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CC BY-NC-ND 4.0 · Avicenna J Med 2016; 06(01): 17-27
DOI: 10.4103/2231-0770.173578
ORIGINAL ARTICLE

Phenotypic detection and molecular characterization of beta-lactamase genes among Citrobacter species in a tertiary care hospital

Ashok Kumar Praharaj
Department of Microbiology, AIIMS, Bhubaneshwar, Odisha, India
,
Atul Khajuria
Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
,
Mahadevan Kumar
Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
,
Naveen Grover
Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Objective: To examine the distribution, emergence, and spread of genes encoding beta-lactamase resistance in Citrobacter species isolated from hospitalized patients in a tertiary care hospital. Methods: A prospective study was conducted in a 1000-bed tertiary care center in Pune, India from October 2010 to October 2013. A total of 221 Citrobacter spp. isolates were recovered from clinical specimens from different patients (one isolate per patient) admitted to the surgical ward, medical ward and medical and surgical Intensive Care Units. Polymerase chain reaction (PCR) assays and sequencing were used to determine the presence of beta-lactamase encoding genes. Conjugation experiments were performed to determine their transferability. Isolate relatedness were determined by repetitive element based-PCR, enterobacterial repetitive intergenic consensus-PCR and randomly amplified polymorphic DNA. Results: Among 221 tested isolates of Citrobacter spp. recovered from various clinical specimens, 179 (80.9%) isolates showed minimum inhibitory concentration (MIC) >4 μg/ml against meropenem and imipenem. One hundred and forty-five isolates with increased MICs value against carbapenems were further processed for molecular characterization of beta-lactamase genes. Susceptibility profiling of the isolates indicated that 100% retained susceptibility to colistin. Conjugation experiments indicated that blaNDM-1was transferable via a plasmid. Conclusion: The ease of NDM-1 plasmid transmissibility may help their dissemination among the Citrobacter species as well as to others in Enterobacteriaceae. Early detection, antimicrobial stewardship and adequate infection control measures will help in limiting the spread of these organisms.

Keywords

blaNDM-1 - blaVIM-2 - combined-disc synergy test - Citrobacter freundii - Citrobacter koseri - double-disc synergy tests - metallo-beta-lactamase - modified Hodge test


Publication History

Article published online:
09 August 2021

© 2016. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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