scholarly journals Outbreak Caused by Enterobacteriaceae Harboring NDM-1 Metallo-β-Lactamase Carried in an IncFII Plasmid in a Tertiary Care Hospital in Mexico City

2015 ◽  
Vol 59 (11) ◽  
pp. 7080-7083 ◽  
Author(s):  
Pedro Torres-González ◽  
Miriam Bobadilla-del Valle ◽  
Estrella Tovar-Calderón ◽  
Francisco Leal-Vega ◽  
Araceli Hernández-Cruz ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mexico City ◽  
Tertiary Care Hospital ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Enterobacter Cloacae ◽  
New Delhi ◽  
Care Hospital ◽  
Content Type ◽  
Carbapenem Resistant

ABSTRACTCarbapenem-resistantEnterobacteriaceaecarrying New Delhi metallo-β-lactamase 1 (NDM-1) have rarely been reported in Latin America. We report of an outbreak caused by ablaNDM-1-harboring plasmid spread through different bacterial species, includingEscherichia coli(ST617) andEnterobacter cloacae(ST182) isolates from the same patient and threeKlebsiella pneumoniaeisolates (ST22) derived from three epidemiologically related patients. IncFII plasmids were found in all strains. Measures to control the outbreak were applied successfully.

scholarly journals NDM Production as a Dominant Feature in Carbapenem-Resistant Enterobacteriaceae Isolates from a Tertiary Care Hospital

Antibiotics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 48
Author(s):  
Fakhur Uddin ◽  
Syed Hadi Imam ◽  
Saeed Khan ◽  
Taseer Ahmed Khan ◽  
Zulfiqar Ahmed ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistance Mechanism ◽  
Enterobacter Cloacae ◽  
Care Hospital ◽  
Healthcare Settings ◽  
Carbapenem Resistant ◽  
Potential Source ◽  
Dominant Feature ◽  
Carbapenem Resistant Enterobacteriaceae

The worldwide spread and increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is of utmost concern and a problem for public health. This resistance is mainly conferred by carbapenemase production. Such strains are a potential source of outbreaks in healthcare settings and are associated with high rates of morbidity and mortality. In this study, we aimed to determine the dominance of NDM-producing Enterobacteriaceae at a teaching hospital in Karachi. A total of 238 Enterobacteriaceae isolates were collected from patients admitted to Jinnah Postgraduate Medical Centre (Unit 4) in Karachi, Pakistan, a tertiary care hospital. Phenotypic and genotypic methods were used for detection of metallo-β-lactamase. Out of 238 isolates, 52 (21.8%) were CRE and 50 isolates were carbapenemase producers, as determined by the CARBA NP test; two isolates were found negative for carbapenemase production by CARB NP and PCR. Four carbapenemase-producing isolates phenotypically appeared negative for metallo-β-lactamase (MBL). Of the 52 CRE isolates, 46 (88.46%) were blaNDM positive. Most of the NDM producers were Klebsiella pneumoniae, followed by Enterobacter cloacae and Escherichia coli. In all the NDM-positive isolates, the blaNDM gene was found on plasmid. These isolates were found negative for the VIM and IPM MBLs. All the CRE and carbapenem-sensitive isolates were sensitive to colistin. It is concluded that the NDM is the main resistance mechanism against carbapenems and is dominant in this region.

scholarly journals Molecular characterization and antimicrobial susceptibility profile of New Delhi metallo-beta-lactamase-1-producing Escherichia coli among hospitalized patients

2018 ◽  
Vol 10 (02) ◽  
pp. 149-154
Author(s):  
Anjali Agarwal ◽  
Jyoti Srivastava ◽  
Ujjwal Maheshwari ◽  
Mohd Iftikhar
Keyword(s):  
Escherichia Coli ◽  
Tertiary Care Hospital ◽  
Treatment Options ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
New Delhi ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
E Coli

