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Backgound & objectives: resistance to carbapenems in Gram-negative bacteria conferred by NDM-1 is a global health problem. We investigated the occurrence of NDM-1 in clinical isolates of Gram-negative bacilli in a tertiary care hospital in Kashmir valley, India. Methods: Gram-negative bacilli from different clinical isolates were included in the study. Antimicrobial susceptibility was performed by Kirby Bauer disk diffusion method and interpreted using Clinical Laboratory Standards Institute (CLSI) guidelines. Isolates resistant to carbapenems were subjected to different phenotypic test such as modified hodge test (MhT), boronic acid and oxacillin based MhT (BA-MhT and OXA-MhT), combined disk test and minimum inhibitory concentration (MIC) with imipenem and imipenem -EDTA for determination of class B metallo enzymes. Presence of blaNDM-1 gene was established by PCR and confirmed by sequencing. Results: Of the total 1625 Gram-negative isolates received, 100 were resistant to imipenem. Of the 100 isolates, 55 (55%) were positive by modified Hodge test indicating carbapenemase production. Of the 100 isolates tested by MhT, BA-MhT and OXA-MhT, 29 (29%) isolates belonged to Class A and 15 (15%) to Class B, while 56 (56%) isolates were negative. Of the 15 class B metallo beta lactamase producers, nine carried the blaNDM-1 gene. NDM-1 was found among escherichia coli (2 isolates), Klebsiella pneumoniae (2 isolates), Citrobacter freundii (3 isolates), Acinetobacter spp (1 isolate), and one isolate of Pseudomonas aeruginosa. Isolates were resistant to all antibiotic tested except polymyxin B and tigecycline. Interpretation & conclusions: Our study showed the presence of clinical isolates expressing NDM-1 in Srinagar, Jammu & Kashmir, India. These isolates harbour plasmid mediated multiple drug resistant determinants and can disseminate easily across several unrelated genera. To halt their spread, early identification of these isolates is mandatory. [ABSTRACT FROM AUTHOR]

Objective(s) The aim of this study was to investigate the presence of PER-1-type ESBLs in drug resistant Pseudomonas aeruginosa isolates. Materials and Methods During one-year period (2008-2009), following isolation and identification of 56 P. aeruginosa, the E-test method was performed for determination of minimal inhibitory concentration of ceftazidim. The isolates that they had MIC≥16 μg/ml against ceftazidim were used for determination of ESBL-producing by combined disk test (CDT) and double disk synergy test (DDST) methods. Bla PER-1 gene was investigated by PCR. P. aeruginosa KOAS was used as positive control. Results Twenty-nine (51.78%) out of fifty six isolates had MIC≥16 μg/ml to ceftazidime, twenty two (75.86%) of them were ESBL producers. Some isolates (27.5%) contained bla PER-1 gene. Conclusion PER-1-type ESBLs producing P.aeruginosa has not been reported previously in Tabriz but there has been a rather high prevalence of it. [ABSTRACT FROM AUTHOR]

The article offers information on treatment of multi-drug resistant Enterobacteriaceae infections by Carbapenems, and also discusses about emergence and dissemination of carbapenem resistance.