ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ACINETOBACTER BAUMANNII WITH PHENOTYPIC DETECTION OF EXTENDED SPECTRUM BETA-LACTAMASES (ESBL) & METALLO BETA LACTAMASES (MBL) PRODUCTION FROM VARIOUS CLINICAL SAMPLES AT A TERTIARY CARE HOSPITAL, NORTH INDIA

Bhawani Shankar Verma, Rachna khatri, Dr. Mohit Agrawal

Abstract


Background:  

Acinetobacter baumannii is one of the major pathogens causing nosocomial infections or healthcare-associated infection due to the emergence of resistance to various antimicrobial agents. Resistance due to antimicrobial degrading enzymes Like ESBL and MBLs is now a worldwide problem and a major reason for concern for the treating physicians.  

Materials and methods:

This is a cross-sectional study, a total of 55 Acinetobacter baumannii isolates from various clinical samples from November 2019 to April 2020. 

Acinetobacter baumannii isolates from various clinical samples were screened for Cephalosporins and Meropenem resistance for the detection of ESBL and MBL production. Carbapenemases production was confirmed by DDST and EDTA DST method for ESBLs and MBLs.

 Results: 

A total of 55 Acinetobacter baumannii isolates of in all clinical samples. Out of isolating Extended Spectrum Beta-Lactamases (ESBL) detection through screening method was 45 (81.82%) & confirmatory detection by DDST method was 42 (76.36%) and MBL (Metallo-β-Lactamases) detection by the screening method Carbapenems resistance were 40 (72.73%) and confirmatory detection EDTA DST method 35 (63.64%) respectively. Out of total isolates, most of the samples were Endotracheal Tube 35 (63.64%) & Blood 9 (16.36%).  Detection of ESBL by phenotypic method out of 45 (81.82%) samples resistance of 3rd generation Cephalosporins were Endotracheal aspirate 31 (56.36%) & blood 6 (10.91%) and 42 (76.37%) ESBL confirmatory detection by DDST method were 30 (54.54%) Endotracheal aspirate & 5 (9.09%) Blood respectively. Out of 40 (72.73%) MBL Positive by  Carbapenems resistance detection with Phenotypic Screening test Endotracheal aspirate 31 (56.36%) & Blood 5 (9.09%) and out of 35 (63.64%) Phenotypic Confirmatory by EDTA DST is Endotracheal Tube 30 (54.54%) & Blood 4 (7.27%) respectively.

 Acinetobacter baumannii isolates were 100% sensitive to Polymyxin B and Colistin for, confirmed MBL & ESBL production. Resistance to 100% Ceftazidime and Ceftriaxone for ESBL & MBL producer Acinetobacter baumannii confirmed ESBL and Meropenem and Imipenem both are antibiotics were 100% resistance in MBL producer. 

Conclusion: 

This study gives an alarming sign of a high ratio of multidrug resistance due to the production of extended-spectrum Beta-lactamase and Metallo beta Lactamases, respectively.


Keywords


Acinetobacter, Carbapenems, MBL, ESBL, DST, and EDTA.

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