Evaluation of the β-Lactamase Disk Test Method in the Detection of Extended-Spectrum-β-Lactamases in Clinical Isolates of Multidrug-Resistant Pseudomonas aeruginosa

Background & Aims: The production of extended-spectrum-β-lactamases (ESBLs) is the main mechanism of resistance to β-lactam antibiotics. The outbreak of isolates simultaneously possessing several resistance mechanisms to β-lactam antibiotics caused a decrease in sensitivity of the confirmatory tests for ESBL. The aim of this study was the evaluation of the β-lactamase disk test method in the detection of ESBLs in clinical isolates of multidrug-resistant Pseudomonas aeruginosa. Methods: A total of ۱۰۰ multidrug-resistant P. aeruginosa isolates were recovered from burn patients. The sensitivity of the isolates to different antibiotics was determined using the standard disk diffusion method. ESBL-producing isolates were detected through the combination disk test with clavulanic acid, double disk synergy test, and β-lactamase disk test. Carbapenemase-producing isolates were detected using the Modified Hodge Test (MHT). The ESBLs genes (blaTEM, blaOXA, blaPER, blaSHV, blaCTX-M and blaPSE) were determined through polymerase chain reaction (PCR). Results: All isolates were multidrug resistant. Only ۳ isolates were detected as ESBL-producing isolates through combination disk test. No ESBL-producing isolates were detected through double disk synergy test. Among the ۱۰۰ studied isolates, ۸۷% were detected as ESBL-producing isolates and ۶۸% as carbpenemase-producing isolates through β-lactamase disk test. . The prevalence of bla TEM , bla OXA , and bla PER among isolates were ۹۷%, ۶۱%, and ۱۳%, respectively. All isolates were negative for bla SHV , bla PSE , and bla CTX-M . Conclusion: According to the results obtained in this study, the β-lactamase disk test is suitable for the detection of ESBLs in multidrug resistant isolates. However, further investigation is required.

Keywords:

β-lactam resistance , Extended-spectrum-β-lactamases (ESBLs) , Confirmatory tests , Pseudomonas aeruginosa , Burn