NEW DELHI METALLO-BETA-LACTAMASE PRODUCING CARBAPENEM-RESISTANT GRAM-NEGATIVE BACILLI: MICROBIOLOGICAL AND GENOTYPIC ANALYSES AT A TERTIARY CARE HOSPITAL IN PAKISTAN

Authors

  • Faryal Yunus Bahria University Medical and Dental college , PNS Shifa ,DHA Phase 2, Karachi
  • Faisel Yunus Department of Public Health, Institute for Health Upgrowth, Luton, United Kingdom Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan
  • Mateen Izhar Chairman Shaikh Zayed Hospital , Lahore. Principal Shaikh Khalifa Bin Zayed Al-Nahyan Medical & Dental College, Lahore. Department of Microbiology and Virology, Division of Pathology, Shaikh Zayed Federal Postgraduate Medical Institute, Lahore, Pakistan

Abstract

Background: Metallo-beta-lactamases (MBL) catalyze the hydrolysis of beta-lactam antibiotics including carbapenems. A novel MBL subtype, New Delhi MBL (NDM), poses a serious public health problem. The aims of this study were to determine the frequency of NDM producers among the Carbapenem-resistant gram-negative bacilli (GNB) in hospitalized patients and carrying out the molecular analysis of the NDM genes as reliable data on this is not available in Pakistan. Methods: We carried out a cross-sectional study on prospectively collected clinical samples from 113 patients hospitalised at Shaikh Zayed Hospital Lahore, Pakistan. All the samples that were carbapenem-resistant on routine sensitivity testing were selected for this study. Various microbiological and genotypic analyses of the samples were performed. Results: The mean age of the patients was 47.8±20.8 years. About a quarter (25.7%) of the samples was from the urology ward and 43% were urine samples. Around two-third of the samples (n=74, 65.5%) tested positive for Non-Enterobacteriaceae GNB. Pseudomonas spp was the most common isolate among the Non-Enterobacteriaceae and E-coli amongst the Enterobacteriaceae. NDM gene was detected in 22 patients (19.5%). We did not find any association of the NDM gene with the demographic and clinical characteristics. Conclusion: NDM-positive GNB are present in our hospitalized patients, which is worrisome as these bacteria can disseminate globally and lead to an extensive and uncontrollable spread of pandemic clones for which efficient antibiotic therapy is currently not available. Systemic surveillance network and infection control strategies should be established to curtail dissemination of NDM-producing GNB in Pakistan.Keywords: Gram-Negative Bacteria; Extended Spectrum Beta Lactamase; New Delhi metallo-beta-lactamase; Carbapenem-Resistant Enterobacteriaceae; Health Care Associated Infections; Pakistan

Author Biographies

Faryal Yunus, Bahria University Medical and Dental college , PNS Shifa ,DHA Phase 2, Karachi

Dr.Faryal Yunus,MBBS,M.Phil Microbiology,FCPS 2(Resident)Assistant Professor Bahria University Medical and Dental college,DHA phase 2,KarachiPNS Shifa ,DHA Phase 2, Karachi

Faisel Yunus, Department of Public Health, Institute for Health Upgrowth, Luton, United Kingdom Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan

Dr.Faisel Yunus MBBS, MPH, FFPHDepartment of Public Health, Institute for Health Upgrowth, Luton, United KingdomProject Director & Director Research, Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan

Mateen Izhar, Chairman Shaikh Zayed Hospital , Lahore. Principal Shaikh Khalifa Bin Zayed Al-Nahyan Medical & Dental College, Lahore. Department of Microbiology and Virology, Division of Pathology, Shaikh Zayed Federal Postgraduate Medical Institute, Lahore, Pakistan

Dr.Mateen Izhar MBBS, MSc, PhD,FRCPathChairman Shaikh Zayed Hospital , LahorePrincipal Shaikh Khalifa Bin Zayed Al-Nahyan Medical & Dental College, LahoreHead of Department of Pathology and Department of Microbiology and Virology, Shaikh Zayed Federal Postgraduate Medical Institute, Lahore, Pakistan

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Published

2019-08-07

Issue

Vol. 31 No. 3 (2019): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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