Molecular characterization of extended-spectrum ?-lactamases among clinical isolates of Escherichia coli & Klebsiella pneumoniae: A multi-centric study from tertiary care hospitals in India

dc.contributor.authorGautam, Ven_US
dc.contributor.authorThakur, Aen_US
dc.contributor.authorSharma, Men_US
dc.contributor.authorSingh, Aen_US
dc.contributor.authorBansal, Sen_US
dc.contributor.authorSharma, Aen_US
dc.contributor.authorKapil, Aen_US
dc.contributor.authorDas, BKen_US
dc.contributor.authorSistla, Sen_US
dc.contributor.authorParija, SCen_US
dc.contributor.authorVeeraraghavan, Ben_US
dc.contributor.authorPrakash, JAen_US
dc.contributor.authorWalia, Ken_US
dc.contributor.authorOhri, V Cen_US
dc.contributor.authorRay, Pen_US
dc.date.accessioned2020-04-10T01:41:45Z
dc.date.available2020-04-10T01:41:45Z
dc.date.issued2019-02
dc.description.abstractBackground & objectives: The increasing prevalence of extended-spectrum ?-lactamases (ESBLs) has abated therapeutic options worldwide. This study was undertaken to investigate the molecular profile and resistance patterns of ESBLs among clinical isolates of Escherichia coli and Klebsiella pneumoniae at four tertiary care centres in India. Methods: Clinical isolates of E. coli and K. pneumoniae were collected from the All India Institute of Medical Sciences (AIIMS), New Delhi; the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry; Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh and Christian Medical College (CMC), Vellore, over one and a half year period. Antimicrobial susceptibility was determined by Kirby-Bauer disc diffusion method. ESBLs were confirmed phenotypically, and multiplex PCR was performed to identify genes for ?-lactamases (blaTEM, blaSHV, blaOXA-1, blaCTXM-1, blaCTXM-2, blaCTXM-9 and blaCTXM-15). Results: Among 341 E. coli isolates collected during the study period, 171 (50%) harboured blaTEM, 145 (43%) blaOXA-1,70 (21%) blaCTXM-1, 19 (6%) blaSHV and four (1%) harboured blaCTXM-2. Phenotypically, combined disc test detected ESBL production in 98/298 (33%) E. coli. Among 304 K. pneumoniae isolates, 115 (38%), 89 (29%), 83 (27%), 64 (21%) and two (0.6%) harboured blaTEM, blaOXA-1, blaCTXM-1, blaSHV and blaCTXM-2, respectively. Combined disc test (CDT) detected ESBL production in 42 per cent K. pneumoniae. Most of the blaCTXM-1positive isolates were also blaCTXM-15 positive. The carbapenem susceptibility ranged from 56 to 88 per cent for E. coli and from 20 to 61 per cent for K. pneumoniae. Antibiotic sensitivity patterns showed that colistin (CST) was the most sensitive drug for both E. coli (271/274, 99%) and K. pneumoniae (229/234, 98%). Interpretation & conclusions: The prevalence of ESBL among four study centres varied, and blaTEM, blaOXA-1 and blaCTXM-15 were the most common genotypes in E. coli and K. pneumoniae isolates in India. The growing carbapenem resistance and emerging colistin resistance warrant the judicious use of these antimicrobials.en_US
dc.identifier.affiliationsDepartment of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Microbiology, All India Institute of Medical Sciences, New Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Indiaen_US
dc.identifier.affiliationsDepartment of Clinical Microbiology, Christian Medical College, Vellore, Indiaen_US
dc.identifier.affiliationsDivision of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, Indiaen_US
dc.identifier.citationGautam V, Thakur A, Sharma M, Singh A, Bansal S, Sharma A, Kapil A, Das BK, Sistla S, Parija SC, Veeraraghavan B, Prakash JA, Walia K, Ohri V C, Ray P. Molecular characterization of extended-spectrum ?-lactamases among clinical isolates of Escherichia coli & Klebsiella pneumoniae: A multi-centric study from tertiary care hospitals in India. Indian Journal of Medical Research. 2019 Feb; 149(2): 208-215en_US
dc.identifier.issn0971-5916
dc.identifier.issn0975-9174
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/195795
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_172_18en_US
dc.subjectAntibiotic sensitivityen_US
dc.subjectcolistin resistanceen_US
dc.subjectEscherichia colien_US
dc.subjectextended-spectrum ?-lactamasesen_US
dc.subjectKlebsiella pneumoniaeen_US
dc.titleMolecular characterization of extended-spectrum ?-lactamases among clinical isolates of Escherichia coli & Klebsiella pneumoniae: A multi-centric study from tertiary care hospitals in Indiaen_US
dc.typeJournal Articleen_US
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