ABSTRACT BACKGROUND: Carbapenemase-producing microorganisms are becoming a major concern among hospital-acquired infections. There is also increased multidrug resistance seen among these isolates. AIMS: We have conducted this study to determine the prevalence of New Delhi metallo-beta-lactamase-1 (NDM-1) gene-producing Escherichia coli among hospitalized patients in a tertiary care hospital in Northern India. SETTINGS AND DESIGN: The study was conducted in the Department of Microbiology with the tertiary care hospital settings. It was a prospective cross-sectional observational study conducted during January 2014–August 2014. MATERIALS AND METHODS: A total of 500 nonduplicate E. coli samples were processed. The isolates with reduced susceptibility to ertapenem, i.e., zone diameter between 19 and 21 mm, were considered carbapenemase producers. These isolates were subjected to modified Hodge test for phenotypic confirmation. Polymerase chain reaction was performed on all the screened isolates for molecular detection of NDM-1 gene. STATISTICAL ANALYSIS USED: Chi-square test was used to analyze the data and P < 0.05 was considered statistically significant. RESULTS: Out of 500 E. coli isolates, 61 (12.2%) were screened for carbapenemase production. 47 (9.4%) isolates were positive by modified Hodge test and 36 (7.2%) isolates showed the presence of blaNDM-1 gene (P < 0.05). CONCLUSION: There is an increased prevalence of NDM-1 gene-producing E. coli isolates. These carbapenemase-producing isolates are more resistant to other group of antibiotics (aminoglycosides, fluoroquinolones along with β-lactam group). Early detection of blaNDM-1 gene can help in choosing the effective treatment options for hospitalized patients in time, thereby reducing the risk of mortality.

scholarly journals Evolution of Outbreak-Causing Carbapenem-Resistant Klebsiella pneumoniae ST258 at a Tertiary Care Hospital over 8 Years

mBio ◽  
2019 ◽  
Vol 10 (5) ◽  
Author(s):  
Jane W. Marsh ◽  
Mustapha M. Mustapha ◽  
Marissa P. Griffith ◽  
Daniel R. Evans ◽  
Chinelo Ezeonwuka ◽  
...  
Keyword(s):  
Health Care ◽  
Klebsiella Pneumoniae ◽  
Care Setting ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Health Care Setting ◽  
Health Concern ◽  
Care Hospital ◽  
Content Type ◽  
Carbapenem Resistant

ABSTRACT Carbapenem-resistant Klebsiella pneumoniae (CRKP) strains belonging to sequence type 258 (ST258) are frequent causes of hospital-associated outbreaks and are a major contributor to the spread of carbapenemases. This genetic lineage emerged several decades ago and remains a major global health care challenge. In this study, genomic epidemiology was used to investigate the emergence, evolution, and persistence of ST258 carbapenem-resistant K. pneumoniae outbreak-causing lineages at a large tertiary care hospital over 8 years. A time-based phylogenetic analysis of 136 ST258 isolates demonstrated the succession of multiple genetically distinct ST258 sublineages over the 8-year period. Ongoing genomic surveillance identified the emergence and persistence of several distinct clonal ST258 populations. Patterns of multidrug resistance determinants and plasmid replicons were consistent with continued evolution and persistence of these populations. Five ST258 outbreaks were documented, including three that were caused by the same clonal lineage. Mutations in genes encoding effectors of biofilm production and iron acquisition were identified among persistent clones. Two emergent lineages bearing K. pneumoniae integrative conjugative element 10 (ICEKp10) and harboring yersiniabactin and colibactin virulence factors were identified. The results show how distinct ST258 subpopulations have evolved and persisted within the same hospital over nearly a decade. IMPORTANCE The carbapenem class of antibiotics is invaluable for the treatment of selected multidrug-resistant Gram-negative pathogens. The continued transmission of carbapenem-resistant bacteria such as ST258 K. pneumoniae is of serious global public health concern, as treatment options for these infections are limited. This genomic epidemiologic investigation traced the natural history of ST258 K. pneumoniae in a single health care setting over nearly a decade. We found that distinct ST258 subpopulations have caused both device-associated and ward-associated outbreaks, and some of these populations remain endemic within our hospital to the present day. The finding of virulence determinants among emergent ST258 clones supports the idea of convergent evolution of drug-resistant and virulent CRKP strains and highlights the need for continued surveillance, prevention, and control efforts to address emergent and evolving ST258 populations in the health care setting.

