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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Existence of Metallo beta lactamases in carbapenem susceptible gram negative bacilli: a cause for concern
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Existence of Metallo beta lactamases in carbapenem susceptible gram negative bacilli: a cause for concern

机译：碳青霉烯易感革兰氏阴性杆菌中存在金属β内酰胺酶：值得关注

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Background: Metallo-?-lactamases (MBLs) have been increasingly recognized among imipenem resistant isolates, but they also appear to exist in imipenem susceptible isolates. These undetected hidden MBLs in sensitive isolates can spread unnoticed in hospitals if such isolates are reported susceptible to carbepenem without screening for the presence of MBLs. The laboratory detection of such isolates is crucial as they pose a serious therapeutic challenge. Aims: The aim of our study was to detect MBLs in both the imipenem resistant and sensitive isolates by using combination of available phenotypic methods. Settings and design: This was a hospital based prospective study which was carried out in a tertiary neuropsychiatric centre from April 2008 to April 2009.Methods and Material: A total of 130 gram negative isolates (50 imipenem sensitive, 30 imipenem intermediate and 50 imipenem resistant by the Kirby Bauer disc diffusion method) were tested for the presence of MBLs by the double disk synergy test (imipenem, EDTA 750μg/ml), the combined disk test (imipenem, imipenem + EDTA 750μg/ml) and the MBL E test strip.Statistical analysis: Descriptive statistics was used and the percentages of MBLs carrying imipenem resistant and sensitive isolates were calculated. Results: MBLs were detected in 11 (20%) imipenem sensitive isolates. Out of these 11 imipenem sensitive MBL producing strains, 8 were from the imipenem sensitive category and 3 were from the intermediate category. These 3 isolates in the intermediate category had MIC for imipenem in the sensitive range (MIC ≤4 ug/ml) by E test method. All the MBL carrying imipenem sensitive isolates had zone diameters in between 16 to 22 mm by the Kirby Baeur disc diffusion method. Among the imipenem resistant isolates, 38 isolates were MBL producers (32 from the imipenem resistant category and 6 from the intermediate category). Conclusions: This study reports the existence of MBLs in carbapenem susceptible organisms and proposes that gram negative bacterial isolates having an imipenem zone diameter ≤22mm by the disk diffusion method should be routinely screened for presence of MBLs.
机译：背景：金属-β-内酰胺酶（MBLs）已在亚胺培南耐药菌株中得到越来越多的认可，但它们似乎也存在于亚胺培南敏感菌株中。如果有报道称此类分离物易感碳青霉烯类药物，而没有筛查MBL的存在，那么这些敏感分离物中未检测到的隐藏MBL可能会在医院中传播而未被注意到。这种分离物的实验室检测至关重要，因为它们构成了严重的治疗挑战。目的：我们的研究目的是通过结合使用现有的表型方法来检测亚胺培南耐药和敏感菌株中的MBL。设置与设计：这是一项基于医院的前瞻性研究，于2008年4月至2009年4月在三级神经精神病学中心进行。方法和材料：总共130克阴性分离株（敏感的50个亚胺培南，中间的30个亚胺培南和50个亚胺培南耐药通过双盘协同试验（亚胺培南，EDTA750μg/ ml），联合盘试验（亚胺培南，亚胺培南+ EDTA750μg/ ml）和MBL E试纸通过Kirby Bauer纸片扩散法检测MBL的存在统计分析：使用描述性统计数据，并计算带有亚胺培南耐药和敏感菌株的MBL百分比。结果：在11个（20％）亚胺培南敏感分离株中检测到MBL。在这11种对亚胺培南敏感的MBL产生菌株中，有8种来自亚胺培南敏感类别，另外3种来自中间类别。通过E检验方法，这3个中级分离株的亚胺培南的MIC在敏感范围内（MIC≤4ug / ml）。通过Kirby Baeur圆盘扩散法，所有携带亚胺培南的MBL敏感菌株均具有16至22 mm的区域直径。在对亚胺培南具有抗药性的菌株中，有38种是MBL产生者（对亚胺培南具有抗药性的菌株32个，对中间亚胺培林有6个菌株）。结论：这项研究报道了碳青霉烯易感生物中存在MBLs，并建议应通过磁盘扩散法常规筛查亚胺培南区直径≤22mm的革兰氏阴性细菌分离株是否存在MBLs。

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