Analysis of colistin resistance in carbapenem-resistant <i>Enterobacterales</i> and XDR <i>Klebsiella pneumoniae</i>

Bir, Raunak; Gautam, Hitender; Arif, Nazneen; Chakravarti, Priyanka; Verma, Jyoti; Banerjee, Sayantan; Tyagi, Sonu; Mohapatra, Sarita; Sood, Seema; Dhawan, Benu; Chaudhry, Rama; Kapil, Arti; Das, Bimal Kumar; Das, Bhabatosh

doi:10.1177/20499361221080650

Cited by 15 publications

(15 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This high VME and ME may be due to the use of plastics in this automated system which is shown to absorb the drug to its surface. All the phenotypic methods performed better against E. coli in comparison to K. pneumoniae, as in previous studies [12].…”

Section: Discussionsupporting

confidence: 75%

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Rout,

Dash,

Sahu

et al. 2023

Access Microbiology

View full text Add to dashboard Cite

Introduction. The increasing antibiotic resistance like the advent of carbapenem resistant Enterobactarales (CRE), Carbapenem Resistant Acinetobacter baumanii (CRAB), and Carbapenem Resistant Pseudomonas aeruginosa (CRPA) has led to to the use of toxic and older drugs like colistin for these organisms. But worldwide there is an increase in resistance even to colistin mediated both by chromosomes and plasmids. This necessitates accurate detection of resistance. This is impeded by the unavailability of a user-friendly phenotypic methods for use in routine clinical microbiology practice. The present study attempts to evaluate two different methods – colistin broth disc elution and MIC detection by Vitek two in comparison to CLSI approved broth microdilution (BMD) for colistin for Enterobactarales, Pseudomonas aeruginosa , and Acinetobacter baumanii clinical isolates. Methods. Colistin susceptibility of 6013 carbapenem resistant isolates was determined by BMD, Colistin Broth Disc Elution (CBDE), and Vitek two methods and was interpreted as per CLSI guidelines. The MIC results of CBDE, Vitek two were compared with that of BMD and essential agreement (EA), categorical agreement (CA), sensitivity, specificity, very major error (VME), major error (ME) and Cohen’s kappa (CK) was calculated. The presence of any plasmid-mediated colistin resistance (mcr-1, 2, 3, 4 and 5) was evaluated in all colistin-resistant isolates by conventional polymerase chain reaction. Results. Colistin resistance was found in 778 (12.9 %) strains among the carbapenem resistant isolates. Klebsiella pneumoniae had the highest (18.9 %) colistin resistance by the BMD method. MIC of Vitek two had sensitivity ranging from 78.2–84.8% and specificity of >92 %. There were 171 VMEs and 323 MEs by Vitek two method, much more than CLSI acceptable range. The highest percentage of errors was committed for Acinetobacter baumanii (27.8 % of VME and 7.9 % ME). On the other hand, the CBDE method performed well with EA, CA, VME and ME within acceptable range for all the organisms. The sensitivity of the CBDE method compared to gold standard BMD varied from 97.5–98.8 % for different strains with a specificity of more than 97.6 %. None of the isolated colistin resistant organisms harboured mcr plasmids. Conclusion. As BMD has many technical complexities, CBDE is the best viable alternative available for countries like India. A sensitive MIC reported by Vitek two needs to be carefully considered due high propensity for VMEs particularly for Klebsiella spp.

show abstract

Section: Discussionsupporting

confidence: 75%

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Rout,

Dash,

Sahu

et al. 2023

Access Microbiology

View full text Add to dashboard Cite

show abstract

“…In this research, antimicrobial susceptibility tests revealed that 28.8% of isolates were resistant to colistin (Table 2) which is lower rather than the result of a study performed by Rad et al (31.7%) in 2020, Iran [18], and is more than the result of a research performed by Bir et al (14.6%) in 2022, India [19], and a study done by Ballen et al (2%) in 2021, Spain [20]. Thus, resistance to colistin has relatively decreased between 2018 and 2022.…”

Section: Discussioncontrasting

confidence: 63%

Detection of Virulence Factors and Antibiotic Resistance among Klebsiella pneumoniae Isolates from Iran

