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Open Access 01-12-2017 | Research

Extended spectrum and metalo beta-lactamase producing airborne Pseudomonas aeruginosa and Acinetobacter baumanii in restricted settings of a referral hospital: a neglected condition

Authors: Fithamlak Bisetegen Solomon, Fiseha Wadilo, Efrata Girma Tufa, Meseret Mitiku

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2017

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Abstract

Background

Frequently encountered multidrug-resistant bacterial isolates of P. aeruginosa and A. baumannii are common and prevalent in a hospital environment. The aim of this study was to determine the prevalence and pattern of antibiotic resistance, extended spectrum and metallo beta-lactamase producing P. aeruginosa and A. baumannii isolates from restricted settings of indoor air hospital environment.

Methods

A hospital-based cross-sectional study was conducted in Wolaita Sodo University Teaching and referral Hospital, Ethiopia from December 1/2015 to April 30/2015. The Air samples were collected from delivery room, intensive care unit and operation theatre of the hospital by active, Anderson six slate sampler technique during the first week of the months, twice a week during Monday’s and Friday’s. Standard microbiological procedures were followed to isolate P. aeruginosa and A. baumannii. Susceptibility testing was performed on isolates using the Kirby-Bauer disk diffusion technique. Extended spectrum beta lactamase production was detected by double disc synergy test and Imipenem-resistant isolates were screened for producing Metallo-beta lactamase.

Results

A total number of 216 indoor air samples were collected from the delivery room, intensive care unit, and operation room. Correspondingly, 43 A. baumannii isolates were identified (13 from delivery room, 21 from intensive care unit and 9 from operation room). Likewise 24 P. aeruginosa isolates were obtained (4 from delivery room, 13 from intensive care unit and 7 from operation room). Extended spectrum beta lactamase and metalo-beta lactamase production were observed in 24 (55.8%) and 13 (30.2%) isolates of A. baumannii respectively, whereas P. aeruginosa showed 15 (62.5%) extended spectrum beta lactamase and 9 (37.5%) metallo-beta lactamase production.

