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Ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae carrying multiple

Mayank Dwivedi1, Anshuman Mishra, Afzal Azim

  • 1Department of Critical Care Medicine, SGPGIMS, Lucknow, India.

Indian Journal of Pathology & Microbiology
|August 15, 2009
PubMed
Abstract

Insights

Metallo-beta-lactamase (MBL) producing Enterobacteriaceae are linked to ventilator-associated pneumonia (VAP) in ICUs. The study found multiple MBL genes in these bacteria, raising concerns about the spread of antibiotic resistance.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Ventilator-associated pneumonia (VAP) is a significant hospital-acquired infection in intensive care units (ICUs).
  • Enterobacteriaceae are common VAP pathogens, often treated with carbapenems.
  • Metallo-beta-lactamase (MBL) production can confer carbapenem resistance, potentially evading standard susceptibility tests.

Purpose of the Study:

  • To investigate the association between MBL-producing Enterobacteriaceae and VAP in an ICU setting.
  • To identify the prevalence and genetic characteristics of MBL-producing Enterobacteriaceae in VAP cases.

Main Methods:

  • Respiratory samples from VAP patients were collected and processed.
  • Enterobacteriaceae isolates were identified, and antibiotic susceptibilities were tested.
  • Carbapenem-resistant isolates underwent phenotypic and genotypic testing for MBL detection.

Main Results:

  • Twelve out of 64 Enterobacteriaceae isolates were identified as MBL producers.
  • The bla(IMP) gene was the most frequently detected MBL gene.
  • Three strains exhibited the simultaneous presence of multiple MBL genes.

Conclusions:

  • The co-occurrence of multiple MBL genes in Enterobacteriaceae represents a serious public health concern.
  • The mobile genetic elements associated with MBL genes (integrons, transposons, plasmids) facilitate their rapid spread.
  • This genetic mobility increases the risk of MBL gene dissemination to other bacterial pathogens.

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