title: First Survey of Metallo-β-Lactamase Producers in Clinical Isolates of Pseudomonas aeruginosa From a Referral Burn Center in Kurdistan Province.
abstract: BACKGROUND
  Treatment of infectious diseases is becoming more challenging with each passing year. This is especially true for infections caused by Pseudomonas aeruginosa, an opportunistic pathogen with the ability to rapidly develop resistance to multiple classes of antibiotics.
  
  
  OBJECTIVE
  This study was conducted to determine the prevalence of metallo-β-lactamase (MBL)-producing strains among multidrug-resistant P. aeruginosa strains isolated from burn patients.
  
  
  METHODS
  The isolates were identified, tested for susceptibility to various antimicrobial agents, and screened for the presence of MβLs by using the double-disk synergy test. The minimal inhibitory concentration of imipenem was determined by microplate broth dilution method on Mueller-Hinton agar. To detect VIM, SIM, and GIM MBLs, the isolates were subjected to polymerase chain reaction.
  
  
  RESULTS
  In this study, we identified 100 P. aeruginosa isolates from 176 clinical specimens obtained from burn patients. The isolates showed maximum resistance to ampicillin (100%), ceftazidime (94%), and ceftriaxone (89%). The CLSI-MBL phenotypic test showed that of the 100 P. aeruginosa isolates, 22 (22%) were positive for MBL production in the double-disk synergy test. Of the 22 MBL-positive P. aeruginosa isolates, 8 were resistant to imipenem. PCR analysis showed that 8 isolates were positive for blaVIM1. The other genes blaSIM1 and blaGIM1 were not detected.
  
  
  CONCLUSIONS
  The study results demonstrate the serious therapeutic threat of the spread of MBL producers among P. aeruginosa populations. Metallo-β-lactamases were detected in 22% of imipenem-resistant P. aeruginosa isolates. Early detection and infection-control practices are the best antimicrobial strategies for this organism; therefore, systematic surveillance to detect MBL producers is necessary.
authors.affiliation: Envirronmental Health Resaerch Center, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Enayatollah
authors.initials: E
authors.lastname: Kalantar
authors.affiliation: Department of Biological Sciences, Islamic Azad University, Sciences Research Branch, Tehran, IR Iran.
authors.forename: Vahideh
authors.initials: V
authors.lastname: Torabi
authors.affiliation: Department of Microbiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Heiman
authors.initials: H
authors.lastname: Salimizand
authors.affiliation: School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Soheili
authors.affiliation: Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Soheila
authors.initials: S
authors.lastname: Beiranvand
authors.affiliation: Division of Microbiology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Soltan Dallal
keywords: Burn Patients; Imipenem Resistance; Metallo-β-lactamase; P. aeruginosa