Prevalence and antibacterial resistance patterns of extended‑spectrum beta‑lactamase producing Gram‑negative bacteria isolated from ocular infections.
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Date
2016-04
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Abstract
Purpose: Extended‑spectrum beta‑lactamases (ESBLs) mediated resistance is more prevalent worldwide,
especially among Gram‑negative bacterial isolates, conferring resistance to the expanded spectrum
cephalosporins. As limited data were available on the prevalence of ESBLs in this area, the current study
was undertaken to determine the prevalence, antibacterial resistance patterns, and molecular detection and
characterization of ESBL encoding resistance genes among ocular Gram‑negative bacterial isolates from
ocular infections. Materials and Methods: A prospective study was done on 252 ocular Gram‑negative
bacterial isolates recovered from ocular infections during a study period from February 2011 to January
2014. All isolates were subjected to detection of ESBLs by cephalosporin/clavulanate combination disc test
and their antibacterial resistance pattern was studied. Molecular detection and characterization of ESBL
encoding blaTEM‑, blaSHV, blaOXA‑, and blaCTX‑M (phylogenetic groups 1, 2, 9, and 8/25) resistance genes by
multiplex polymerase chain reaction and DNA sequence analysis. Results: Of all Gram‑negative bacteria,
Pseudomonas aeruginosa (44%) was the most common strain, followed by Enterobacter agglomerans and
Klebsiella pneumoniae each (10%). Among the 252, 42 (17%) were ESBL producers. The major source of ESBL
producers were corneal scraping specimens, highest ESBL production was observed in P. aeruginosa 16 (38%)
and Escherichia coli 7 (16.6%). Among ESBL‑producing genes, the prevalence of blaTEM‑gene was the highest
(83%) followed by blaOXA‑gene (35%), blaSHV‑gene (18.5%), and blaCTX‑M‑1‑gene (18.5%) alone or together.
Conclusion: The higher rate of prevalence of ESBLs‑encoding genes among ocular Gram‑negative bacteria is
of great concern, as it causes limitation to therapeutic options. This regional knowledge will help in guiding
appropriate antibiotic use which is highly warranted.
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Keywords
Antibiotic resistance, extended‑spectrum beta‑lactamases, multiplex polymerase chain reaction, ocular Gram‑negative bacteria
Citation
Rameshkumar G, Ramakrishnan R, Shivkumar C, Meenakshi R, Anitha V, Reddy Y C Venugopal, Maneksha V. Prevalence and antibacterial resistance patterns of extended‑spectrum beta‑lactamase producing Gram‑negative bacteria isolated from ocular infections. Indian Journal of Ophthalmology. 2016 Apr; 64(4): 303-311.