Molecular Characterization Identifies Upstream Presence of ISAba1 to OXA Carbapenemase Genes in Carbapenem-Resistant Acinetobacter baumannii Isolated from a Tertiary Care Hospital in Western Maharashtra

Abstract Background Evaluating the expression pattern of oxacillinases (OXA) carbapenemases is essential to understand the prevalence and spread of carbapenem resistance Acinetobacter baumannii. Objectives The aim of the study is to evaluate the presence of OXA carbapenemase genes and ISAba1 upstream to these genes in carbapenem-resistant A. baumannii clinical isolates. Material and Methods A. baumannii isolated from clinical samples were phenotypically identified and antibiotics sensitivity was performed. Multiplex polymerase chain reaction (PCR) was used to detect OXA51-like gene, OXA carbapenemases genes (OXA-23-like, OXA-24-like, and OXA-58-like), and ISAba1 in carbapenem-resistant isolates. Results Out of 55 Acinetobacter isolates, 54 were confirmed as A. baumannii by PCR. Bla OXA-23-like gene was observed in 51 isolates of A. baumannii and none of the isolates showed the presence of bla OXA-24-like and bla OXA-58-like genes. Presence of ISAba1 upstream to OXA-23-like gene, OXA-51-like gene, and both OXA-51-like/OXA-23-like genes was observed in 51, 7, and 4 A. baumannii isolates, respectively. Conclusion The genetic pattern of carbapenem-resistant A. baumannii isolated in this study was unique, which should be factored for clinical protocols to manage infections caused by emerging resistant strains of A. baumannii.

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Emerging resistance to carbapenem among Gram-negative bacteria in a tertiary care hospital

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl2.2177 ◽

2020 ◽

Vol 11 (SPL2) ◽

pp. 153-156

Author(s):

Pooja Nair ◽

Renu Mathews ◽

Kalyani M

Keyword(s):

Minimum Inhibitory Concentration ◽

Inhibitory Concentration ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Clinical Samples ◽

Care Hospital ◽

Gram Negative ◽

Carbapenem Resistant ◽

Diffusion Technique

The emergence of bacterial antibiotic resistance is a cardinal concern in the health care system. The spread of resistance in Enterobacteriaceae and non-fermenters to the currently available drugs make the treatment of serious nosocomial infections troublesome. The purpose of the study is to find out the carbapenem resistance among Gram-negative bacilli in a tertiary care hospital. Antibiotic susceptibility pattern of 1913 aerobic Gram-negative bacilli isolated from clinical samples was made for a period of 6 months. All the isolates were tested for susceptibility to antibiotics by the Kirby-Bauer disc diffusion technique according to CLSI guidelines. Carbapenemase production was confirmed by the Modified Hodge Test (MHT). Minimum Inhibitory Concentration (MIC) by Epsilometer (E) test was performed (for Imipenem and Meropenem) for carbapenem-resistant strains. A total of 1731 clinical samples, 1913 Gram-negative bacilli were isolated. 1476 (77.1%) were Enterobacteriaceae and 433 (22.6%) were non-fermenters. 54 were carbapenemase-producing Gram-negative bacilli. Meropenem E test was done for carbapenemase-producing Gram-negative bacilli. The minimum inhibitory concentration for Meropenem ranged from 0.002μg/ml to 32μg/ml. To overcome the problem of emerging resistance, combined interaction and cooperation of microbiologists, clinicians and the infection control team is needed.

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Molecular Typing of Imipenem-ResistantAcinetobacter baumannii-calcoaceticusComplex in a Singapore Hospital Where Carbapenem Resistance Is Endemic

Infection Control and Hospital Epidemiology ◽

10.1086/518964 ◽

2007 ◽

Vol 28 (8) ◽

pp. 941-944 ◽

Cited By ~ 2

Author(s):

Thean Yen Tan ◽

Karen Poh ◽

Siew Yong Ng

Keyword(s):

Tertiary Care ◽

Carbapenem Resistance ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Typing Method ◽

Disk Diffusion Method ◽

Carbapenem Resistant ◽

High Prevalence ◽

Resistant Strains

Objective.To investigate the molecular epidemiology of carbapenem-resistantAcinetobacter baumannii-calcoaceticuscomplex isolates in a tertiary care hospital where the prevalence of carbapenem resistance among these organisms is high.Design.The study was a prospective, observational study performed during an 8-month period (May 1 through December 31, 2004).A. baumanniiisolates recovered from all clinical samples during the study period were included in the study. Antibiotic susceptibility testing was performed using the disk diffusion method, and all carbapenem-resistant strains were typed by a polymerase chain reaction-based typing method.Setting.An 800-bed hospital in Singapore.Results.More than half of recovered isolates were clonally unrelated, with the remaining isolates grouped into 4 genotypes.Conclusions.The results of the study suggest that the high prevalence of carbapenem resistance amongAcinetobacterorganisms in this institution is not caused by the spread of a predominant clone and that other factors may need to be investigated.

