Molecular characterization and clinical significance of New Delhi metallo-beta-lactamases-1 producing Escherichia coli recovered from a South Indian tertiary care hospital.
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Date
2015-07
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Abstract
Context: The increased rate of infection by New Delhi metallo-beta-lactamases-1
(NDM1) producing Escherichia coli is a major concern since they show a high
rate of drug resistance and are responsible for mortality and morbidity. Aims: To
characterize the NDM1 producing E. coli isolates and their impact on patients’
clinical outcome. Settings and Design: This descriptive study was carried
out in a multi-specialty tertiary care hospital. Materials and Methods: Three
hundred nonrepeat strains of E. coli from inpatients were included in the study.
Modifi ed Hodge test and metallo-beta-lactamases (MBL) e-test were performed
to detect carbapenemase and MBL activity. Polymerase chain reaction (PCR)
technique was performed to detect NDM1. NDM1 positive isolates were further
tested for plasmid mediated AmpC, blaCTX, blaSHV, blaTEM genes and also for
phylogrouping by PCR methods. Treatment and patients’ clinical outcome were
also analyzed. Results: Out of 300 isolates, 21 (7%) were MBL producers by
phenotypic methods. Of this, 17 (81%) were NDM1 positives, among the NDM1
producers 6 (35%) isolates were belongs to phylogroups D followed by A 5
(29%), B1 4 (24%) and B2 2 (12%), 15 (88%) isolates were blaCTX-M positive
suggestive of extended-spectrum beta lactamase producing strain and 7 (47%)
were positive with CIT type of AmpC. With the follow-up of the patients, it was
found that 12 (71%) recovered and 3 (18%) developed relapses, and mortality
was seen in 2 (12%) patients. Conclusions: NDM1 producing isolates showed
a high degree of drug resistance but can be treated with suitable antimicrobials,
in the majority. Early detection and choice of appropriate antibiotics may help
in reducing mortality and morbidity.
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Keywords
Drug resistance, Escherichia coli, New Delhi metallo-betalactamases-1, phylogroups
Citation
Ckakraborty Arindam, Adhikari Prabha, Shenoy Shalini, Baliga Shrikala, Bhat Gopalkrishna, Rao Satish, Biranthabail Dhanashree, Saralaya Vishwas. Molecular characterization and clinical significance of New Delhi metallo-beta-lactamases-1 producing Escherichia coli recovered from a South Indian tertiary care hospital. Indian Journal of Pathology & Microbiology. 2015 Jul-Sept 58(3): 323-327.