Emergence of Pan-drug resistance amongst gram negative bacteria! The First case series from India

Abstract

Objective: Increasing prevalence of carbapenem resistant Gram negative bacteria is a serious clinical and public health challenge. Bacteria resistant to all available antibiotics (Pan Drug Resistance) herald the onset of post antibiotics era. We hereby report clinical profile of 13 patients with pan drug resistant gram negative isolates. Methods: Retrospective analysis of 13 patients with pan drug resistant gram negative isolates over the last 18 months was done by medical records review. Identification of the isolates and susceptibility testing was done using VITEK auto analyzer in concordance with the corresponding CLSI guidelines. Results: Out of four patients with bacteremic isolates, three patients received colistin based combination therapy. Though two of these patients had microbiologic clearance, all the three died. Out of the 9 patients with non bacteremic isolates, 4 had infection and 5 had colonization. Three (out of four) were treated with combination therapy including colistin and one patient received colistin monotherapy. All four patients had microbiological clearance. Three patients had clinical cure and were discharged. One patient later developed bacteremia and died. Conclusion: Infections, particularly blood stream with pan drug resistant organisms has a higher mortality. Urgent studies to reevaluate existing therapeutic options and research into new antibiotic molecules are the need of the hour.

Molecular study of colistin resistant clinical isolates of Enterobacteriaceae species

“…The presence of Mcr-1 was associated with in high MIC >16mg/L, Several reports had documented the association of carbapenem resistance and resistance to the third generation of cephalosporines with colistin resistance among different species of Enterobactericaea [27][28][29][30]. Therefore there is a need for the study of the prevalence of colistin resistance among isolates with extended spectrum beta lacatamase resistance [31,32].…”

Multiresistant bacterial isolates in University Clinical Centre of the Republic of Srpska

“…Visoka smrtnost zabeležena je kod bolesnika sa PDR Klebsiella spp. infekcijom (12). Slični rezultati PDR izolata gram negativnih bakterija zabeleženi su u Grčkoj, gde je izolovana 21 PDR bakterija (13).…”

Use of carbapenems and glycopepdides is significant risk for multidrug resistant Acinetobacter baumannii infections

“…This Gram-negative coccobacillus is ubiquitous and occurs mostly as commensals on the skin and in the environment [1][2][3]. Niche adaptation of Acinetobacter species to survive in hospital environments had enabled Acinetobacter strains to develop resistance against the first line antimicrobials [4,5].…”