Agarwal Anjali, Srivastava Jyoti, Maheshwari Ujjwal, Iftikhar Mohd
Department of Microbiology, Hind Institute of Medical Sciences, Barabanki, India.
Department of Cardiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.
J Lab Physicians. 2018 Apr-Jun;10(2):149-154. doi: 10.4103/JLP.JLP_76_17.
Carbapenemase-producing microorganisms are becoming a major concern among hospital-acquired infections. There is also increased multidrug resistance seen among these isolates.
We have conducted this study to determine the prevalence of New Delhi metallo-beta-lactamase-1 (NDM-1) gene-producing among hospitalized patients in a tertiary care hospital in Northern India.
The study was conducted in the Department of Microbiology with the tertiary care hospital settings. It was a prospective cross-sectional observational study conducted during January 2014-August 2014.
A total of 500 nonduplicate samples were processed. The isolates with reduced susceptibility to ertapenem, i.e., zone diameter between 19 and 21 mm, were considered carbapenemase producers. These isolates were subjected to modified Hodge test for phenotypic confirmation. Polymerase chain reaction was performed on all the screened isolates for molecular detection of NDM-1 gene.
Chi-square test was used to analyze the data and < 0.05 was considered statistically significant.
Out of 500 isolates, 61 (12.2%) were screened for carbapenemase production. 47 (9.4%) isolates were positive by modified Hodge test and 36 (7.2%) isolates showed the presence of NDM-1 gene ( < 0.05).
There is an increased prevalence of NDM-1 gene-producing isolates. These carbapenemase-producing isolates are more resistant to other group of antibiotics (aminoglycosides, fluoroquinolones along with β-lactam group). Early detection of NDM-1 gene can help in choosing the effective treatment options for hospitalized patients in time, thereby reducing the risk of mortality.
产碳青霉烯酶微生物正成为医院获得性感染中的一个主要问题。这些分离株中还出现了多药耐药性增加的情况。
我们开展这项研究以确定印度北部一家三级护理医院住院患者中产新型德里金属β-内酰胺酶-1（NDM-1）基因的情况。
该研究在设有三级护理医院的微生物学系进行。这是一项于2014年1月至2014年8月期间开展的前瞻性横断面观察性研究。
共处理了500份非重复样本。对厄他培南敏感性降低的分离株，即抑菌圈直径在19至21毫米之间的分离株，被视为产碳青霉烯酶菌株。这些分离株接受改良Hodge试验进行表型确认。对所有筛选出的分离株进行聚合酶链反应以检测NDM-1基因。
采用卡方检验分析数据，P<0.05被认为具有统计学意义。
在500株分离株中，61株（12.2%）被筛选用于检测碳青霉烯酶产生情况。47株（9.4%）分离株改良Hodge试验呈阳性，36株（7.2%）分离株显示存在NDM-1基因（P<0.05）。
产NDM-1基因的分离株患病率有所增加。这些产碳青霉烯酶的分离株对其他类抗生素（氨基糖苷类、氟喹诺酮类以及β-内酰胺类）耐药性更强。早期检测NDM-1基因有助于及时为住院患者选择有效的治疗方案，从而降低死亡风险。