Conclusions

Extended spectrum beta lactamase and metallo-beta lactamase producing bacteria in hospital air is a new dimension for specific setting of the study area where antimicrobial resistance is increasing and surgical site infection is prevalent. So, identification of these microorganisms has a great role in reducing the burden of antibiotic resistance and could also provide a significant input for framing hospital infection control policies.
Literature
1.
go back to reference Gorny R. Filamentous microorganisms and their fragments in indoor air: a review. Ann Agric EnvironMed. 2004;11:185–97. Gorny R. Filamentous microorganisms and their fragments in indoor air: a review. Ann Agric EnvironMed. 2004;11:185–97.
2.
go back to reference Asghar AH, Faidah HS. Frequency and antimicrobial susceptibility of gram- negative bacteria isolated from 2 hospitals in Makkah. Saudi Arabia Saudi Med J. 2009;30:1017–23.PubMed Asghar AH, Faidah HS. Frequency and antimicrobial susceptibility of gram- negative bacteria isolated from 2 hospitals in Makkah. Saudi Arabia Saudi Med J. 2009;30:1017–23.PubMed
3.
go back to reference WHO. The evolving threats of antimicrobial resistance, option for action ISSN 9789241503181. 2012. WHO. The evolving threats of antimicrobial resistance, option for action ISSN 9789241503181. 2012.
4.
go back to reference CDC. Antibiotic resistance threats in the United States. 2013. CDC. Antibiotic resistance threats in the United States. 2013.
5.
go back to reference Lee TB, Baker OG, Lee JT, Scheckler WE. Recommended practices for surveillance. Am J Infect Contr. 1998;26:277–88.CrossRef Lee TB, Baker OG, Lee JT, Scheckler WE. Recommended practices for surveillance. Am J Infect Contr. 1998;26:277–88.CrossRef
6.
go back to reference Gad G, Eldomany E, Zaki S, Ashour H. Characterization of Pseudomonas Aeruginosa isolated from clinical and environmental samples in Minia, Egypt: prevalence, Antibiogram and resistance mechanisms. J Antimicrob Chemother. 2007;60:1010–7.CrossRefPubMed Gad G, Eldomany E, Zaki S, Ashour H. Characterization of Pseudomonas Aeruginosa isolated from clinical and environmental samples in Minia, Egypt: prevalence, Antibiogram and resistance mechanisms. J Antimicrob Chemother. 2007;60:1010–7.CrossRefPubMed
7.
go back to reference Vahdani M, Azimi L, Asghari B, Bazmi F, Rastegar LA. Phenotypic screening of extended-spectrum ß-lactamase and metallo-ß-lactamase in multidrug-resistant Pseudomonas Aeruginosa from infected burns. Ann Burns Fire Disasters. 2012;25(2):78–81.PubMedPubMedCentral Vahdani M, Azimi L, Asghari B, Bazmi F, Rastegar LA. Phenotypic screening of extended-spectrum ß-lactamase and metallo-ß-lactamase in multidrug-resistant Pseudomonas Aeruginosa from infected burns. Ann Burns Fire Disasters. 2012;25(2):78–81.PubMedPubMedCentral
9.
go back to reference Vila J, Pachón J. Therapeutic options for Acinetobacterbaumannii infections. Expert OpinPharmacother. 2008;9:587–99.CrossRef Vila J, Pachón J. Therapeutic options for Acinetobacterbaumannii infections. Expert OpinPharmacother. 2008;9:587–99.CrossRef
10.
go back to reference Owlia P, Azimi L, Gholami A, Asghari B, Lari AR. ESBL and MBL mediated resistance in Acinetobacterbaumannii: a global threat to burnt patients. Infez Med. 2012;20(3):182–7.PubMed Owlia P, Azimi L, Gholami A, Asghari B, Lari AR. ESBL and MBL mediated resistance in Acinetobacterbaumannii: a global threat to burnt patients. Infez Med. 2012;20(3):182–7.PubMed
11.
go back to reference Roy FC, Sarah S, Charles D. The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment. TherAdv Infect Dis. 2014;2:79–90. Roy FC, Sarah S, Charles D. The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment. TherAdv Infect Dis. 2014;2:79–90.
12.
go back to reference Pasquarella C, Pitzurra O, Savino A. The index of microbial air contamination (review). J Hosp Infect. 2000;46:241–56.CrossRefPubMed Pasquarella C, Pitzurra O, Savino A. The index of microbial air contamination (review). J Hosp Infect. 2000;46:241–56.CrossRefPubMed
13.
