Occurrence, prevalence and genetic environment of CTX-M  -lactamases in Enterobacteriaceae from Indian hospitals

Ensor, V. M.; Shahid, Mohd; Evans, Jonathan D.; Hawkey, Peter M.

doi:10.1093/jac/dkl422

Cited by 123 publications

(93 citation statements)

References 14 publications

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“…By MIC, majority of the isolates conferred high resistance to cefotaxime ([256 to [1,024 lg/ml) as well as to ceftazidime (16 to [256 lg/ml). Thus, MIC determination to cefotaxime and ceftazidime is not a reliable approach for CTX-M, this correlates with other studies [19].…”

Section: Antibiotic Susceptibility Testingsupporting

confidence: 85%

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Study of CTX-M Type of Extended Spectrum β-Lactamase among Nosocomial Isolates of Escherichia coli and Klebsiella pneumoniae in South India

et al. 2011

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Data on CTX-M type extended-spectrum b-lactamase (ESBL) produced by Gram-negative bacteria by molecular methods are limited from India. This study was conducted to investigate the prevalence of CTX-M type ESBL producing Escherichia coli and Klebsiella pneumoniae from nosocomial isolates in a tertiary care hospital in southern India. A total of 179 clinical isolates of K. pneumoniae (n = 72) and E. coli (n = 107) were obtained in a period of 3 months and assessed for ESBL production phenotypically. Associated resistance to a panel of antibiotics and Minimum Inhibitory Concentration for 3rd generation cephalosporins was determined. Phenotypically ESBL positive isolates were subjected to PCR for bla CTX-M gene using two sets of primers for the simultaneous detection of all the five major groups of CTX-M types. All the positive isolates were then subjected to a group specific PCR to detect the prevalent group. Out of 179 isolates, 156 (87.1%) were positive for ESBL phenotypically, which includes 39.2% of K. pneumoniae and 60.8% of E. coli. All of them were examined by PCR using two primers for the presence of bla CTX-M genes. Among the 156 phenotypic positive isolates, 124 (79.4%) were positive for bla CTX-M genes, of which 45 (36.2%) were K. pneumoniae, 79 (63.7%) were E. coli. When the 124 positive clinical isolates were further tested with CTX-M group-specific primers, all were positive for the CTX-M-1 group. Our findings document evidence of the high prevalence of multidrug resistant CTX-M group 1 type ESBL among nosocomial isolates in this region. High co-resistance to other non-b-lactam antibiotics is a major challenge for management of ESBL infections. This is alarming and calls for the judicious use of carbapenems, especially in developing countries. This has significant implications for patient management, and indicates the need for increased surveillance and for further molecular characterization of these isolates.

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Section: Antibiotic Susceptibility Testingsupporting

confidence: 85%

“…A variant of the CTX-M-3 enzyme, designated CTX-M-15 was reported in May 2000 [3]. CTX-M-15 appears to be the predominant ESBL in northern India [19,24,25]. Jemima et al [22] reported prevalence of CTX-M-1 type gene in 58.3% Klebsiella spp.…”

Section: Molecular Analysis By Pcrmentioning

confidence: 99%

Study of CTX-M Type of Extended Spectrum β-Lactamase among Nosocomial Isolates of Escherichia coli and Klebsiella pneumoniae in South India

et al. 2011

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“…IdentiÞ cation of CTX-M-15 in four strains of Enterobacteriaceae by sequence analysis correlated well with the earlier Þ ndings from north India. [5,6] In conclusion, this study documents the presence of CTX-M type β lactamase among the ESBLs in this tertiary care hospital in south India.…”

Section: Discussionsupporting

confidence: 51%

“…[4] Isolates producing ESBLs have not been characterized in most of the earlier studies except two studies from North India, which have reported CTX-M-15 β lactamases in isolates of Enterobacteriaceae. [5,6] Although ESBL phenotypes have been reported from south India, there is no information on their molecular types. Hence, the present study was undertaken to characterize the β-lactamases in multidrugresistant clinical isolates of Enterobacteriaceae by molecular techniques.…”

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confidence: 99%

Detection of <i> Enterobacteriaceae</i> producing CTX-M extended spectrum β-lactamases from a tertiary care hospital in south India

Padmini¹,

Raju²,

Mani³

2008

Indian J Med Microbiol

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A total of 23 clinical isolates (15 Escherichia coli and 8 Klebsiella pneumoniae), resistant to cefotaxime and ceftazidime recovered during 2002 and 2003, were investigated for production of CTX-M extended spectrum β-lactamase (ESBL) by phenotypic and molecular methods. The presence of ESBL was tested by NCCLS phenotypic conÞ rmatory test using cephalosporin/clavulanate combination discs and E-test ESBL strips. Determination of MIC of cefotaxime and ceftazidime was done with and without the presence of clavulanic acid by agar dilution technique. Polymerase chain reaction revealed the presence of CTX-M type ESBLs in 19 isolates. Further sequencing resulted in identiÞ cation of CTX-M-15 ESBLs. This is the Þ rst report identifying CTX-M type ESBL from clinical isolates of E. coli and K. pneumoniae from a tertiary care hospital in south India.

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“…CTX-M-15 is known to be an ESBL that has peculiar association with community-onset E. coli infections. Ensor et al [14] have shown that in India bla CTX-M-15 are the most prevalent than any other type and it is widely distributed in both North and South India. They also reported that the Indian population represented a significant reservoir and source of bla CTX-M-15 [14].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance in Extra Intestinal Pathogenic Escherichia Coli

Chakraborty¹

2017

JMEN

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Occurrence, prevalence and genetic environment of CTX-M -lactamases in Enterobacteriaceae from Indian hospitals

Cited by 123 publications

References 14 publications

Study of CTX-M Type of Extended Spectrum β-Lactamase among Nosocomial Isolates of Escherichia coli and Klebsiella pneumoniae in South India

Study of CTX-M Type of Extended Spectrum β-Lactamase among Nosocomial Isolates of Escherichia coli and Klebsiella pneumoniae in South India

Detection of <i> Enterobacteriaceae</i> producing CTX-M extended spectrum β-lactamases from a tertiary care hospital in south India

Antibiotic Resistance in Extra Intestinal Pathogenic Escherichia Coli

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