Imipenem resistant Metallo –Beta-lactamase producing Pseudomonas aeruginosa (IR-MBLP-PA) are an emerging threat causing noscomial infections with increased mortality and morbidity and with a potential to spread rapidly and cause outbreaks and epidemics. Very little data is available after review of literature on detection of IR-MBLP-PA from hospital environmental sources and their role as source and/or reservoir of nosocomial infections. The present study was conducted to detect IR-MBLP-PA from different hospital environmental sources from different areas of hospital, Antibiogram typing, to assess their role as source and /or reservoir of nosocomial infections and study the impact of infection control measures on environmental sources of IR-MBLP-PA. 460 environmental specimens collected and processed by standard laboratory procedures. Susceptibility testing done by Kirby-Bauer’s disc diffusion method. IR-MBLP-PA detection was done by IMIPENEM+EDTA combined disc test. Antibiogram typing done. Association with clinical cases done by strain of same antibiogram type from environmental source and case. Impact of Infection control measures were assessed by percentage reduction of IR-MBLP-PA isolates from respective environmental sources.
Study reported an incidence of 24.78 %;5.65 % and 3.48%;1.08% for Pseudomonas aeruginosa and IR-MBLP-PA respectively, before and after strict infection control measures. High incidence of IR-MBLP-PA of 14.8% and 10.52% in suction apparatus and mops respectively, 11.53%, 8.89% and 8.24% in Burns ward, ICCU and MICU respectively was reported. Six of the eight IR-MBLP-PA antibiogram types from environmental sources could be associated with fourteen nosocomial infections with two strains with no association. Strain 1 (Resistant to all antibiotics used) was most common strain (30.76%) associated with six nosocomial infections during the study period. Sinks, suction apparatus were observed to be high risk sources and/or reservoirs of IR-MBLP-PA. MICU and ICCU were found to be high risk areas of environmental isolates necessitating periodic environmental sampling for their detection. Hospital air, aprons and gowns of health care workers, curtains, beddings and linen were not found to be important reservoirs of IR-MBLP-PA. Infection control measures according to CDC guidelines reduced the incidence of environmental IR-MBLP-PA isolates.
Imipenem resistant Metallo-Beta-lactamase positive Pseudomonas aeruginosa (IR-MBLP-PA), Environmental sources, Infection control measures
© 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.