go back to reference Anderson AA. New sampler for the collection, sizing and enumeration of viable airborne particles. J Bacteriol. 1958;76(5):471–84. Anderson AA. New sampler for the collection, sizing and enumeration of viable airborne particles. J Bacteriol. 1958;76(5):471–84.
14.
go back to reference Govan JR. Pseudomonas aeruginosa. In: Collee G, Barrie PM, Andrew PF, Anthony S, editors. Mackie and McCartney practical medical microbiology. 14th ed. New York: Churchill Livingstone; 2006. p. 413–24. Govan JR. Pseudomonas aeruginosa. In: Collee G, Barrie PM, Andrew PF, Anthony S, editors. Mackie and McCartney practical medical microbiology. 14th ed. New York: Churchill Livingstone; 2006. p. 413–24.
15.
go back to reference Bauer A, Kirby W, Sherris J, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J ClinPathol. 1966;45:493–6. Bauer A, Kirby W, Sherris J, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J ClinPathol. 1966;45:493–6.
16.
go back to reference Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement, M100-S24, 2014. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement, M100-S24, 2014.
17.
go back to reference Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Sixteenth informational supplement. Approved standards, M100 -S16, Wayne, PA. 2007. Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Sixteenth informational supplement. Approved standards, M100 -S16, Wayne, PA. 2007.
18.
go back to reference Yong D, Lee K, Yum J, Shin H, Rossolini G, Chong Y. Imipenem-EDTA disk method for differentiation of metallo-betalactamase- producing clinical isolates of pseudomonas spp. and Acinetobacter spp. J ClinMicrobiol. 2002;40:3798–801. Yong D, Lee K, Yum J, Shin H, Rossolini G, Chong Y. Imipenem-EDTA disk method for differentiation of metallo-betalactamase- producing clinical isolates of pseudomonas spp. and Acinetobacter spp. J ClinMicrobiol. 2002;40:3798–801.
19.
go back to reference Bergogne E and Towner K. Acinetobacter spp. as Nosocomial Pathogens: Microbiological, Clinical, and Epidemiological Features. Clinical microbiology reviews. 1996;9(2):148–65. Bergogne E and Towner K. Acinetobacter spp. as Nosocomial Pathogens: Microbiological, Clinical, and Epidemiological Features. Clinical microbiology reviews. 1996;9(2):148–65.
20.
go back to reference Huang PY, Shi ZY, Chen CH, Den W. Airborne and surface-bound microbial contamination in two intensive care units of a medical Center in Central Taiwan. Aerosol Air Qual Res. 2013;13:1060–9. Huang PY, Shi ZY, Chen CH, Den W. Airborne and surface-bound microbial contamination in two intensive care units of a medical Center in Central Taiwan. Aerosol Air Qual Res. 2013;13:1060–9.
21.
go back to reference Alireza A, Sanam M. Microbial profile of air contamination in hospital Ward. Iranian J Pathol. 2012;7:168–74. Alireza A, Sanam M. Microbial profile of air contamination in hospital Ward. Iranian J Pathol. 2012;7:168–74.
22.
go back to reference Kritu P, Prakash G, Shiba K, Reena K, Mukhiya RN, Ganesh R. Screening of Antibiotype among environmental isolates of Acinetobacter spp.in hospital setting. Nepal J Sci Technol. 2012;13(2):203–8. Kritu P, Prakash G, Shiba K, Reena K, Mukhiya RN, Ganesh R. Screening of Antibiotype among environmental isolates of Acinetobacter spp.in hospital setting. Nepal J Sci Technol. 2012;13(2):203–8.
23.
go back to reference HakemiVala M, Hallajzadeh M, Fallah F, Hashemi A, Goudarzi H. Characterization of theextended-spectrum beta-lactamase producers among non-fermenting gram-negative bacteria isolated from burnt patients. Arch Hyg Sci. 2013;2(1):1–6. HakemiVala M, Hallajzadeh M, Fallah F, Hashemi A, Goudarzi H. Characterization of theextended-spectrum beta-lactamase producers among non-fermenting gram-negative bacteria isolated from burnt patients. Arch Hyg Sci. 2013;2(1):1–6.
24.
go back to reference Mirnejad R, Vafaei S. Antibiotic resistance patterns and the prevalence of ESBLs amongstrains of A. baumannii isolated from clinical specimens. JGMI. 2013;2:1–8. Mirnejad R, Vafaei S. Antibiotic resistance patterns and the prevalence of ESBLs amongstrains of A. baumannii isolated from clinical specimens. JGMI. 2013;2:1–8.
25.
