Epidemiological Pattern of Non-fermenting Metallo Beta Lactamase Producing Bacterial Pathogens Isolated from Clinical Specimens in a Tertiary Care Hospital in Kakinada, India

Abstract

Background: Non-fermentative Gram negative bacilli are known causative pathogens responsible for hospital associated infection and responsible high morbidity and mortality rate across all genders and ages. Objectives: This study examined the prevalence of Non-fermentative Gram negative isolates expressing Metallo beta-lactamase isolates (NFGNB-MBL) among carbapenem-resistant isolated from clinical specimens and the epidemiological pattern (Age, Sex and Source of infection). Methodology: A total of 250 clinical specimens from diverse infections were collected and analyzed, using standard microbiological methods. For MBL detection, two previously described methods were employed i.e. Imipenem-EDTA combined disc test and Imipenem-EDTA double disc synergy test (DDST). Results: Sixty (24%) NFGNB isolates were identified; highest of isolation was recovered from hospital associated infections (93.33%). Pseudomonas aeruginosa accounted for n=40 (66.67%) followed by Acinetobacter baumannii n=10 (16.67%), Alcaligenes faecalis n=6 (10%) and Stenotrophomonas maltophilia n=4 (6.66%) respectively. The isolates showed high sensitivity to imipenem and least sensitivity to Gentamicin. All the carbapenem resistant isolates of non-fermenters showed Metallo-beta lactamase production. Conclusion: The prevalence of MBL producing isolates and association with hospital infection is of clinical concern and the therapeutic option in treatment and management of patients may be futhered worsen.