STUDY OF METALLO BETA LACTAMASE IN MEROPENEM RESISTANT CLINICAL ISOLATES IN A TERTIARY CARE HOSPITALVIVEK AGWAN, RITU KANSAL, ASHISH ASTHANA AND MOLLY MADAN
This study was undertaken to detect metallo-ß-lactamase (MBL) in meropenem resistant clinical isolates of Gram negative bacteria. A total of 100 clinical isolates of meropenem resistant Gram negative bacteria, were selected for this study. All the isolates were screened for MBL production, by EDTA disk synergy (EDS) test, using both imipenem and meropenem separately. Among the 100 meropenem resistant clinical isolates 29 were found to be MBL producers. MBL production was detected in 19 out of 38 (50.0%) Pseudomonas species, 3 out of 46 (6.5 %) Acinetobacter species, 5 out of 9 (55.5%) Klebsiella species, 1 out of 6 (16.6%) Escherichia coli and 1 (100.0%) Citrobacter species. MBL production is an important mechanism of carbapenem resistance and its prevalence amongst Gram negative bacteria is being increasing reported worldwide, not only in Pseudomonas species but also amongst other Gram negative bacteria. Detection of MBL producing gram negative bacilli is crucial for optimal treatment of patients and also to control the spread of resistance. EDS test is a sensitive test and is better than or comparable to other phenotypic tests for MBL detection. In our study EDS test using imipenem detected 29 and using meropenem detected 23 MBL producers. The difference between MBL producers detected by EDS test using imipenem and meropenem was 6 (P=0.970), which is not significant. Being inexpensive and easy to perform, EDS test using imipenem can become part of mainstream clinical laboratory testing for MBL.
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