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Emergence and spread of carbapenem-resistant strains of Acinetobacter baumannii in a tertiary-care hospital in Poland

Clinical Microbiology and Infection ◽

10.1111/j.1469-0691.2007.01694.x ◽

2007 ◽

Vol 13 (5) ◽

pp. 490-496 ◽

Cited By ~ 30

Author(s):

M.M. Wroblewska ◽

K.J. Towner ◽

H. Marcher ◽

M. Luczak

Keyword(s):

Acinetobacter Baumannii ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Carbapenem Resistant ◽

Resistant Strains

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Molecular detection of blaOXA-23gene and blaOXA-51 gene in carbapenem resistant strains of Acinetobacterbaumannii in patients with ventilator associated pneumonia at tertiary care hospital

Journal of the Pakistan Medical Association ◽

10.47391/jpma.01537 ◽

2021 ◽

Vol 71 (11) ◽

pp. 2576-2581

Author(s):

Saima Ishtiaq ◽

Sidrah Saleem ◽

Abdul Waheed ◽

Arslan Ahmed Alvi

Keyword(s):

Acinetobacter Baumannii ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Conventional Polymerase Chain Reaction ◽

Diffusion Method ◽

Military Hospital ◽

Care Hospital ◽

Acinetobacter Baumanii ◽

Cross Sectional ◽

Carbapenem Resistant

Objective: To evaluate carbapenem resistance and to detect blaOXA-23 and blaOXA-51 genes in carbapenem-resistant acinetobacter baumanii isolates recovered from patients having pneumonia secondry to ventilation. Methods: The cross-sectional study was conducted from July 2017 to June 2018 at the Department of Microbiology, University of Health Sciences, Lahore, Pakistan, and comprised endotracheal aspirates / tracheobroncheal lavage samples from patients irrespective of age and gender who developed pneumonia after being on the ventilator for 48 hrs at the Combined Military Hospital, and Jinnah Hospital, Lahore. The samples were inoculated on MacConkey and blood agar and aerobically incubated at a temperature of 370C for 18-24 hours. The isolated organisms were further assessed by standard morphological, cultural and biochemical profile. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method. Carbapenem-resistant acinetobacter baumannii were checked for carbapenemase production using Modified Hodge Test. Conventional polymerase chain reaction and agarose gel electrophoreses were performed to detect blaOXA-23 and blaOXA-51 genes. Data was analysed using SPSS 17. Results: Out of 157 samples, 92(58.6%) yielded growth of bacteria, and, among them, 39(42.4%) were identified as acinetobacter baumannii. All (100%) acinetobacter baumannii cases showed resistance to carbapenem, were producing carbapenemase enzyme, and were positive for blaOXA-51 gene. The blaOXA-23 gene was amplified in 38(97.4%) isolates. Conclusion: BlaOXA-23 gene appeared to be the major cause of carbapenem resistance. Continuous...

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Prevalence of Carbapenem Resistant Enterobacteriaceae in a Tertiary Care Hospital of Gujarat, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47332.14627 ◽

2021 ◽

Author(s):

Chirag Manojkumar Modi ◽

Suman Praveen Singh ◽

Yagnesh Gajanand Pandya ◽

Chirag Premjibhai Patel ◽

Rupal Minesh Patel

Keyword(s):

Tertiary Care Hospital ◽

Demographic Data ◽

Treatment Options ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Defined Daily Dose ◽

Sample Type ◽

Care Hospital ◽

Carbapenem Resistant ◽

Carbapenem Resistant Enterobacteriaceae

Introduction: Carbapenem Resistant Enterobacteriaceae (CRE) are major cause of community as well as healthcare associated infections and have limited treatment options. Measuring the magnitude of the problem of CRE, it is important for making strategies to lower its spread. Aim: To assess the incidence and prevalence rate of CRE in a tertiary care hospital of Gujarat, India. Materials and Methods: Retrospective data was collected for a period from 2014 to 2018 using Laboratory Information System (LIS). Prevalence of CRE was determined as number of CRE isolated per 100 Enterobacteriaceae isolated during the study period whereas incidence rate was determined as number of CRE cases per 1000 patient-days. Consumption of Carbapenems was calculated as Defined Daily Dose (DDD) per 1000 patient-days. Demographic data including age, gender, location in the hospital and sample type from which CRE was isolated was also analysed using Microsoft Excel. Results: The incidence of CRE cases per 1000 patient-days in 2014 to 2018 was 1.66, 2.11, 1.90, 2.26 and 1.91, respectively with an overall incidence of 1.99 per 1000 patient-days. The overall prevalence of CRE over a period of five years was found to be 29.07%. Klebsiellasp. was the most common CRE and had the highest percentage of Carbapenem resistance among all Enterobacteriaceae. Conclusion: The rate of CRE in present study was high and worrisome. Screening of the patient for CRE, source isolation and stringent implementation of infection control practices is required to confine the spread of CRE in this institute.

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Phenotypic and genotypic characterization of multidrug-resistant isolates from patients with catheter-associated urinary tract infection in a tertiary care hospital

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_22_19 ◽

2019 ◽

Vol 11 (03) ◽

pp. 206-211

Author(s):

Jaison Jayakaran ◽

Nirupa Soundararajan ◽

Priyadarshini Shanmugam

Keyword(s):

Urinary Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Diffusion Method ◽

Care Hospital ◽

Disk Diffusion Method ◽

Carbapenem Resistant ◽

Tract Infections

Abstract INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country. AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23. MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23. RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene. CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.

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