title: Emerging Carbapenem-ResistantPseudomonas aeruginosaIsolates CarryingblaIMPAmong Burn Patients in Isfahan, Iran.
abstract: BACKGROUND
  Metallo-β-lactamase (MBL)-producingPseudomonas aeruginosais a significant pathogen in burn patients.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence of carbapenem-resistantP. aeruginosaisolates, including those resistant to imipenemase (IMP), in a burn unit in Isfahan, Iran.
  
  
  METHODS
  One hundred and fiftyP. aeruginosaisolates from burn patients were tested for antibiotic susceptibility by the disc diffusion method in accordance with CLSI guidelines. Production of MBL was identified with the EDTA disk method. DNA was purified from the MBL-positive isolates, and detection of theblaIMPgene was performed with PCR.
  
  
  RESULTS
  Fifty-seven out of 150 (38%) isolates were multi-drug resistant (MDR), and 93 (62%) were extensively-drug resistant (XDR). Among all isolates, the resistance rate to ciprofloxacin, tobramycin, imipenem, meropenem, amikacin, ceftazidime, and cefepime was higher than 90%, while the resistance rates to piperacillin/tazobactam and aztreonam were 70.7% and 86%, respectively. Colistin and polymyxin B remained the most effective studied antibiotics. All of the imipenem-resistantP. aeruginosaisolates were MBL-positive, and 107 out of 144 (74.3%) of the MBL isolates were positive for theblaIMPgene.
  
  
  CONCLUSIONS
  The results of this study show that the rate ofP. aeruginosa-caused burn wound infections was very high, and many of the isolates were resistant to three or more classes of antimicrobials. Such extensive resistance to antimicrobial classes is important because few treatment options remain for patients with burn wound infections.blaIMP-producingP. aeruginosaisolates are a rising threat in burn-care units, and should be controlled by conducting infection-control assessments.
authors: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors: Mohsen
authors: M
authors: Radan
authors: Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran.
authors: Rezvan
authors: R
authors: Moniri
authors: Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran.
authors: Ahmad
authors: A
authors: Khorshidi
authors: Faculty of Health, Department of Epidemiology, Kashan University of Medical Sciences, Kashan, IR Iran.
authors: Hamidreza
authors: H
authors: Gilasi
authors: Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, IR Iran.
authors: Zohreh
authors: Z
authors: Norouzi
authors: Department of Genetic, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran.
authors: Fahimeh
authors: F
authors: Beigi
authors: University of Maryland College Park, Maryland, United States of America.
authors: Yasaman
authors: Y
authors: Dasteh Goli
keywords: Antibiotic Resistance; Burn; Carbapenem-Resistant; Metallo-Beta-Lactamase; P. aeruginosa