Genome-wide identification of carbapenem-resistant Gram-negative bacterial (CR-GNB) isolates retrieved from hospitalized patients in Bihar, India

Abstract

Carbapenemase-producing clinical isolates are becoming more common over the world, posing a severe public health danger, particularly in developing nations like India. Carbapenem-resistant Gram-negative bacterial (CR-GNB) infection has become a fast-expanding global threat with limited antibiotic choice and significant mortality. This study aimed to highlight the carbapenem-resistance among clinical isolates of hospital admitted patients in Bihar, India. A cross-sectional study was conducted with 101 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. All GNB isolates were tested for their antimicrobial susceptibility using Kirby-Bauer disc diffusion method. Double disc synergy test / modified Hodge test (DDST/MHT) were used to detect carbapenemase production by these isolates. Subsequently, these isolates were evaluated for carbapenem-resistance genes using whole-genome sequencing method. The overall percentage of carbapenem-resistance among GNB was (17/101) 16.8%. The genomic analysis of antimicrobial-resistance (AMR) demonstrates a significantly high prevalence of blaCTX-M followed by blaSHV, blaTEM, blaOXA, and blaNDM β-lactam or carbapenem resistance genes among clinical isolates of GNB. Co-occurrence of blaNDM with other beta-lactamase-encoding genes was found in 70.6% of carbapenemase-producing isolates. Our study highlights the mechanism of carbapenem-resistance to curb the overwhelming threat posed by the emergence of drug-resistance in India.

Identification and Characterization of Plasmids and Genes from Carbapenemase-Producing Klebsiella pneumoniae in Makkah Province, Saudi Arabia

“…Several studies have shown the possibility of K. pneumoniae carrying more than one carbapenem resistance gene in isolates from China, Singapore, India, Europe, and the Middle East [ 43 , 44 , 45 ]. In this study, all isolates showed the coexistence of at least two carbapenems genes, except for isolates K5 and K21, which produced the bla VIM gene only.…”

Enhancement of anti-bactericidal and anti-biofilm activities of silver nanoparticles against multidrug-resistant enteric pathogens isolated from children with diarrhea

“…Interestingly, AgNPs exhibit superior antibacterial action against multi-drug resistant (MDR) Enterobacteriaceae (E. coli and S. typhi) with MIC from 10 -15 μg/ml and disrupts growth with inhibition around 50%-60 % for E. coli and S. typhi respectively as shown in table (4) and as illustrated in figure (3). Moreover, combination of sublethal doses of AgNPs with sub-MIC (½MIC) of aminoglycoside antibiotic (Kanamycin) exhibited substantial synergistic bactericidal effects against multi-drug resistant Enterobacteriaceae with FIC index range 0.21 -0.5 for E. coli and 0.2-0.45 for S. typhi as shown in the table (4). The data in the figure (5) confirmed that AgNPs had 55%-65% inhibitory action on biofilm development for pathogenic bacteria isolated from children with diarrhea.…”

“…The biofilm production classified as strong, moderate, and weak according to ability of microorganism to developing of the biofilms. About 15% of the E. coli strains developed strong biofilm production and compared to approximately 10% of S. typhi; moreover, moderate biofilm production recorded about 10% and 5% for E. coli and S. typhi respectively as described in figure (4). Bacterial cells were cultivated to produce biofilms and then treated with AgNPs alone or in combination with aminoglycoside antibiotics (Kanamycin) to investigate the synergistic effects.…”

“…Enterobacteriaceae resistance to antimicrobials is a major public health concern, particularly in underdeveloped nations. Transferable plasmids that encode multidrug resistance have been shown to be a major cause of the issue, and it has been demonstrated that species of enterobacter (4).…”

Recent advances in therapeutic targets identification and development of treatment strategies towards Pseudomonas aeruginosa infections

“…P. aeruginosa can get further resistance by overexpression of AmpC, acquisition of mutations causing AmpC hyperactivity or through modification of the antimicrobial target structures [ 6 ]. In addition, horizontal gene transfer plays an important role, allowing the acquisition of resistance genes towards carbapenems [ 7 ] or quinolones ( qnrB , qnrA , and qnrS ), among others [ 8 ].…”