Nivitha, M (2016) Identification Of Non Fermenting Gram Negative Bacilli From Clinical, Environmental Samples, their Antimicrobial Resistance and Detection Of blaVIM/blaIMP genes in Imipenem resistant isolates. Masters thesis, Chennai Medical College Hospital and Research Centre, Trichy.
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Abstract
INTRODUCTION: Non-fermenting gram negative bacilli (NFGNB) are a group of aerobic, nonspore forming bacilli. They are ubiquitous in nature, inhabiting soil, water and also present in the hospital environment. NFGNB accounts for nearly 12-16% of all bacterial isolates in a clinical microbiology laboratory. The important members are Pseudomonas aeruginosa, Acinetobacter baumannii. They cause various infections such as septicemia, meningitis, pneumonia, UTI, and surgical site infections. Risk factors include immunosuppression, trauma, foreign body, infused body fluids, indwelling catheters, prolonged hospital stay and using broad spectrum antibiotics. MATERIALS AND METHODS: A hospital based cross-sectional descriptive study was undertaken between August 2014 to May 2015 to isolate NGFNB from various clinical samples received for culture and sensitivity in department of microbiology and environmental samples from ICUs and burns unit in tertiary care hospital, Trichy. The NFGNBs were identified using standard methods and antimicrobial susceptibility test was performed to determine the sensitivity pattern of the isolates. The isolates were screened for imipenem resistance and various phenotypic methods like combined disk method, EDS disk synergy test, MBL E- test were performed for identification of MBL genes. Genotypic detection of blaVIM and blaIMP genes was performed using multiplex PCR. RESULTS: NFGNB was isolated most commonly from pus sample (52.3%). The commonest NFGNB to be isolated was P.aeruginosa (58%) followed by A.baumannii (20%). P.aeruginosa showed highest sensitivity to imipenem (86%) and A.baumannii showed highest sensitivity to Aztronam (80%).14% of P.aeruginosa were resistant to imipenem, and 57% of A.baumannii were resistant to imipenem. In phenotypic tests for MBL detection, 6, 8 and 10 isolates showed positivitiy for MBL gene by Combined disc test, EDS test, MBL E test respectively. Genotypic study showed that blaIMP was present in 7 isolates blaVIM gene 3, and in one isolate both the genes were present. In hospital environment P.aeruginosa was isolated in 5 sites and A,baumannii in 2 sites. All the isolates were sensitive strains. CONCLUSION: It is evident from the study that NFGNB are becoming resistant to carbapenems. To prevent the spread of the resistant bacteria, it is critically important to have strict antibiotic policies.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Non-fermenting gram negative bacilli ; Carbapenem Resistance ; Metallo Beta Lactamase ; blaIMP ; blaVIM gene. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Punitha K |
| Date Deposited: | 27 Jun 2017 07:13 |
| Last Modified: | 27 May 2018 04:53 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/417 |
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