scholarly journals Resistant Escherichia coli strains circulating in a tertiary-care hospital in New Delhi, India

Critical Care ◽  
2012 ◽  
Vol 16 (S3) ◽  
Author(s):  
B Uppal ◽  
P Aggarwal ◽  
R Ghosh ◽  
AK Jha ◽  
S Krishna Prakash
Keyword(s):  
Escherichia Coli ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital

scholarly journals Air Bacteriology of Operation Theatres and Intensive Care Units from a Tertiary Care Hospital in New Delhi

2019 ◽  
Vol 4 (11) ◽  
Author(s):  
Patel Pritikumari ◽  
Shalini Malhotra ◽  
Saloni Garg ◽  
Renu Yadav ◽  
NK Bhatia ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care Hospital ◽  
Bacterial Species ◽  
Tertiary Care ◽  
North India ◽  
New Delhi ◽  
Care Hospital ◽  
Strict Adherence ◽  
Hospital Associated Infections

Background: Hospital-associated infections are a major cause of patient morbidity and mortality. Microbiological contamination of air in the operation theaters (OTs) and Intensive care units (ICUs) is a major risk factor for surgical site and other hospital-associated infections. The aim of the study was to determine the microbial contamination of air in the OTs and ICUs of a tertiary care hospital in north India. Methods: The study was conducted in the department of microbiology, Dr. RML hospital & PGIMER, New Delhi. Air samples were collected from 9 OTs and 4 ICUs by settle plate method between January 2017–June 2018. Bacterial species were isolated and identified by conventional methods. Results: A total of 630 samples were collected from environment of various OTs and ICUs. Out of these, 130 (20%) plates showed bacterial growth and yielded 380 isolates. Emergency OT and ECS OT showed highest bacterial CFU per plate. The most common isolate was Bacillus species 472 (75%) followed by micrococcus 352(56%), Staphylococcus aureus 6 (1%). Conclusion: Routine surveillance of OT and ICU air in conventional OTs where there is no control on air quality, meticulous cleaning and strict adherence to OT and ICU protocol are essential steps for the prevention of hospital acquired infections. Further, the hospitals need to develop and implement processes for good infection control practices

scholarly journals Superbugs causing infections at a tertiary care hospital and the return of pre-antibiotic era!

2015 ◽  
Vol 7 (2) ◽  
pp. 76-79
Author(s):  
Kalyan Rajkumar ◽  
Shruti Radera ◽  
Jyotsna Agarwal ◽  
Mastan Singh
Keyword(s):  
Tertiary Care Hospital ◽  
Treatment Options ◽  
Tertiary Care ◽  
Clinical Samples ◽  
New Delhi ◽  
Care Hospital ◽  
E Coli ◽  
Northern India ◽  
Carbapenem Resistant ◽  
Intensive Education

Aims and Objectives: Increase in the incidence of Escherichia coli and Klebsiella pneumoniae carrying New Delhi metallo beta lactamase-1 (NDM-1) gene are called superbugs is of great concern as presence of blaNDM-1 gene makes E.coli and K.pneumoniae highly resistant to most of currently available antibiotics. This study was planned to observe the burden of blaNDM-1 gene carrying E. coli and K.pneumoniae at a tertiary care hospital in northern India. Materials and Methods: A total of 1709 E. coli and 327 K. pneumonia nonrepitive isolates were taken from various clinical samples received in a tertiary care hospital in northern India Lucknow during the period from May 2012 to April 2013. Carbapenemase production was phenotypically detected in all the carbapenem resistant isolates by modified Hodge test. Metallo-β-lactamase production was detected by using meropenem and imipenem discs with and without EDTA and blaNDM-1 gene was detected by polymerase chain reaction. Results: Over all metallo β- lactamase production was found in 82% and 88.89% of carbapenem resistant E.coli and K. pneumonia respectively. Out of 366 carbapenem resistant isolates, 102 were found positive for blaNDM-1 gene out of which 89 were E.coli and 13 were K. pneumoniae. Conclusions: With limited treatment options left for this crisis situation like the pre-antibiotic era; it is an alarm for rational antibiotic therapy usage and intensive education programs.Asian Journal of Medical Sciences Vol.7(2) 2015 76-79

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