INCIDENCE AND OUTCOME OF MULTIDRUG RESISTANT AEROBIC GRAM-NEGATIVE BACTERIA CAUSING VARIOUS CLINICAL INFECTIONS

Authors

  • PURIMITLA USHARANI Department of Microbiology, Dr. Patnam Mahender Reddy Institute of Medical Sciences, Hyderabad, Telangana, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i2.43436

Keywords:

Gram-negative bacteria, Multidrug resistant bacteria, Modified Hodge test, Colistin

Abstract

Objective: The purpose of the present study was to isolate, characterize, and evaluate Gram-negative antibiotic bacteria isolated from different clinical samples.

Methods: The Clinical and Laboratory Standard Institute guidelines were used to isolate and identify microbial isolates on Muller–Hinton agar using standard bacteriological techniques and to monitor for antibiotic susceptibility by disc diffusion method.

Results: The study involved 129 clinical samples that were obtained from 70 males and 59 females. A maximum number of cases were recorded in the age group 51–60 (33%) followed by 41–50 (16%). The results showed that the common isolates were Escherichia coli 49 (37%), Klebsiella spp. 37 (28%), Pseudomonas aeruginosa 30 (23%), and among 12% microbial isolates, four isolates were Proteus species, seven isolates were Citrobacter species, and two isolates were Providencia species. The most of the isolates were multidrug resistant isolates. However, few isolates showed sensitivity to meropenem and imipenem and most of them were colistin sensitive. Out of 129 isolated microorganisms, 53 isolates were again screened for carbapenemase production through modified Hodge test. It was found that 50 strains were positive for carbapenemase producers (94%) and three strains were negative for carbapenemase production (6%). E. coli and P. aeruginosa followed by Klebsiella species showed carbapenemase production. Among the 50 strains that were positive for the development of carbapenemase, 47 strains were susceptible to colistin that was identified by the “E” strip method and three strains showed resistance to colistin.

Conclusion: The study allows clinicians to select the right antimicrobial agent that not only leads to improved treatment but also helps to avoid the emergence of drug resistance strains which are still sensitive.

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References

Amjad A, Mirza IA, Abbasi SA, Rarwa U, Malik N, Zia F. Modified hodge test for detection of carbapenemase production. Iran J Microbiol 2011;3:189-93.

Amudhan SM, Sekar U, Arunagiri K, Sekar B. OXA Beta-lactamase mediated carbapenem resistance in Acinetobacter baumannii. Ind J Med Microbiol 2011;29:243-5.

Anderson DJ, Engemann JJ, Harrell LJ, Carmeli Y, Reller LB, Kaye KS. Predictors of mortality in patients with bloodstream infection due to ceftazidime-resistant Klebsiella pneumoniae. Antimicrob Agents Chemother 2006;50:1715-20.

Antoniadou A, Kontopidou F, Poulakou G, Koratzanis E, Galani I, Papadomichelakis E, et al. Colistin-resistant isolates of Klebsiella pneumoniae emerging in intensive care unit patients: first report of a multiclonal cluster. J Antimicrob Chemother 2007;59:786-90.

Sarkar A, Sen MR, Nath G, Sharma BM, Gulati AK, Mohapatra TM. Prevalence of methicillin resistant Staphylococcus aureus in a tertiary care referral hospital in Eastern Uttar Pradesh. Indian J Med Microbiol 2003;21:49-51.

Bartolini A, Frasson I, AntoniettaCavallaro, Richter SN, Giorgio P. Comparison of phenotypic methods for the detection of carbapenem non-susceptible Enterobacteriaceae. Gut Pathog 2014;6:1-7.

Basak S, Attal RO, Mallick SK, Bose S. Mettalobetalactamase producing Pseudomonas aeruginosa: An emerging threat to clinicians. J Clin Diagn Res 2010;4:2691-6.

Ben-David D, Maor Y, Keller N, Regev-Yochay G, Tal I, Shachar D, et al. Potential role of active surveillance in the control of a hospital-wide outbreak of carbapenem-resistant Klebsiella pneumonia infection. Infect Cont Hosp Epid 2010;31:620-6.

Bisson G, Fishman NO, Patel JB, Edelstein PH, Lautenbach E. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species: Risk factors for colonization and impact of antimicrobial formulary interventions on colonization prevalence. Infect Control Hosp Epidemiol 2002;23:254-60.

Bush K. New beta-lactamases in gram-negative bacteria: Diversity and impact on the selection of antimicrobial therapy. Clin Infect Dis 2001;32:1085-9.

Lin MF, Huang ML, Lai SH. Risk factors in the acquisition of extended-spectrum beta-lactamase Klebsiella pneumoniae: A case-control study in a district teaching hospital in Taiwan. J Hosp Infect 2003;53:39-45.

Medeiros AA. Evolution and dissemination of beta-lactamases accelerated by generations of beta-lactam antibiotics. Clin Infect Dis 1997;24 Suppl 1:S19-45.

Mendiratta DK, Deotale V, Narang P, Metallobetalactamases producing of P. aeruginosa in hospital from rural area. Indian J Med Res 2005;121:701-3.

Nordmann P. Carbapenamase producing Enterobacteriaceae; overview of a major public health challenge. Med Mal Infect 2014;44:51-6.

Nordmann P, Poirel L, Walsh TR, Livermore DM. The emerging NDM carbapenemases. Trends Microbiol 2011;19:588-95.

Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie and McCartney Practical Medical Microbiology. 14th ed. New Delhi: Churchill Livingstone; 2006.

Khatoon R, Khan SA, Jahan N. Antibiotic resistance pattern among aerobic bacterial isolates from osteomyelitis cases attending a tertiary care hospital of North India with special reference to ESBL, AmpC, MBL and MRSA production. Int J Res Med Sci 2017;5:482-90.

Shindo Y, Ito R, Kobayashi D, Ando M, Ichikawa M, Shiraki A, et al. Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia. Am J Respir Crit Care Med 2013;188:985-95.

Galani I, Rekatsina DP, Hatzaki D, Plachouras D, Souli M, Giamarellou H. Evaluation of different laboratory tests for the detection of metallo-β-lactamase production in Enterobacteriaceae. J Antimicrob Chemother 2008;61:548-53.

Hirsch EB, Guo B, Chang KT, Cao H, Ledesma KR, Singh M, et al. Assessment of antimicrobial combinations for Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. J Infect Dis 2013;207:786-93.

Anupurba S, Sen MR, Nath G, Sharma BM, Gulati AK, Mohapatra TM. Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in Eastern Uttar Pradesh. Indian J Med Microbiol 2003;21:49-51.

Satlin M, Kubin CJ, Blumenthal JS, Cohen AB, Furuya EY, Wilson SJ, et al. Comparative effectiveness of aminoglycosides, polymyxin B, and tigecycline for clearance of carbapenem-resistant Klebsiella pneumonia from urine. Antimicrob Agents Chemother 2011;55:5893-9.

Published

07-02-2022

How to Cite

USHARANI, P. “INCIDENCE AND OUTCOME OF MULTIDRUG RESISTANT AEROBIC GRAM-NEGATIVE BACTERIA CAUSING VARIOUS CLINICAL INFECTIONS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 15, no. 2, Feb. 2022, pp. 123-6, doi:10.22159/ajpcr.2022.v15i2.43436.

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