to human health. Among clinically significant carbapenamases, NDM-1 is the biggest menace. It significantly hydrolyses beta-lactams and carbapenems. NDM-1 producing strains exhibit multidrug resistant profile because they also harbor genes that encode for resistance to aminoglycosides and fluoroquinolones.(4)(5)

This mixed bag of rapidly emerging antimicrobial resistant organisms and increasing rates of healthcare infections has always drawn the attention of clinical microbiologists and thus put us under an obligation to detect these resistance mechanism at the earliest. Emerging ‘Superbugs or Multi-Drug Resistant (MDR)’ pathogens have always been an enduring hitch in the health care settings and also challenges the effectiveness and usefulness of even most potent antibiotics. (6)Knowledge of NDM and its prevalence is essential because P. aeruginosa with intrinsic colonization capacity has the ability to persist in the hospital environment for indefinite periods but there is paucity of such reports. Hence the present study was undertaken as a pilot project to detect the NDM-1 gene in multi drug resistant Pseudomonas species, because determination of resistance mechanism helps to formulate efficient antibiotic policy and infection control protocols for holistic health care.

Objectives

1) Identification of pseudomonas species from various clinical isolates

2) Detection of their antimicrobial resistance

3) Detection of MBL production by screening tests

4) Detection of NDM-1 gene in the MBL positive isolates

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Source: NDM-1 gene detection from Metallobeta lactamase (MBL) producing Pseudomonas aeruginosa: A pilotstudy from a teritiary care centre