go back to reference Aktas O, Ozbek A. Prevalence and In-vitro antimicrobial susceptibility patterns of Acinetobacter strains isolated from patients in intensive care units. J Int Med Res. 2003;31:272–80.CrossRefPubMed Aktas O, Ozbek A. Prevalence and In-vitro antimicrobial susceptibility patterns of Acinetobacter strains isolated from patients in intensive care units. J Int Med Res. 2003;31:272–80.CrossRefPubMed
26.
go back to reference Parviz O, Leila A, Abbas G, Abdolaziz R. L. ESBL- and MBL-mediated resistance in Acinetobacter baumannii: a global threat to burn patients. Infez Med. 2012;3:182–7. Parviz O, Leila A, Abbas G, Abdolaziz R. L. ESBL- and MBL-mediated resistance in Acinetobacter baumannii: a global threat to burn patients. Infez Med. 2012;3:182–7.
27.
go back to reference Sofia C, Angela R, Luminiţa S, Raluca F, Iuliana T. Cultural and biochemical characteristics of acinetobacter spp. strains isolated from hospital units. J Prev Med. 2004;12(3–4):35–42. Sofia C, Angela R, Luminiţa S, Raluca F, Iuliana T. Cultural and biochemical characteristics of acinetobacter spp. strains isolated from hospital units. J Prev Med. 2004;12(3–4):35–42.
28.
go back to reference Agersew A, Degisew M, Yitayih W. Bacterial profile and their antimicrobial susceptibility patterns of computer keyboards and mice at Gondar University hospital, Northwest Ethiopia. Biomedicine Biotechnology. 2015;3(1):1–7. Agersew A, Degisew M, Yitayih W. Bacterial profile and their antimicrobial susceptibility patterns of computer keyboards and mice at Gondar University hospital, Northwest Ethiopia. Biomedicine Biotechnology. 2015;3(1):1–7.
29.
go back to reference Medeiros M, Lincopan N. Oxacillinase (OXA)-producing Acinetobacter baumanniiin Brazil: clinical and environmental impact and therapeutic options. J Bras Patol Med Lab. 2013;49(6):391–405.CrossRef Medeiros M, Lincopan N. Oxacillinase (OXA)-producing Acinetobacter baumanniiin Brazil: clinical and environmental impact and therapeutic options. J Bras Patol Med Lab. 2013;49(6):391–405.CrossRef
30.
go back to reference Luca G, Andreas P, John E, Anders D. Antibiotic resistance in Acinetobacter spp. isolated from sewers receiving waste effluent from a hospital and a pharmaceutical plant. Appl Environ Microbiol. 1998;64(9):3499–502. Luca G, Andreas P, John E, Anders D. Antibiotic resistance in Acinetobacter spp. isolated from sewers receiving waste effluent from a hospital and a pharmaceutical plant. Appl Environ Microbiol. 1998;64(9):3499–502.
31.
go back to reference Azizun N, Shasheda A, Ruhulu AM AAS. Isolation of and their antimicrobial resistance pattern in an intensive care unit (ICU) of a tertiary care hospital in Dhaka, Bangladesh. Bangladesh J Med Microbiol. 2012;06(01):03–6. Azizun N, Shasheda A, Ruhulu AM AAS. Isolation of and their antimicrobial resistance pattern in an intensive care unit (ICU) of a tertiary care hospital in Dhaka, Bangladesh. Bangladesh J Med Microbiol. 2012;06(01):03–6.
32.
go back to reference Mahua S, Srinivasa H, Macaden R. Antibiotic resistance profile & extended spectrum beta-lactamase (ESBL) production in Acinetobacterspecies. Indian J Med Res. 2007:63–7. Mahua S, Srinivasa H, Macaden R. Antibiotic resistance profile & extended spectrum beta-lactamase (ESBL) production in Acinetobacterspecies. Indian J Med Res. 2007:63–7.
33.
go back to reference Enas A, Ismael S, Ahmad S, Sherein G, Entsar H, Ibrahim M. Relationship between clinical and environmental isolates of Acinetobacter baumanniiin Assiut university hospitals. J Am Sci. 2013;9(11):67–73. Enas A, Ismael S, Ahmad S, Sherein G, Entsar H, Ibrahim M. Relationship between clinical and environmental isolates of Acinetobacter baumanniiin Assiut university hospitals. J Am Sci. 2013;9(11):67–73.
34.
go back to reference Aktas O, Ozbek A. Prevalence and in-vitro antimicrobial susceptibility patterns of Acinetobacter strains isolated from patients in intensive care units. J Int Med Res. 2003;31:272–80.CrossRefPubMed Aktas O, Ozbek A. Prevalence and in-vitro antimicrobial susceptibility patterns of Acinetobacter strains isolated from patients in intensive care units. J Int Med Res. 2003;31:272–80.CrossRefPubMed
35.
