Identification of Carbapenemase Enzymes in Clinical Isolates of Enterobacteriaceae Using Modified Hodge Test

Document Type : Original Article (s)

Authors

1 Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

2 Professor, Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran

3 Associate Professor, Brucellosis Research Center AND Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Background: Carbapenem antibiotics are a subtype of beta-lactam antibiotics, which can play an important role in the treatment of severe infections and multi-drug resistant bacteria. The most important mechanism of resistance to carbapenems is carbapenemase production. Since these enzymes are located on mobile genetic elements such as plasmids, they can rapidly spread among gram-negative bacteria.Methods: A total of 500 Enterobacteriaceae clinical isolates were collected in Hamadan city, Iran, during October 2012 to June 2013. The isolates detected by biochemical tests and confirmed by polymerase chain reaction (PCR) method. Antimicrobial susceptibility patterns were determined using the agar diffusion method for 14 antibiotics. Modified Hodge test (MHT) was used for carbapenemase production in the resistant isolates to carbapenem antibiotics.Findings: Among the family members of Enterobacteriaceae, Escherichia coli (66.8%), Klebsiella spp. (21.2%) and Proteus spp. (6.8%) showed the highest role in infections, respectively. These organisms showed the highest resistance to cefotaxime (64.2%), aztreonam (59.3%) and cotrimoxazole (58.6%). Out of 40 isolates which were intermediate or non-susceptible for carbapenems, 29 (72.5%) were positive for carbapenemase production by Modified Hodge test.Conclusion: Over the past decade, carbapenem-resistant Enterobacteriaceae have emerged and spread throughout the world. Widespread emergence of carbapenem-resistant isolates has been increasing concerned in recent years; because the Carbapenem antibiotics are often used as the last line of treatment for severe infections caused by resistant Gram-negative bacilli including Enterobacteriaceae family. Modified Hodge test can be used as a simple method for the identification of carbapenemase-producing strains in gram-negative strains.

Keywords

References

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Journal of Isfahan Medical School
Volume 32, Issue 278 - Serial Number 278
January and February 2014
Pages 308-320

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History

  • Receive Date: 26 January 2014
  • Revise Date: 29 April 2024
  • Accept Date: 06 April 2022

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