Study on imipenem resistance and prevalence of blaVIM1 and blaVIM2 metallo-beta lactamases among clinical isolates of Pseudomonas aeruginosa from Mashhad, Northeast of Iran
-
Seyedeh Zohreh-Mirbagheri
,
Zahra Meshkat
,
Mahboubeh Naderinasab
,
Sina Rostami
,
Maryam Sadat-Nabavinia
,
Mehdi Rahmati
Abstract
Background and Objectives: The main cause of serious nosocomial infections is a Gram-negative pathogen known as Pseudomonas aeruginosa (P. aeruginosa). Carbapenems are widely used as an appropriate treatment for these infections, however resistance to these agents has been observed and is increasing. Metallo beta-lactamase (MBLs) enzyme is one of the main causes of resistance to carbapenem. In the current study the frequency and production of VIM1 and VIM2 by imipenem-resistant P. aeruginosa isolates of patients hospitalized in Imam Reza hospital were evaluated.
Materials and Methods: In this study, 131 clinical samples were collected from patients hospitalized in Imam Reza hospital in Mashhad during a 15-month period from May 2011 to November 2012. After verification of P. aeruginosa isolates, antibiotic resistance patterns of isolates were determined for 14 antibiotics by Kirby-Bauer standard disk diffusion according to the CLSI guidelines. Combined-disk test was used for phenotypic determination of MBLs-producing isolates and after DNA extraction, genotypic determination of VIM1 and VIM2 metallo beta-lactamase genes was carried out using Multiplex- PCR.
Results: Of 63 imipenem-resistant isolates (48.5%), 56 (88.8%) were MBL-producing in phenotypic assessments. Also amongst imipenem-resistant isolates, the frequency of VIM1 and VIM2 genes were 58.7 and 3.17%, respectively.
Conclusion: The results of the current study along with the results of the other conducted studies in Iran in recent years demonstrate that the average resistance to imipenem in P. aeruginosa isolates was 51.3% which has increased in comparison with the results in 2006 (32.9%). It was also determined that the frequency of VIM1 gene was more than VIM2 gene. In phenotypic assessment by using CD method, 49.6% of isolates were determined as MBLs-producing. The sensitivity and specificity of this method were verified in comparison with the results of PCR test.
Streit JM, Jones RN, Sader HS, Fritsche TR.Assessment of pathogen occurrences and resistance profiles among infected patients in the intensive care unit: report from the SENTRY Antimicrobial Surveillance Program (North America, 2001). Int J Antimicrob Agents 2004; 24:111-118.
PA L. Mechanisms of antibiotic resistance in Pseudomonas aeruginosa. JRSM 2002; 25:22.
Bush K JG, Medeiros AA. A functional classification scheme for b-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 1995;39:1211-1233.
Cometta A BJ, Lew D, Zimmerli W, Pittet D, Chopart P, Schaad U, Herter C, Eggimann P and Huber O. Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in nonneutropenic patients. Antimicrob Agents Chemother 1994;38:1309.
Zanetti G, Bally F, Greub G, Garbino J, Kinge T, Lew D, et al. Cefepime versus imipenem-cilastatin for treatment of nosocomial pneumonia in intensive care unit patients: a multicenter, evaluator-blind, prospective, randomized study. Antimicrob Agents Chemother 2003;47:3442.
Strateva T, Yordanov D. Pseudomonas aeruginosa–a phenomenon of bacterial resistance. J Med Microbiol 2009;58:1133-1148.
Nordmann P, Poirel L. Emerging carbapenemases in Gram-negative aerobes. Clin Microbiol Infect 2002;8:321-331.
Toleman MA, Simm AM, Murphy TA, Gales AC, Biedenbach DJ, Jones RN, et al. Molecular characterization of SPM-1, a novel metallo-β- lactamase isolated in Latin America: report from the SENTRY antimicrobial surveillance programme. J Antimicrob Chemother 2002;50:673-679.
Jamali SH, Bahar MA, Hooshmand SM. Prevalence of bla VIM and bla IMP metallo-β-lactamase genes in imipenem-resistant Pseudomonas aeruginosa strains isolated from burn patients in Motahari Tehran hospital. Daneshe Microbshenasi 2008;1:1-7 [In persian].
Clinical and Laboratory standards institute (CLSI).Performance standards for antimicrobial susceptibility testing, 16 th informational supplements. CLSI Document M2-A9, Wayne PA: 2006.
Saderi H, Lotfalipour H, Owlia P, Salimi H. Detection of Metallo-β-Lactamase Producing Pseudomonas aeruginosa Isolated From Burn Patients in Tehran, Iran. Lab Medicine 2010;41:609-12.
Franklin C, Liolios L, Peleg AY. Phenotypic detection of carbapenem-susceptible metallo-β-lactamase- producing gram-negative bacilli in the clinical laboratory. J Clin Microbiol 2006; 44:3139-3144.
Sepehri Seresht S, Najar Peerayeh S, Sattari M, Rezaee MA. Production of plasmid-mediated ß-lactamases in Pseudomonas aeruginosa isolated from burnpatients. Hakim Research Journal 2007;10:61-65.
Sacha P, Wieczorek P, Hauschild T, Żórawski M, Olszańska D, Tryniszewska E. Metallo-β-lactamases of Pseudomonas aeruginosa-a novel mechanism resistance to β-lactam antibiotics. Folia Histochem Cytobiol 2008;46:137-142.
Khosravi AD, Mihani F. detection of metallo-b- lactamase producing Pseudomonas aeruginosa strains isolated from burn patients in Ahwaz, Iran. Diagn Microbiol Infect Dis 2008;60:125-128.
Oh E-J, Lee S, Park Y-J, Park JJ, Park K, Kim S-I, et al. Prevalence of metallo-β-lactamase among Pseudomonas aeruginosa and Acinetobacter baumannii in a Korean University hospital and comparison of screening methods for detecting metallo- β-lactamase. J Microbiol Methods.2003;54:411-418.
Mohajeri P. Antibiotic susceptibility and resistance patterns of pseudomonas aeruginosa strains isolated from different clinical specimens in patients referred to the teaching hospitals in Kermanshah (2001-2). Behbood Res J Kermanshah Univ Med Sci 2004;7(4).
Qu T-t, Zhang J-l, Wang J, Tao J, Yu Y-s, Chen Y-g, et al. Evaluation of phenotypic tests for detection of Metallo-β-lactamase-producing Pseudomonas aeruginosa strains in China. J Clin Microbiol 2009;47:1136-1142.
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| Issue | Vol 7 No 2 (2015) | |
| Section | Original Article(s) | |
| Keywords | ||
| Pseudomonas aeruginosa Imipenem Metallobeta-lactamase genes | ||
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