go back to reference Ava B, Mohammad R, Jalil V. Frequency of extended spectrum beta-lactamase (ESBLs) producing Escherichia coli and klebseilla pneumonia isolated from urine in an Iranian 1000-bed tertiary care hospital. Afr J Microbiol Res. 2010;4(9):881–4. Ava B, Mohammad R, Jalil V. Frequency of extended spectrum beta-lactamase (ESBLs) producing Escherichia coli and klebseilla pneumonia isolated from urine in an Iranian 1000-bed tertiary care hospital. Afr J Microbiol Res. 2010;4(9):881–4.
36.
go back to reference Sinha M, Srinivasa H, Macaden R. Antibiotic resistance profile & extended spectrum beta-lactamase (ESBL) production in Acinetobacter species. Indian J Med Res. 2007;126(1):63–7.PubMed Sinha M, Srinivasa H, Macaden R. Antibiotic resistance profile & extended spectrum beta-lactamase (ESBL) production in Acinetobacter species. Indian J Med Res. 2007;126(1):63–7.PubMed
37.
go back to reference Goel V, Hogade SA, Karadesai SG. Prevalence of extended spectrum beta lactamases, AmpC beta lactamase, and metallo beta lactamase producing Pseudomonas Aeruginosa and Acinetobacterbaumannii in an intensive care unit in a tertiary care hospital. J Sci Soc. 2013;40(1):28–31. Goel V, Hogade SA, Karadesai SG. Prevalence of extended spectrum beta lactamases, AmpC beta lactamase, and metallo beta lactamase producing Pseudomonas Aeruginosa and Acinetobacterbaumannii in an intensive care unit in a tertiary care hospital. J Sci Soc. 2013;40(1):28–31.
38.
go back to reference Enas A, Ismael S, Ahmad S, et al. Relationship between Clinical and Environmental Isolates of Acinetobacter baumannii in Assiut University Hospitals Journal of American Science 2013;9(11):67-73. Enas A, Ismael S, Ahmad S, et al. Relationship between Clinical and Environmental Isolates of Acinetobacter baumannii in Assiut University Hospitals Journal of American Science 2013;9(11):67-73.
39.
go back to reference Elizabeth B, Vincent HT. Impact of multidrug-resistant Pseudomonas aeruginosa infection on patient outcomes. Expert Rev Pharmacoecon Outcomes Res. 2010;10(4):441–51.CrossRef Elizabeth B, Vincent HT. Impact of multidrug-resistant Pseudomonas aeruginosa infection on patient outcomes. Expert Rev Pharmacoecon Outcomes Res. 2010;10(4):441–51.CrossRef
40.
go back to reference Jones AM, Govan JR, Doherty CJ, et al. Identification of airborne dissemination of epidemic multiresistant strains of Pseudomonas Aeruginosa at a CF Centre during a cross infection outbreak. Thorax. 2003;58:525–7.CrossRefPubMedPubMedCentral Jones AM, Govan JR, Doherty CJ, et al. Identification of airborne dissemination of epidemic multiresistant strains of Pseudomonas Aeruginosa at a CF Centre during a cross infection outbreak. Thorax. 2003;58:525–7.CrossRefPubMedPubMedCentral
41.
go back to reference Gamal F, Ramadan A, Sahar Z, Hossam M. Characterization of Pseudomonas aeruginosa isolated from clinical and environmental samples in Minia, Egypt: prevalence, antibiogram and resistance mechanisms. J Antimicrob Chemother. 2007 Nov;60(5):1010–7.CrossRef Gamal F, Ramadan A, Sahar Z, Hossam M. Characterization of Pseudomonas aeruginosa isolated from clinical and environmental samples in Minia, Egypt: prevalence, antibiogram and resistance mechanisms. J Antimicrob Chemother. 2007 Nov;60(5):1010–7.CrossRef
42.
go back to reference Teklu S, Lakew G, Girma M, Adinew Z, Feleke B, Daba M, Endalew Z. Bacterial indoor-air load and its implications for healthcare-acquired infections in a teaching hospital in Ethiopia. Int J Infect Control. 2016;12:1–9. Teklu S, Lakew G, Girma M, Adinew Z, Feleke B, Daba M, Endalew Z. Bacterial indoor-air load and its implications for healthcare-acquired infections in a teaching hospital in Ethiopia. Int J Infect Control. 2016;12:1–9.
43.
go back to reference Meseret M, Solomon A, Gebre K. Antimicrobial drug resistance and disinfectants susceptibility of Pseudomonas aeruginosa isolates from clinical and environmental samples in Jimma University specialized hospital, Southwest Ethiopia. Am J Biomedical Life Sci. 2014; 2 (2). 40-45. doi:10.11648/j.ajbls.20140202.12. Meseret M, Solomon A, Gebre K. Antimicrobial drug resistance and disinfectants susceptibility of Pseudomonas aeruginosa isolates from clinical and environmental samples in Jimma University specialized hospital, Southwest Ethiopia. Am J Biomedical Life Sci. 2014; 2 (2). 40-45. doi:10.​11648/​j.​ajbls.​20140202.​12.
