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Kotwal A, Biswas D, Kakati B, et al. ESBL and MBL in Cefepime Resistant Pseudomonas aeruginosa: An Update from a Rural Area in Northern India. J Clin Diagn Res. 2016;10(4):DC09-11doi: 10.7860/JCDR/2016/18016.7612.
Kotwal, A., Biswas, D., Kakati, B., & Singh, M. (2016). ESBL and MBL in Cefepime Resistant Pseudomonas aeruginosa: An Update from a Rural Area in Northern India. Journal of clinical and diagnostic research : JCDR, 10(4), DC09-11. https://doi.org/10.7860/JCDR/2016/18016.7612
Kotwal, Aarti, et al. "ESBL and MBL in Cefepime Resistant Pseudomonas aeruginosa: An Update from a Rural Area in Northern India." Journal of clinical and diagnostic research : JCDR vol. 10,4 (2016): DC09-11. doi: https://doi.org/10.7860/JCDR/2016/18016.7612
Kotwal A, Biswas D, Kakati B, Singh M. ESBL and MBL in Cefepime Resistant Pseudomonas aeruginosa: An Update from a Rural Area in Northern India. J Clin Diagn Res. 2016 Apr;10(4):DC09-11. doi: 10.7860/JCDR/2016/18016.7612. Epub 2016 Apr 01. PMID: 27190800; PMCID: PMC4866098.
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J Clin Diagn Res. 2016 Apr;10(4):DC09-11. doi: 10.7860/JCDR/2016/18016.7612. Epub 2016 Apr 01.

ESBL and MBL in Cefepime Resistant Pseudomonas aeruginosa: An Update from a Rural Area in Northern India.

Journal of clinical and diagnostic research : JCDR

Aarti Kotwal, Debasis Biswas, Barnali Kakati, Malvika Singh

Affiliations

  1. Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences , Jolly Grant, Dehradun, Uttarakhand, India .
  2. Additional Professor, Department of Microbiology, AIIMS B hopal, Saket Nagar, Bhopal, India .
  3. Senior Resident, Department of Microbiology, Himalayan Institute of Medical Sciences , Jolly Grant, Dehradun, Uttarakhand, India .

PMID: 27190800 PMCID: PMC4866098 DOI: 10.7860/JCDR/2016/18016.7612

Abstract

INTRODUCTION: Cefepime, a fourth generation cephalosporin, is widely used for the empirical treatment of serious infections in critically ill hospitalized patients. Pseudomonas aeruginosa (P. aeruginosa), one of the commonest bacteria causing nosocomial infections has a propensity to develop antibiotic resistance quite promptly.

AIM: We undertook this study to assess the efficacy of cefepime against current clinical isolates of P. aeruginosa and to study existence of different beta-lactamase enzymes among cefepime resistant P. aeruginosa isolates.

MATERIALS AND METHODS: Total of 618 isolates of P. aeruginosa recovered consecutively from various clinical samples of a tertiary care hospital were analysed. Their Antimicrobial sensitivity profile against piperacilin (100μg), piperacillin/tazobactam (100μg/10μg), ceftazidime (30μg), cefoperazone (75μg), cefepime (30μg), ciprofloxacin (5μg), gentamycin (10μg), amikacin (30μg) and imipenem (10μg) (Himedia) was tested by Kirby-Bauer disc diffusion method (Clinical and Laboratory Standards Institute guidelines). We further looked for ESBL, MBL and ESBL + MBL co producers among the cefepime resistant isolates by two different methods (combined double disc synergy test, imipenem-EDTA combined disc test and vitek2).

RESULTS: Among 618 consecutive clinical isolates of P. aeruginosa, we observed resistance to cefepime in 457 (74%) isolates. We observed resistance to ciprofloxacin (n=506, 82%) in maximum number of isolates followed by that to Gentamycin (n=475, 77%), amikacin (n=366, 60%), and cefoperazone (n=350, 56.6%). Among all our cefepime resistant P. aeruginosa isolates only 27(6%) were ESBL producers, 18(4%) MBL producers and 2(0.4%) were ESBL+ MBL co-producers. All the ESBL and MBL isolates were also tested by VITEK 2 advanced expert system (bioMırieux Vitek Systems Inc, Hazelwood, MO, France) which revealed a 100% concordance with the phenotypic method tested.

CONCLUSION: This paper highlights the need to reconsider prescribing empirical antibiotics for Pseudomonas infections in this region and formulate a strong antibiotic policy to curb the menace of spread of multidrug resistant strains.

Keywords: Beta lactamases; Co-producers; Drug resistance; Fourth generation cephalosporin

References

  1. Indian J Pathol Microbiol. 2008 Apr-Jun;51(2):222-4 - PubMed
  2. Indian J Med Res. 2014 Oct;140(4):560-2 - PubMed
  3. Arch Intern Med. 1996 Oct 14;156(18):2121-6 - PubMed
  4. Indian J Crit Care Med. 2010 Oct;14(4):217-9 - PubMed
  5. Clin Microbiol Infect. 2007 Jun;13(6):560-78 - PubMed
  6. Clin Microbiol Rev. 2005 Oct;18(4):657-86 - PubMed
  7. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416 - PubMed
  8. Antimicrob Agents Chemother. 2005 Apr;49(4):1306-11 - PubMed
  9. Antimicrob Agents Chemother. 2004 Jul;48(7):2431-6 - PubMed
  10. Clin Infect Dis. 1998 Aug;27 Suppl 1:S93-9 - PubMed
  11. Diagn Microbiol Infect Dis. 2005 Jul;52(3):265-73 - PubMed
  12. J Antimicrob Chemother. 1999 Mar;43(3):415-8 - PubMed
  13. Clin Infect Dis. 2000 Mar;30(3):454-60 - PubMed
  14. Clin Infect Dis. 2005 Sep 15;41(6):848-54 - PubMed
  15. Antimicrob Agents Chemother. 2006 Jan;50(1):226-9 - PubMed
  16. JAMA. 2003 Feb 19;289(7):885-8 - PubMed

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