Molecular characterization and antimicrobial susceptibility profile of New Delhi metallo-beta-lactamase-1-producing Escherichia coli among hospitalized patients

Anjali Agarwal; Jyoti Srivastava; Ujjwal Maheshwari; Mohd Iftikhar

doi:10.4103/JLP.JLP_76_17

Journal of Laboratory Physicians, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Lab Physicians 2018; 10(02): 149-154
DOI: 10.4103/JLP.JLP_76_17

Original Article

Molecular characterization and antimicrobial susceptibility profile of New Delhi metallo-beta-lactamase-1-producing Escherichia coli among hospitalized patients

Autor*innen

Anjali Agarwal

Department of Microbiology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
Jyoti Srivastava

Department of Microbiology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
Ujjwal Maheshwari

Department of Cardiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
Mohd Iftikhar

Department of Microbiology, State Reference Laboratory, GSVM, Kanpur, Uttar Pradesh, India

Abstract

als PDF herunterladen

ABSTRACT

BACKGROUND: Carbapenemase-producing microorganisms are becoming a major concern among hospital-acquired infections. There is also increased multidrug resistance seen among these isolates.

AIMS: We have conducted this study to determine the prevalence of New Delhi metallo-beta-lactamase-1 (NDM-1) gene-producing Escherichia coli among hospitalized patients in a tertiary care hospital in Northern India.

SETTINGS AND DESIGN: The study was conducted in the Department of Microbiology with the tertiary care hospital settings. It was a prospective cross-sectional observational study conducted during January 2014–August 2014.

MATERIALS AND METHODS: A total of 500 nonduplicate E. coli samples were processed. The isolates with reduced susceptibility to ertapenem, i.e., zone diameter between 19 and 21 mm, were considered carbapenemase producers. These isolates were subjected to modified Hodge test for phenotypic confirmation. Polymerase chain reaction was performed on all the screened isolates for molecular detection of NDM-1 gene.

STATISTICAL ANALYSIS USED: Chi-square test was used to analyze the data and P < 0.05 was considered statistically significant.

RESULTS: Out of 500 E. coli isolates, 61 (12.2%) were screened for carbapenemase production. 47 (9.4%) isolates were positive by modified Hodge test and 36 (7.2%) isolates showed the presence of blaNDM-1 gene (P < 0.05).

CONCLUSION: There is an increased prevalence of NDM-1 gene-producing E. coli isolates. These carbapenemase-producing isolates are more resistant to other group of antibiotics (aminoglycosides, fluoroquinolones along with β-lactam group). Early detection of blaNDM-1 gene can help in choosing the effective treatment options for hospitalized patients in time, thereby reducing the risk of mortality.

Key words

blaNDM-1 gene - carbapenemase - modified Hodge test

PDF (657 kb)