44.
go back to reference Sivaraj S, Murugesan S. Muthuvelu S, et al. Comparative study of Pseudomonas aeruginosaisolate recovered from clinical and environmental samples against antibiotics. Int J Pharm PharmSci. 2012;4:103–107. Sivaraj S, Murugesan S. Muthuvelu S, et al. Comparative study of Pseudomonas aeruginosaisolate recovered from clinical and environmental samples against antibiotics. Int J Pharm PharmSci. 2012;4:103–107.
45.
go back to reference Indu B, BalvInder S, Imple K. Incidence of multidrug resistant Pseudomonas aeruginosa isolated from burn patients and environment of teaching institution. J Clin Diagnostic Research. 2014;8(5):26–9. Indu B, BalvInder S, Imple K. Incidence of multidrug resistant Pseudomonas aeruginosa isolated from burn patients and environment of teaching institution. J Clin Diagnostic Research. 2014;8(5):26–9.
46.
go back to reference Eyo AA, Ibeneme BD, Thumamo AE. Antibiotic resistance profiles of clinical and environmentalisolates of Pseudomonas aeruginosain Calabar, Nigeria. J Pharm Biol Sci. 2015;10(4):09–15. Eyo AA, Ibeneme BD, Thumamo AE. Antibiotic resistance profiles of clinical and environmentalisolates of Pseudomonas aeruginosain Calabar, Nigeria. J Pharm Biol Sci. 2015;10(4):09–15.
47.
go back to reference Nasreen M, Sarker A, Malek MA, Ansaruzzaman Md, Rahman M. Prevalence and resistance pattern of Pseudomonas aeruginosaIsolated from surface water. Adv Microbiol. 2015;5:74-81. doi:10.4236/aim.2015.51008. Nasreen M, Sarker A, Malek MA, Ansaruzzaman Md, Rahman M. Prevalence and resistance pattern of Pseudomonas aeruginosaIsolated from surface water. Adv Microbiol. 2015;5:74-81. doi:10.​4236/​aim.​2015.​51008.
48.
go back to reference Gaikwad V., Bharadwaj R., Dohe V. Study the Prevalence and Risk Factors of Metallo- Betalactamase Producing Pseudomonas aeruginosa from Teriary Care Centre. 2015;4(5):3126–32. Gaikwad V., Bharadwaj R., Dohe V. Study the Prevalence and Risk Factors of Metallo- Betalactamase Producing Pseudomonas aeruginosa from Teriary Care Centre. 2015;4(5):3126–32.
49.
go back to reference Inacio H, Bomfim M, França R, Farias LM, Carvalho M, Serufo J, Santos S. Phenotypic and Genotypic Diversity of Multidrug-Resistant Pseudomonas aeruginosa Isolates from Bloodstream Infections Recovered in the Hospitals of Belo Horizonte, Brazil. Chemotherapy. 2014:60;54-62. Inacio H, Bomfim M, França R, Farias LM, Carvalho M, Serufo J, Santos S. Phenotypic and Genotypic Diversity of Multidrug-Resistant Pseudomonas aeruginosa Isolates from Bloodstream Infections Recovered in the Hospitals of Belo Horizonte, Brazil. Chemotherapy. 2014:60;54-62.
50.
go back to reference Alisha A, Afsaneh S, Bizhan N, Kamal A. Prevalence and Clonal dissemination of Metallo-Beta-Lactamase-producing Pseudomonas Aeruginosa in Kermanshah. Jundishapur J Microbiol. 2015 Jul;8(7):e20980. Alisha A, Afsaneh S, Bizhan N, Kamal A. Prevalence and Clonal dissemination of Metallo-Beta-Lactamase-producing Pseudomonas Aeruginosa in Kermanshah. Jundishapur J Microbiol. 2015 Jul;8(7):e20980.
51.
go back to reference Arunava K, Sreenivasan S, Shailesh K, Hema A, Akhila K, Sivaraman U. Incidence of metallo beta lactamase producing Pseudomonas aeruginosa in ICU patients. Indian J Med Res. 2008 Apr;127(4):398–402. Arunava K, Sreenivasan S, Shailesh K, Hema A, Akhila K, Sivaraman U. Incidence of metallo beta lactamase producing Pseudomonas aeruginosa in ICU patients. Indian J Med Res. 2008 Apr;127(4):398–402.
Metadata
Title
Extended spectrum and metalo beta-lactamase producing airborne Pseudomonas aeruginosa and Acinetobacter baumanii in restricted settings of a referral hospital: a neglected condition
Authors
Fithamlak Bisetegen Solomon
Fiseha Wadilo
Efrata Girma Tufa
Meseret Mitiku
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2017
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-017-0266-0

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