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Reasonable Detection Tests of Metallo Beta-Lactamases and Oxacillinases Products in Carbapenem-Resistant Acinetobacter Strains

Hazem Hamed, Asaad Gaber, Mohammed Ali Ahmed Eid.




Abstract

Acinetobacter baumannii (A. baumannii) is suggested to be common cause infection and outbreaks. Carbapenems are often used as antibiotics of last resort for treating infections caused by A. baumannii. Metallo beta-lactamases (MBL) are liable for carbapenem resistance, as well as oxacillinases (OXA). A total of 70 non-repetitive imipenem and meropenem resistant Acinetobacter species were isolated from clinical samples. The VITEK-2 system was used for species identification and detection of antibiotic susceptibility. This was followed by modified Hodge test (MHT) and combined disc diffusion test (CDDT) for phenotypic detection of carbapenemase (also referred to OXA-like) and metallo-β-lactamase enzyme production, respectively. 92.8 % of the A. baumannii isolates were carbapenem-resistant, of which 100% were carbapenemase producers by MHT, and only 15.4% were metallo-β-lactamase producers by CDDT. PCR was used to detect carbapenemase genes (blaOXA-23, blaOXA-24, blaOXA- 51, and blaOXA-58). Our data showed that resistance to carbapenems is due to the presence of blaOXA-23, blaOXA-58 and blaOXA-24 genes. Resistance to imipenem was found to be a better indicator of MBL production. IPM-EDTA disk synergy test appears to be useful in differentiating MBL and non-metalloenzyme producers. During this study, we reported a reasonable detection tests of MBL and OXA producing species as a crucial step for an efficient infection control policy and may to prevent their uncontrolled spread in clinical settings.

Key words: Acinetobacter baumannii, Antibiotic resistance, Carbapenem resistance, Modified Hodge Test, Combined Disc Diffusion test.






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