PREVALENCE OF PLASMID MEDIATED AMINOGLYCOSIDE MODIFYING ENZYMES IN PSEUDOMONAS AERUGINOSA IN HOSPITALIZED PATIENTS AT A TERTIARY CARE CENTRE.

Abstract

Background:-Pseudomonas aeruginosa is an important cause of hospital-acquired infection. It is frequently recovered species from clinical specimens and multidrug-resistant are increasingly being reported worldwide. In spite of high resistance, aminoglycosides are still an important treatment option in infection with P. aeruginosa. The major factor responsible for aminoglycoside resistance is Aminoglycoside-modifying enzymes (AMEs), carried by mobile genetic elements. Aim: The study was conducted to determine the prevalence of plasmid-mediated AME coding genes in P. aeruginosa. Methods: One hundred and forty consecutive, non-repeat isolates of P. aeruginosa were collected from various clinical samples. Sensitivity to amikacin, gentamicin, netilmicin, and tobramycin were detected by Kirby-Bauer disc diffusion method. AMEs-coding genes were detected by the molecular method. Result: Out of the 140 isolates, 62.14% were resistant to amikacin, 80% to gentamicin, 77.86% to netilmicin and 72.86% to tobramycin. 77.14% isolates were found to carry AMEs-coding genes. aac(6')-I was the most frequently encountered gene (58.57%) present either singly or in combinatios, followed by ant(2")-I (50%) and aph(3')-I (32.14%). Conclusions: Markedly high resistance was observed against all aminoglycoside tested along with the high prevalence of AMEs-coding genes. These isolate may represent as potential reservoirs of aminoglycoside resistance in hospitals, having combinations of AMEs-coding genes on their plasmids. Good infection control practices and antibiotic stewardship programme are very important to prevent the spread of infections.