Posters

Clinical, phenotypic, and genotypic characterisation of multidrug resistant (MDR) pseudomonas aeruginosa isolated from keratitis patient from a tertiary eyecare centre, South India

Poster Details

First Author: M.Lakshmipathy INDIA

Co Author(s):    M. Jambulingam   M. Nandagopal                 

Abstract Details

Purpose:

To characterize the MDR Pseudomonas aeruginosa (P. aeruginosa ) isolated from bacterial keratitis patients with special emphasis on the antimicrobial pattern and molecular characterisation of drug resistance and to correlate with the clinical outcome

Setting:

Department of Cornea and Refractive surgery, Medical Research Foundation, Chennai. India

Methods:

It is a retrospective study with 46 (46 patients) isolates of MDR P. aeruginosa from keratitis patients during the 3 years study period. (2012-2014). Majority of the patients (23.9%) were between 51-60yrs of age group. The other parameters like , Demography, risk factors, clinical presentation and outcome were also analysed. All the 46 MDR P. aeruginosa isolates were characterized by both phenotypic(Disk diffusion & Double disk diffusion method for betalacatamase detection) and genotypic methods (PCR based DNA sequencing by targeting genes for antibiotic resistance)

Results:

Common risk factors noted of foreign body(8) and contact lens use(9) . Near total corneal infiltrate in 12 and perforation in 7 .Three patients underwent evisceration. Extended Spectrum Betalactamase (ESBL) and Metallo Betalactamase (MBL) production was detected in 13 MDR isolates by phenotypic method. Genotypical analysis showed that ESBL genes Tem (30), Oxa (13), CTX-M (6) and, Ges (12), ampC (3 ) and MBL genes like Vim (7), Veb(3) and Dim (1) gene among 46 isolates. Majority of the MDR strains were sensitive to colistin (93.18%), followed by amikacin (90.90%) by invitro disk diffusion method

Conclusions:

Fortified amikacin and colistin are the drugs of choice for treating MDR P. aeruginosa keratitis. This is the first study to report on the detection of blaDIM gene among MDR P.aeruginosa isolates from keratitis patients in India. Prompt therapy with surgical management salvaged all eyes except 3 who underwent evisceration

Financial Disclosure:

None