title: Presence of metallo-beta-lactamases (MBL), extended-spectrum beta-lactamase (ESBL) & AmpC positive non-fermenting Gram-negative bacilli among Intensive Care Unit patients with special reference to molecular detection ofblaCTX-M&blaAmpCgenes.
abstract: OBJECTIVE
  Non-fermenting Gram-negative bacilli (NFGNB) including Pseudomonas aeruginosa and Acinetobacter baumannii have been implicated in a variety of infections, particularly in the Intensive Care Units (ICUs). This study was aimed to overview the burden of multidrug-resistant NFGNB causing infections in ICU and also to assess the occurrence of extended-spectrum beta-lactamases (ESBLs), AmpC and metallo-beta-lactamases (MBLs) among these isolates.
  
  
  METHODS
  Bacterial culture, identification and antibiotic susceptibility were carried out. ESBLs and AmpC were detected both phenotypically and genotypically. MBL was detected by modified Hodge and imipenem-ethylenediaminetetraacetic acid double-disc synergy test.
  
  
  RESULTS
  NFGNB represented 45 (37%) of total 121 Gram negative isolates. Multidrug resistance was observed in 66.9 per cent and 72.5 per cent isolates of P. aeruginosa and A. baumannii, respectively. Detection by phenotypic methods showed presence of ESBL, AmpC and MBL in 21.4, 51.1 and 21.4 per cent isolates, respectively. When detected genotypically by polymerase chain reaction, ESBL and AmpC were detected in 21.4 and 41.4 per cent of NFGNB isolates, respectively. BlaCTX-M (21.4%) was the most prevalent gene responsible for ESBL production.
  
  
  CONCLUSIONS
  Most of the NFGNB isolated from ICU patients were multidrug-resistant and producers of ESBL, AmpC and MBL. A regular surveillance is required to detect ESBL, AmpC and MBL producers, especially in ICU patients.
authors.affiliation: Department of Microbiology, J. N. Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Richa
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Microbiology, J. N. Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Abida
authors.initials: A
authors.lastname: Malik
authors.affiliation: Department of Microbiology, J. N. Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Meher
authors.initials: M
authors.lastname: Rizvi
authors.affiliation: Department of Anaesthesiology, J. N. Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Moied
authors.initials: M
authors.lastname: Ahmed
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics* / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial / Q000235:genetics; D018432:Drug Resistance, Multiple / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000235:genetics / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D001618:beta-Lactamases / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C048795:AmpC beta-lactamases; D001618:beta-Lactamases; C000600039:beta-lactamase blaCTX-M, Pseudomonas aeruginosa