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Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection

The clinical utility of carbapenems is under threat with the emergence of acquired carbapenemases producing bacteria, particularly metallo-~-lactamases (MBLs). Such enzymes have emerged in bacteria in many geographical locations and often confer highlevel of resistance to all ~lactams antibiotics...

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Main Author: Ng Woei, Kean
Format: Monograph
Language:English
Published: Pusat Pengajian Sains Perubatan Universiti Sains Malaysia 2008
Subjects:
R Medicine (General)
Online Access:http://eprints.usm.my/50699/1/NG%20WEN%20JIE%20-%2024%20pages.pdf
http://eprints.usm.my/50699/
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spelling my.usm.eprints.50699 http://eprints.usm.my/50699/ Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection Ng Woei, Kean R Medicine (General) The clinical utility of carbapenems is under threat with the emergence of acquired carbapenemases producing bacteria, particularly metallo-~-lactamases (MBLs). Such enzymes have emerged in bacteria in many geographical locations and often confer highlevel of resistance to all ~lactams antibiotics except aztreonam. The prevalence of MBLs have been studied in many countries but not been done yet in Malaysia. Besides, rapid detection of MBLs-producing Gram-negative bacilli is critical to prevent their widespread dissemination. Thus far, no standardized detection method is available for routine laboratory used. The purpose of the study is to detennine the isolation rate of MBLsproducing P. aeruginosa, Acinetobacer baumannii and Acinetobacter spp in clinical samples from Hospital Universiti Sains Malaysia (HUSM) within year 2007 and also to develop a chelating agent based double disk synergic test and disk potentiation test for detection of MBL-producing P. aeruginosa and Acinetobacter isolated from clinical samples. During year 2003-2007, the resistance of P. aeruginosa to imipenem (carbapenem group's antibiotic) ranged between 11-20 % while for Acinetobacter spp it was 44-71 %. Out of the 22 strains of carbapenem resistant P. aeruginosa, 17 (77 .3 %) were positive for MBLs. However, only 3.5 % Acinetobacter spp was positive for MBLs. None of the Acinetobacter baumannii was positive for MBL. The disk potentiation test with 2-mercaptopropionic acid (2-MP A) in dilution of 1: 12 provided more conclusive and accurate result in detecting MBL-producing strains. In disk potentiation test, the diameter of enlargement of growth inhibitory zone by 5 mm or more (cutoff value) around CAZ + 2- MP A disk compared to CAZ disk has accurately detected MBL-producing strains. The sensitivity and specificity of the test was 89.5% and 100% respectively for P. aeruginosa and I 00 % sensitivity and specificity for Acinetobacter. This study is the first report of high prevalence of MBL-producing P. aeruginosa in a tertiary care hospital in Malaysia. The study also reports the validation of a simple and accurate MBL detection method that can be easily incorporated into the routine clinical laboratory. Pusat Pengajian Sains Perubatan Universiti Sains Malaysia 2008 Monograph NonPeerReviewed application/pdf en http://eprints.usm.my/50699/1/NG%20WEN%20JIE%20-%2024%20pages.pdf Ng Woei, Kean (2008) Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection. Other. Pusat Pengajian Sains Perubatan Universiti Sains Malaysia. (Submitted)
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Ng Woei, Kean
Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection
description The clinical utility of carbapenems is under threat with the emergence of acquired carbapenemases producing bacteria, particularly metallo-~-lactamases (MBLs). Such enzymes have emerged in bacteria in many geographical locations and often confer highlevel of resistance to all ~lactams antibiotics except aztreonam. The prevalence of MBLs have been studied in many countries but not been done yet in Malaysia. Besides, rapid detection of MBLs-producing Gram-negative bacilli is critical to prevent their widespread dissemination. Thus far, no standardized detection method is available for routine laboratory used. The purpose of the study is to detennine the isolation rate of MBLsproducing P. aeruginosa, Acinetobacer baumannii and Acinetobacter spp in clinical samples from Hospital Universiti Sains Malaysia (HUSM) within year 2007 and also to develop a chelating agent based double disk synergic test and disk potentiation test for detection of MBL-producing P. aeruginosa and Acinetobacter isolated from clinical samples. During year 2003-2007, the resistance of P. aeruginosa to imipenem (carbapenem group's antibiotic) ranged between 11-20 % while for Acinetobacter spp it was 44-71 %. Out of the 22 strains of carbapenem resistant P. aeruginosa, 17 (77 .3 %) were positive for MBLs. However, only 3.5 % Acinetobacter spp was positive for MBLs. None of the Acinetobacter baumannii was positive for MBL. The disk potentiation test with 2-mercaptopropionic acid (2-MP A) in dilution of 1: 12 provided more conclusive and accurate result in detecting MBL-producing strains. In disk potentiation test, the diameter of enlargement of growth inhibitory zone by 5 mm or more (cutoff value) around CAZ + 2- MP A disk compared to CAZ disk has accurately detected MBL-producing strains. The sensitivity and specificity of the test was 89.5% and 100% respectively for P. aeruginosa and I 00 % sensitivity and specificity for Acinetobacter. This study is the first report of high prevalence of MBL-producing P. aeruginosa in a tertiary care hospital in Malaysia. The study also reports the validation of a simple and accurate MBL detection method that can be easily incorporated into the routine clinical laboratory.
format Monograph
author Ng Woei, Kean
author_facet Ng Woei, Kean
author_sort Ng Woei, Kean
title Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection
title_short Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection
title_full Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection
title_fullStr Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection
title_full_unstemmed Studies On Metallo-fJ-Lactamse Producing Pseudomonas Aeruginosa And Acinetobacter In A Tertiary Care Hospital And Development Of A Simple Screening Test For Its Detection
title_sort studies on metallo-fj-lactamse producing pseudomonas aeruginosa and acinetobacter in a tertiary care hospital and development of a simple screening test for its detection
publisher Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
publishDate 2008
url http://eprints.usm.my/50699/1/NG%20WEN%20JIE%20-%2024%20pages.pdf
http://eprints.usm.my/50699/
_version_ 1717094542245625856
score 13.211869

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