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INTRODUCTION
Antibiotics are developed and produced to treat dangerous diseases caused by bacteria,
viruses and several others. However, antimicrobial resistance continuously develops naturally
over time. This development is caused by numerous factors like environmental changes,
chemical reactions, adaptation and genetic mutation of the microorganism which is accelerated
by the misuse and overuse of antibiotics. This results to the inability of antibiotics to cure
diseases due to the development of the different strains of microorganisms. As this is a growing
problem worldwide, multi-drug resistant (MDR) strains of bacteria can also be found here in the
Philippines. This study focuses on the drug resistance of Pseudomonas aeruginosa and
Acinetobacter baumanii, both of which causes nosocomial infections here in the Philippines.
The purpose of this study is to detect the resistance-causing genes bla OXA23 and blaNDM in
Pseudomonas aeruginosa and Acinetobacter baumanii, both of which should be resistant to
imipenem and meropenem.
Multi-drug resistance is a growing threat not only in the Philippines, but also in other
countries worldwide. Despite the effort of the World Health Organization (WHO), as well as
local organizations like the Department of Health (DOH) and Philippine Association of Medical
Technologists (PAMET), to prevent and manage antimicrobial resistance, it is still occurring
rapidly because of genetic changes, misuse and overuse of antibiotics, irrational prescriptions,
lack of awareness of consumers and several other factors. This problem has negatively impacted
the society most especially those with weakened immune systems. In line with the growing
multi-drug resistance being observed here in the Philippines, this study's main problem is to
detect the resistant genes blaOXA23 and blaNDM in Pseudomonas aeruginosa and Acinetobacter
baumanii towards carbepenems, specifically imipenem and meropenem. This study intends to
find out from what source of specimen the said genes are most frequently isolated from to see
which strains and diseases are of top most priority to be researched on. Lastly, this study
compares the antibiotic resistance profile of blaOXA23 and blaNDM producing strains against those
that are non-producing. By conducting this, this study will be able to identify the cause of the
resistance in Pseudomonas aeruginosa and Acinetobacter baumanii through the use phenotypic
and genotypic methods. This will benefit the research society because this study will find out if
the strains are the cause of the antibacterial resistance or if there is another mechanism behind it.
This study aims to detect the genes blaOXA23 and blaNDM in strains of Pseudomonas
aeruginosa and Acinetobacter baumanii resistant to carbapenem, specifically imipenem and
meropenem through the use of Polymerase Chain Reaction. It also aims to determine what
source of specimen blaOXA23 and blaNDM genes are frequently isolated from and in what
percentage. Lastly, it aims to compare the resistance profile of bla OXA23 and blaNDM producing
strains against those that are non-producing.
As this study will aim to answer its objectives, it will aid the research community, and the
general public, in terms of providing additional data and reference that can be used for future
researches.
This study will further strengthen the scientific basis for the cause of the resistance of
Pseudomonas aeruginosa and Acinetobacter baumanii towards carbapenems, specifically to
imipenem and meropenem, especially since this will be a first in the Philippines. As the
prevalence of the carbapenem resistant bacteria in the Asia-Pacific region is high (Kiratisin et.
al., 2012), the results of this study will influence medical institutions to improve protocols
involved in addressing such resistance, thus conserving money (Hsueh et. al., 2011), time and
effort (Falagas & Kopterides, 2006), in order to put into minimum the casualties caused by the
organisms pathogenicity (Kiratisin et. al., 2012). This research will also expand knowledge and
update research findings regarding multi-drug resistance in the Philippines. It will also
strengthen campaigns of global and local organizations against misuse and overuse of antibiotics
as consumers lack awareness concerning the emergent multi-drug resistance, its causes, harmful
effects and impact nowadays and in the near future.
This research will focus on the detection of genes coding for resistance in imipenem and
meropenem resistant Pseudomonas aeruginosa and Acinetobacter baumanii. The said genes to
be detected are limited to bla OXA23 and blaNDM. The method of detection to be used will be
Polymerase Chain Reaction. Fifteen clinical samples from an unclassified tertiary hospital in
Manila, Philippines will be used. These clinical samples do not have a specific site of acquisition
but the highest frequency of isolation or the distributions of the genes in the clinical isolated
strains will be investigated.
DEFINITION OF TERMS