Emerge of NDM-1-Producing Multidrug-Resistant Pseudomonas aeruginosa and Co-Harboring of Carbapenemase Genes in South of Iran

Background: new delhi metallo-beta-lactamase-1 (ndm-1) is one of the most important emerging antibiotic resistance. co-harboring three or four carbapenemases is rare and only a few reports exist in the literature. we described the characteristics of the large epidemic outbreaks and reports co-producing blandm-1 with the other carbapenemase genes in p. aeruginosa isolates. methods: this present cross-sectional research was conducted on 369 p. aeruginosa isolates obtained from burn and general hospitals within years 2013 to 2016. beta-lactamase classes a, b and d genes were identified by pcr method. modified hodge test (mht), double-disk potentiation tests (ddpt) and double disk synergy test (ddst) were performed for detection carbapenemase and metallo beta-lactamase (mbl) production of blandm-1 positive p. aeruginos isolates. results: from 236 carbapenem-resistant p. aeruginosa (crpa), 116 isolates have had mbl genes and twenty-nine isolates were found positive for blandm-1. in crpa isolates, blaimp-1, blavim-2 and blaoxa-10 were identified in 27.5%, 21.1% and 32.2% of isolates respectively, while co-producing blandm-1, blaimp-1, blaoxa-10, co-producing blandm-1, blavim-2, blaoxa-10 and co-producing blaimp-1, blavim-2 were determined in 11 (4.6%), 8 (3.4%) and 27 (11.4%) of isolates respectively. conclusion: the finding of this co-existence of multiple carbapenemase resistance genes is threating for public health. dipicolinic acid is a superior mbl inhibitor in ddpt antique than edta in ddst method for the detection of mbl-blandm-1 producing p. aeruginosa