ISSN: 0973-7510

E-ISSN: 2581-690X

K.V. Yogeesha Babu1 , V. Vijayanath2, H.P. Niranjan1 and M.R. Anitha3
1Department of Microbiology, S.S. Institute of Medical Sciences & Research Centre,
Jnanashankara, NH-4 Bypass Road, Davangere – 577 005, India.
2Department of Forensic Medicine & Toxicology, VMKV Medical College, Salem, India.
3Department of Anatomy, VMKV Medical College, Salem, India.
J Pure Appl Microbiol. 2011;5(2):695-703
© The Author(s). 2011
Received: 04/01/2011 | Accepted: 21/02/2011| Published: 31/10/2011
Abstract

Imipenem resistant Metallo –Beta-lactamase producing Pseudomonas  aeruginosa (IR-MBLP-PA) is an  emerging threat causing burns wound infections with increased mortality and morbidity and with a potential to spread rapidly resulting in  outbreaks and epidemics. Very limited data is available after review of literature on detection of IR-MBLP-PA from burns wound infections, environmental sources, their role as source and/or reservoir of nosocomial infections and impact of strict infection control measures on incidence of IR-MBLP-PA infections from burn care centers. Present study was conducted to  detect  IR-MBLP-PA from burns wound infections,  different  hospital environmental sources, their antibiogram typing, to assess the role of environmental  source and /or reservoir on nosocomial infections and study the impact of Infection control measures on environmental sources of IR-MBLP-PA. During two years study period, 226 clinical and 62 environmental and 20 hand specimens of health care workers, collected and processed by standard laboratory procedures. IR-MBLP-PA detection was done by IMIPENEM+EDTA combined disc test. Antibiogram typing done. Association with clinical cases done by isolation of strain with identical antibiogram type of IR-MBLP-PA isolate from environmental source and clinical case. Impact of Infection control measures were assessed by percentage reduction in incidence of IR-MBLP-PA isolates from respective environmental sources. Study reported an overall  incidence of 10.2%(23/226) for IR-MBLP-PA with 16.4% and 6.9% for IR-MBLP-PA before and after infection control measures respectively. Incidence of 34.78% from environmental sources and 10% (2/20) hands of HCWs was observed. Six of the eight IR-MBLP-PA antibiogram types from environmental sources and patients  could be associated with 23 burns wound  infections with two strains with no association. Strain 1 (Resistant to all antibiotics used) was most common strain (26.08%) associated with seven burns wound  infections during the study period.  Infection control measures reduced the incidence of P. aeruginosa among patients but was not successful in eradicating this organism from various environmental sources. With a high incidence of IR-MBLP-PA (10.2%), present study underscores the role of environmental source in burn care centre (sinks, suction apparatus , water of hydrotherapy tanks and mask of AMBU bags) as a source/or reservoir of infections by temporospatial association and by antibiogram typing. Although met with partial success, implementation of  CDC recommended infection control measures resulted in decreased incidence of IR-MBLP-PA burns wound infections  necessitating periodic environmental sampling for their detection. Aprons and gowns of health care workers, curtains, beddings and linen were not found to be important source/or reservoirs of IR-MBLP-PA. Resistance profile of predominant IR-MBLP-PA isolates helps in choosing initial empirical antibiotic therapy.

Keywords

Pseudomonas aeruginosa, Burns wound infections, Environmental sources, Infection control measures

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© The Author(s) 2011. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.