Referenzen

REFERENCES
1 Lenz R, Leal JR, Church DL, Gregson DB, Ross T, Laupland KB, et al. The distinct category of healthcare associated bloodstream infections. BMC Infect Dis 2012;12:85.
2 Guentzel MN. Escherichia, Klebsiella, Enterobacter, Serratia, Citrobacter, and Proteus. Ch. 26. Medical Microbiology. 4^th ed. Galveston, Texas: University of Texas Medical Branch; 1996.
3 Wang S, Zhao SY, Xiao SZ, Gu FF, Liu QZ, Tang J, et al. Antimicrobial resistance and molecular epidemiology of Escherichia coli causing bloodstream infections in three hospitals in Shanghai, China. PLoS One 2016;11:e0147740.
4 Paterson DL. Resistance in Gram-negative bacteria: Enterobacteriaceae. Am J Med 2006;119:S20-8.
5 Fair RJ, Tor Y. Antibiotics and bacterial resistance in the 21^st century. Perspect Medicin Chem 2014;6:25-64.
6 Ahmed-Bentley J, Chandran AU, Joffe AM, French D, Peirano G, Pitout JD, et al. Gram-negative bacteria that produce carbapenemases causing death attributed to recent foreign hospitalization. Antimicrob Agents Chemother 2013;57:3085-91.
7 Doyle D, Peirano G, Lascols C, Lloyd T, Church DL, Pitout JD, et al. Laboratory detection of Enterobacteriaceae that produce carbapenemases. J Clin Microbiol 2012;50:3877-80.
8 Deshpande P, Rodrigues C, Shetty A, Kapadia F, Hedge A, Soman R, et al. New Delhi Metallo-beta lactamase (NDM-1) in Enterobacteriaceae: Treatment options with carbapenems compromised. J Assoc Physicians India 2010;58:147-9.
9 Bush K, Jacoby GA. Updated functional classification of beta-lactamases. Antimicrob Agents Chemother 2010;54:969-76.
10 Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother 2009;53:5046-54.
11 Bora A, Ahmed GU, Hazarika NK, Prasad KN, Shukla SK, Randhawa V, et al. Incidence of bla NDM-1 gene in Escherichia coli isolates at a tertiary care referral hospital in Northeast India. Indian J Med Microbiol 2013;31:250-6.
12 Khajuria A, Praharaj AK, Kumar M, Grover N. Emergence of Escherichia coli, co-producing NDM-1 and OXA-48 carbapenemases, in urinary isolates, at a tertiary care centre at central India. J Clin Diagn Res 2014;8:DC01-4.
13 Raghunath D. New metallo β-lactamase NDM-1. Indian J Med Res 2010;132:478-81.
14 Forbes BA, Sahm DF, Weissfeld AS. Bailey & Scott Diagnostic Microbiology. 12^th ed. USA: Elsevier Science Health Science Div.; 2007.
15 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement. M100-S24. Wayne, PA: Clinical and Laboratory Standards Institute; 2014.
16 Nordmann P, Poirel L, Carrër A, Toleman MA, Walsh TR. How to detect NDM-1 producers. J Clin Microbiol 2011;49:718-21.
17 Assem M, Abdalla Wifi MN, Elsherif R, Saad A, Ismail DK, Hasanin A, et al. Emergence of Gram-negative bacilli with concomitant blaNDM-1 and blaOXA-48-like genes in Egypt. Am J Intern Med 2017;5:1-6.
18 Seema K, Ranjan Sen M, Upadhyay S, Bhattacharjee A. Dissemination of the New Delhi metallo-β-lactamase-1 (NDM-1) among Enterobacteriaceae in a tertiary referral hospital in North India. J Antimicrob Chemother 2011;66:1646-7.
19 Jamal WY, Albert MJ, Rotimi VO. High prevalence of New Delhi metallo-β-lactamase-1 (NDM-1) producers among carbapenem-resistant Enterobacteriaceae in Kuwait. PLoS One 2016;11:e0152638.
20 Shenoy KA, Jyothi EK, Ravikumar R. Phenotypic identification & molecular detection of bla (ndm-1) gene in multidrug resistant Gram-negative bacilli in a tertiary care centre. Indian J Med Res 2014;139:625-31.
21 Amjad A, Mirza Ia, Abbasi S, Farwa U, Malik N, Zia F, et al. Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iran J Microbiol 2011;3:189-93.
22 Jha TNN DN. Ganga Ram study finds high levels of superbug NDM-1. The Times Of India. 2011 Oct 05: Delhi.
23 Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet Infect Dis 2010;10:597-602.
24 Solanki R, Vanjari L, Subramanian S, Aparna B, Nagapriyanka E, Lakshmi V, et al. Comparative evaluation of multiplex PCR and routine laboratory phenotypic methods for detection of carbapenemases among Gram negative bacilli. J Clin Diagn Res 2014;8:DC23-6.
25 Castanheira M, Deshpande LM, Mathai D, Bell JM, Jones RN, Mendes RE, et al. Early dissemination of NDM-1- and OXA-181-producing Enterobacteriaceae in Indian hospitals: Report from the SENTRY antimicrobial surveillance program, 2006-2007. Antimicrob Agents Chemother 2011;55:1274-8.
26 Fomda BA, Khan A, Zahoor D. NDM-1 (New Delhi metallo beta lactamase-1) producing Gram-negative bacilli: Emergence & clinical implications. Indian J Med Res 2014;140:672-8.
27 Mataseje LF, Abdesselam K, Vachon J, Mitchel R, Bryce E, Roscoe D, et al. Results from the Canadian nosocomial infection surveillance program on carbapenemase-producing Enterobacteriaceae, 2010 to 2014. Antimicrob Agents Chemother 2016;60:6787-94.