Farajzadeh Sheikh Ahmad, Rostami Soodabeh, Jolodar Abbas, Tabatabaiefar Mohammad Amin, Khorvash Farzin, Saki Azadeh, Shoja Saeed, Sheikhi Raheleh
Department of Microbiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran ; Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
Department of Biomolecular and Biochemistry, School of Veterinary Medicine, Shahid Chamran University, Ahvaz, IR Iran.
Jundishapur J Microbiol. 2014 Nov;7(11):e12289. doi: 10.5812/jjm.12289. Epub 2014 Nov 1.
Carbapenems are important drugs used for the treatment of Pseudomonas aeruginosa infections, however metallo-β-lactamases (MBL) are able to efficiently hydrolyze these classes of drugs. Immediate detection of the MBL-producing P. aeruginosa is necessary in order to accurately treat infections caused by this organism.
To determine the prevalence of MBL producing P. aeruginosa in burn and non-burn patients by two phenotypic tests and polymerase chain reaction (PCR) and to compare phenotypic tests with PCR.
A total of 223 non-duplicate strains of P. aeruginosa were collected from three teaching hospitals of Ahvaz, Iran. Antimicrobial susceptibility and minimum inhibitory concentrations (MICs) of carbapenems (imipenem, meropenem, doripenem and ertapenem) were determined by the Kirby-Bauer and E-test methods. Combined disk (CD) test, MBL E-test and PCR were performed for carbapenem-resistant P. aeruginosa isolates.
Amongst all the P. aeruginosa isolates, 58.7% were resistant to imipenem while 31.8%, 13.5% and 74.4% were resistant to meropenem, doripenem and ertapenem, respectively. Amongst all the P. aeruginosa isolates, 44.4% were multidrug resistant and 13.45% were resistant to all of the carbapenems. The CD test with doripenem disk / 750 μg ethylene diamine tetra acetic acid (EDTA) had the highest efficiency compared to the other phenotypic tests. bla IMP and bla VIM genes were detected in 11.7% and 0.4% of isolates, respectively. bla SPM and bla NDM genes were not observed.
Epidemiological and regional evaluation of MBL-producing P. aeruginosa through simple and inexpensive methods should be considered for effective treatment of carbapenem-resistant P. aeruginosa infections.
碳青霉烯类药物是用于治疗铜绿假单胞菌感染的重要药物，然而金属β-内酰胺酶（MBL）能够有效水解这类药物。为了准确治疗由该菌引起的感染，对产MBL的铜绿假单胞菌进行即时检测很有必要。
通过两种表型试验和聚合酶链反应（PCR）确定烧伤和非烧伤患者中产MBL的铜绿假单胞菌的流行情况，并将表型试验与PCR进行比较。
从伊朗阿瓦士的三家教学医院收集了总共223株非重复的铜绿假单胞菌菌株。采用 Kirby-Bauer和E-test法测定碳青霉烯类药物（亚胺培南、美罗培南、多黏菌素B和厄他培南）的药敏性和最低抑菌浓度（MIC）。对耐碳青霉烯类铜绿假单胞菌分离株进行联合纸片（CD）试验、MBL E-test和PCR。
在所有铜绿假单胞菌分离株中，58.7%对亚胺培南耐药，而对美罗培南、多黏菌素B和厄他培南的耐药率分别为31.8%、13.5%和74.4%。在所有铜绿假单胞菌分离株中，44.4%为多重耐药，13.45%对所有碳青霉烯类药物耐药。与其他表型试验相比，多黏菌素B纸片/750μg乙二胺四乙酸（EDTA）联合纸片试验效率最高。分别在11.7%和0.4%的分离株中检测到bla IMP和bla VIM基因。未观察到bla SPM和bla NDM基因。
为有效治疗耐碳青霉烯类铜绿假单胞菌感染，应考虑通过简单且廉价的方法对产MBL的铜绿假单胞菌进行流行病学和区域评估。