Davoudabadi

Goudarzi

Hashemi

2023

BioMed Research International

View full text Add to dashboard Cite

The current study assessed the detection of virulence genes and drug resistance among Klebsiella pneumoniae isolates from Iran. During 2018 to 2020, 52 K. pneumoniae isolates were obtained from patients at Iran hospitals. By disk diffusion method, the antimicrobial susceptibility of K. pneumoniae isolates was assessed, and ESBL-producing K. pneumoniae isolates were detected by CDDT method. PCR analysis was done to detect virulence genes (iucB, iutA, iroN, kfu, allS, fimH, ybtS, mrkD, and entB); ESBL-encoding genes (blaTEM, blaPER, blaCTX-M, blaVEB, and blaSHV); and class D (blaOXA-48), class B (blaVIM, blaNDM, and blaIMP), and class A (blaKPC and blaGES) carbapenemase genes. Among all isolates, 84.6%, 13.5%, and 1.9% isolates were multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR), respectively. Also, 84.6% were ESBL-producing and 71.2%, 53.8%, 40.4%, and 9.6% of all isolates were carrying blaTEM, blaSHV, blaCTX-M, and blaOXA-48 genes, respectively. Six isolates (11.5%) were positive for blaNDM gene. In contrast, no isolates were positive for the presence of blaKPC, blaIMP, and blaVIM. Virulence factor genes including iucB, iutA, iroN, kfu, allS, fimH, ybtS, mrkD, and entB were carried by 24%, 46.2%, 25%, 11.5%, 17.3%, 86.5%, 75%, 88.5%, and 100% isolates, respectively. This study evaluated the distribution and prevalence of virulence factor genes among K. pneumoniae isolates. The treatment of these infections is challenging due to the existence of particular virulence factors and the rise of antibiotic resistance. Therefore, the current study accentuates the necessity of finding new and efficient solutions for stopping the increase of antibiotic resistance.

show abstract

“…On the contrary, lower rates (18.5% and 23.1%) were reported in other studies 18-19 . K. pneumonia was the most common isolated CRGNB in some studies 20-21 but E.coli was the commonest (56.5% and 50%) in others 17, 22 .…”

Section: Discussionmentioning

confidence: 94%

Assessment of Colistin Susceptibility among Carbapenem-Resistant Clinical Isolates

Ajlan¹,

Elmahdy

Sleem

2022

Egyptian Journal of Medical Microbiology

View full text Add to dashboard Cite

Background: Colistin is the last treatment option for infections caused by carbapenem resistant Gram-negative bacilli (CRGNB). The increasing spread of chromosomally encoded and plasmid-mediated colistin resistance made colistin susceptibility assessment a necessity. Objectives: Assessment of colistin susceptibility in CRGNB by broth micro dilution method (BMD), as the standard method and colistin broth disk elution method (CBDE), as a substitute procedure with genotypic determination of plasmid mediated colistin resistance (mcr) genes. Methodology: CRGNB were collected and identified by conventional methods. Testing carbapenemase production by modified Carbapenem Inactivation Method (mCIM) and colistin susceptibility (by BMD and CBDE) were done and results were interpreted regarding CLSI ( 2022) guidelines followed by genotypic detection of mcr-1, -2, -3, -4, and -5 genes by multiplex PCR. Results: 155 out of 308 GNB (50.3%) were carbapenem resistant. Among them, 129 (83.2%) isolates were carbapenemase positive by mCIM. Colistin susceptibility testing by BMD revealed 43 out of 155 CRGNB isolates (27.7%) were colistin resistant. Sensitivity, specificity, PPV, NPV and accuracy of CBDE were 99.09%, 93.33%, 97.32% 97.67%, 97.42% respectively with almost perfect agreement with BMD. By PCR, only 3 CRGNB isolates (6.98%) carried mcr-1 while other mcr genes were not detected at all. Conclusion: Colistin resistance rate among CRGNB is concerning, causing serious and even deadly infections so prospective surveillance is essential. Broth disk elusion method is a simple, non-expensive reliable option to test colistin susceptibility.

show abstract

Analysis of colistin resistance in carbapenem-resistant Enterobacterales and XDR Klebsiella pneumoniae

Cited by 15 publications

References 53 publications

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli

Detection of Virulence Factors and Antibiotic Resistance among Klebsiella pneumoniae Isolates from Iran

Assessment of Colistin Susceptibility among Carbapenem-Resistant Clinical Isolates

Contact Info

Product

Resources

About