Prevalence of Metallo-beta-lactamase Production in Imipenem-resistant Pseudomonas in Tertiary Care Center at Kota Region

Introduction: Pseudomonas spp. is common cause of nosocomial infection. Metallo-beta-lactamase (MBL) production is an important cause of antimicrobial drug resistance in Pseudomonas. Determination of their prevalence is essential to form an effective antibiotic policy and for prevention of their spread in hospital and community. Objective: To detect the prevalence of MBL production in imipenem-resistant Pseudomonas isolated from different clinical samples and their antibiotic sensitivity profile. Methods: Pseudomonas isolates from various clinical samples were subjected to antibiotic susceptibility testing by Kirby-Bauer disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. Imipenem-resistant Pseudomonas isolates were further processed for MBL detection by combined disc synergy test (CDST) and double disc synergy test (DDST) with imipenem. Result: Among 7493 processed clinical specimens, 202 Pseudomonas spp. were isolated. Of these, a total of 73 Pseudomonas spp. was found resistant to imipenem. 69 (94.52%) imipenem-resistant Pseudomonas isolates were positive for MBL by CDSTimipenem- EDTA (CDST-IPM) method, whereas 65 (89.04%) were positive by DDST-IPM method, respectively. MBL positive Pseudomonas was most prevalent in pus (36.23%). MBL-producing Pseudomonas was most susceptible to piperacillintazobactam combination (43.48%). All MBL-producing Pseudomonas isolates were resistant to ceftriaxone. Conclusion: MBL-producing Pseudomonas was highly prevalent in Kota region, which is one of the major causes of resistance to imipenem and other antimicrobial agents. There is a requirement of regular surveillance and strict antibiotic policy to fight against these multi-drug resistant pathogens.