KV Yogeesha Babu1, Amruta Kumari2, Arun Kumar3, KG Raghu Kumar1
1Department of Microbiology, SS Institute of Medical Sciences and Research Centre, Jnanashankara, NH-4 Bypass Road, Davanagere, India.
2Department of Microbiology, Government Medical College Mysore and Research Centre, Mysore, Karnataka, India.
3Department of Anesthesiology and Critical Care Medicine, SS Institute of Medical Sciences and Research Centre, Jnanashankara, NH-4 Bypass Road, Davanagere, India.
Background: Imipenem-resistant metallo-beta-lactamase Positive Pseudomonas aeruginosa (IR-MBLP-PA) infections occur as outbreaks and epidemics with a potential to spread within and between hospitals and intercontinentally. Limited data is available on IR-MBLP-PA carriers and their role as source and/or reservoir of nosocomial infection. Objectives: Detection and antibiogram typing of IR-MBLP-PA from healthy healthcare workers (HCW) from different areas of hospital and to assess role of carriers as source and/or reservoir of nosocomial infections. Material and Methods: Specimens from 200 HCWs [ICUs (120), General wards (40) and OPDs (40)] were collected from axilla, hands, stool and throat and processed by standard laboratory procedures. IR-MBLP-PA detection is done by IMIPENEM+EDTA combined disc test. Antibiogram typing is done. Association of carriers with clinical cases is done by IR-MBLP-PA with identical antibiogram type from carriers and cases. Distribution of carriers was assessed by Chi-square test. Results: Incidence of P. aeruginosa and IR-MBLP-PA carriers among HCWs was 25%, 3.21% in ICUs, 10% from general wards and 0% from OPDs. A total of five IR-MBLP-PA antibiogram types were observed from four carriers and none from general wards and OPDs. Distribution of P. aeruginosa and IR-MBLP-PA carriers in different areas of hospital was not statistically significant with P values of 0.058 and 0.76, respectively. Conclusions: Role of IR-MBLP-PA carriers as source and/or reservoirs of infections could not be assessed with certainty; however, the possibility cannot be ruled out. Periodic carrier studies in targeted high risk areas of hospital should be undertaken.
Keywords: Imipenem-resistant metallo-beta-lactamase positive P. aeruginosa (IR-MBLP-PA), Carriers, Healthcare workers.