Molecular Characterization of Carbapenem Resistant Isolates of Acinetobacter baumannii in An Intensive Care Unit of A Tertiary Care Centre at Central India

Khajuria, Atul; Praharaj, Ashok Kumar; Kumar, Manjit; Grover, Naveen

doi:10.7860/jcdr/2014/7749.4398

Cited by 18 publications

(24 citation statements)

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“…Interestingly, we detected OXA-58 as the second most abundant carbapenemase gene. OXA-58 has been found on a plasmid in Enterobacteriaceae, and it is a mobile carbapenemase regularly encountered in Acinetobacter [51,52]. A previous study of ours showed that the abundance of OXA-58 in Indian river sediments contaminated with untreated urban waste strongly correlates with the abundance of Acinetobacter [53].…”

Section: Discussionmentioning

confidence: 50%

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Sewage effluent from an Indian hospital harbors novel carbapenemases and integron-borne antibiotic resistance genes

et al. 2019

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Background: Hospital wastewaters contain fecal material from a large number of individuals, of which many are undergoing antibiotic therapy. It is, thus, plausible that hospital wastewaters could provide opportunities to find novel carbapenemases and other resistance genes not yet described in clinical strains. Our aim was therefore to investigate the microbiota and antibiotic resistome of hospital effluent collected from the city of Mumbai, India, with a special focus on identifying novel carbapenemases. Results: Shotgun metagenomics revealed a total of 112 different mobile antibiotic resistance gene types, conferring resistance against almost all classes of antibiotics. Beta-lactamase genes, including encoding clinically important carbapenemases, such as NDM, VIM, IMP, KPC, and OXA-48, were abundant. NDM (0.9% relative abundance to 16S rRNA genes) was the most common carbapenemase gene, followed by OXA-58 (0.84% relative abundance to 16S rRNA genes). Among the investigated mobile genetic elements, class 1 integrons (11% relative abundance to 16S rRNA genes) were the most abundant. The genus Acinetobacter accounted for as many as 30% of the total 16S rRNA reads, with A. baumannii accounting for an estimated 2.5%. High throughput sequencing of amplified integron gene cassettes identified a novel functional variant of an IMP-type (proposed IMP-81) carbapenemase gene (eight aa substitutions) along with recently described novel resistance genes like sul4 and bla RSA1. Using a computational hidden Markov model, we detected 27 unique metallo-beta-lactamase (MBL) genes in the shotgun data, of which nine were novel subclass B1 genes, one novel subclass B2, and 10 novel subclass B3 genes. Six of the seven novel MBL genes were functional when expressed in Escherichia coli. Conclusion: By exploring hospital wastewater from India, our understanding of the diversity of carbapenemases has been extended. The study also demonstrates that the microbiota of hospital wastewater can serve as a reservoir of novel resistance genes, including previously uncharacterized carbapenemases with the potential to spread further.

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Section: Discussionmentioning

confidence: 50%

“…The rates of A. baumannii nosocomial infections have risen globally in past decades [54]. Acinetobacter is invariably resistant to [51,55]. GES-type beta-lactamases were the second most abundant ESBLs in our study, with several variants capable of low-level hydrolysis of carbapenems [56].…”

Section: Discussionmentioning

confidence: 60%

Sewage effluent from an Indian hospital harbors novel carbapenemases and integron-borne antibiotic resistance genes

et al. 2019

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“…This reduces the response to long term treatment and generates the multidrug resistant (MDR) strains that show resistance to last three groups of antibiotics [8]. MDR strains are often resistant to carbapenems [9,10]. In this study, all strains were defined as MDR and of these, 31.2% were extensively drug-resistant (sensitive only to colistin).…”

Section: Discussionmentioning

confidence: 93%

β-lactamase genes in carbapenem resistance Acinetobacter baumannii isolates from a Turkish university hospital

Çoşkun

Çalışkan

Cicek

et al. 2019

J Infect Dev Ctries

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Introduction: The spread of Acinetobacter baumannii, resistant to most of the available antimicrobial agents, is a serious health problem. The high rate of carbapenem resistance among Acinetobacter baumannii isolates is considered as a threat to public health. In this study, we aimed to determine the antibiotic resistance and related genes in carbapenem-resistant Acinetobacter baumannii isolates. Methodology: Ninety six isolates of A. baumannii were included. Antimicrobial susceptibility was performed by Phoenix Automated System and disk diffusion method. Carbapenem resistane was characterized by scrneeing of resistance genes such as blaTEM, blaSHV, blaCTX-M1-2, blaPER, blaVEB, blaKPC, blaGES, blaNDM, blaVIM, blaIMP and blaOXA23-24-51-58 using multiplex polymerase chain reaction. Results: Resistance for the levofloxacin, gentamicin, amikacin, and tigecycline were determined as 96.9%, 93.7%, 72.9% and 45.8% respectively. Colistin was the only susceptible antibiotic against all clinical isolates. All isolates were defined as multidrug resistance and of these, 31.2% were extensively drug-resistant (sensitive only to colistin). BlaOXA-51 and blaOXA-23 genes were detected in 100% strains while blaTEM was found in only 2% strains. There was no amplification for the blaSHV, blaCTX-M1-2, blaPER, blaVEB, blaKPC, blaGES blaNDM, blaVIM, blaIMP and blaOXA24-58 genes. Conclusions: The high frequency of blaOXA-23 and low frequency of blaTEM gene was observed that indicate prevalence of a variety of A. baumannii strains. The rates of resistance genes vary from region to region. Studies are required for the prevention and control of A. baumannii infection and to formulate the strategies of antibiotic usage.

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“…The results from recent reports (published from 2010) with a high number (Ͼ100) of sequential nonduplicate AB isolates tested are summarized in Table 2. Based on the summary in Table 2, carbapenem resistance rates in AB have generally exceeded 40% throughout all of India (53)(54)(55)(56)(57)(58)(59)(60), and OXA enzymes are the predominant carbapenemases in AB in India (61). CRAB remains a health care-associated opportunistic pathogen, and there are no significant reports of CRAB in the community in India to our knowledge.…”

Section: South Asiamentioning

confidence: 99%

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

et al. 2017

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SUMMARY Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.

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Molecular Characterization of Carbapenem Resistant Isolates of Acinetobacter baumannii in An Intensive Care Unit of A Tertiary Care Centre at Central India

Abstract: Objective: To detect genes encoding carbapenem resistance in Acinetobacter baumannii in an intensive care unit. Methods

Cited by 18 publications

References 18 publications

Sewage effluent from an Indian hospital harbors novel carbapenemases and integron-borne antibiotic resistance genes

Sewage effluent from an Indian hospital harbors novel carbapenemases and integron-borne antibiotic resistance genes

β-lactamase genes in carbapenem resistance Acinetobacter baumannii isolates from a Turkish university hospital

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

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