Molecular epidemiology & therapeutic options of carbapenem-resistant Gram-negative bacteria

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dc.contributor.authorGarg, Aen_US
dc.contributor.authorGarg, Jen_US
dc.contributor.authorKumar, Sen_US
dc.contributor.authorBhattacharya, Aen_US
dc.contributor.authorAgarwal, Sen_US
dc.contributor.authorUpadhyay, G Cen_US
dc.date.accessioned2020-04-10T01:41:46Z
dc.date.available2020-04-10T01:41:46Z
dc.date.issued2019-02
dc.description.abstractBackground & objectives: The growing incidence and the wide diversity of carbapenemase-producing bacterial strains is a major concern as only a few antimicrobial agents are active on carbapenem-resistant bacteria. This study was designed to study molecular epidemiology of carbapenem-resistant Gram-negative bacterial (GNB) isolates from the community and hospital settings. Methods: In this study, non-duplicate GNB were isolated from clinical specimens, and phenotypic test such as modified Hodge test, metallo ?-lactamase E-strip test, etc. were performed on carbapenem-resistant bacteria. Multiplex PCR was performed to identify the presence of blaIMP, blaVIM, blaKPC, blaOXA48, blaOXA23, blaSPM, blaGIM, blaSIM and blaNDM. Minimum inhibitory concentration (MIC) of colistin, fosfomycin, minocycline, chloramphenicol and tigecycline was also determined. Results: Of the 3414 GNB studied, carbapenem resistance was 9.20 per cent and maximum resistance (11.2%) was present at tertiary care centre, followed by secondary care (4%) and primary centre (2.1%). Among the carbapenem-resistant bacteria, overall, the most common isolate was Pseudomonas aeruginosa (24%). On multiplex PCR 90.3 per cent carbapenem-resistant isolates were positive for carbapenemase gene. The blaNDM(63%) was the most prevalent gene followed by blaVIM(18.4%). MIC results showed that 88 per cent carbapenem-resistant Enterobacteriaceae were sensitive to fosfomycin, whereas 78 per cent of P. aeruginosa and 85 per cent Acinetobacter spp. were sensitive to colistin. Interpretation & conclusions: Carbapenem resistance in GNB isolates from the community and hospital settings was found to be on the rise and should be closely monitored. In the absence of new antibiotics in pipeline and limited therapeutic options, prudent use of antibiotics and strict infection control practices should be followed in hospital to limit the emergence and spread of multidrug-resistant bacteria.en_US
dc.identifier.affiliationsDepartment of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Indiaen_US
dc.identifier.affiliationsDepartment of Microbiology, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Indiaen_US
dc.identifier.affiliationsDepartment of Pharmacy, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Indiaen_US
dc.identifier.affiliationsDepartment of Microbiology, Assam University, Silchar, Indiaen_US
dc.identifier.affiliationsDepartment of Medicine, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Indiaen_US
dc.identifier.affiliationsDepartment of Microbiology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Indiaen_US
dc.identifier.citationGarg A, Garg J, Kumar S, Bhattacharya A, Agarwal S, Upadhyay G C. Molecular epidemiology & therapeutic options of carbapenem-resistant Gram-negative bacteria. Indian Journal of Medical Research. 2019 Feb; 149(2): 285-289en_US
dc.identifier.issn0971-5916
dc.identifier.issn0975-9174
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/195807
dc.languageenen_US
dc.publisherIndian Council of Medical Researchen_US
dc.relation.issuenumber2en_US
dc.relation.volume149en_US
dc.source.urihttps://dx.doi.org/10.4103/ijmr.IJMR_36_18en_US
dc.subjectAntimicrobial resistanceen_US
dc.subjectCarba NP testen_US
dc.subjectcarbapenemaseen_US
dc.subjectcolistinen_US
dc.subjectmultiplex polymerase chain reactionen_US
dc.subjectNDMen_US
dc.titleMolecular epidemiology & therapeutic options of carbapenem-resistant Gram-negative bacteriaen_US
dc.typeJournal Articleen_US
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