Pattern of colistin resistance in Klebsiella isolates in an Intensive Care Unit of a tertiary care hospital in India

Sodhi, Kanwalpreet; Mittal, Vishal; Arya, Muktanjali; M, Krishna Kumar; Phillips, Atul; Kajla, Benika

doi:10.1016/j.jiph.2019.10.013

Cited by 16 publications

(14 citation statements)

References 25 publications

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“…In present study we found the reduce susceptibility for many potent antimicrobial drug. These findings supported by other studies [14,15].Our overview of the microbial resistance patterns especially colistin resistant Klebsiella pneumoniae in a tertiary care hospital suggest that specific infection control strategies, periodic targeted surveillance and stringent antibiotic usage policies including restricted antimicrobial policy and antibiotic cycling, may be the appropriate measures for dealing with infections caused by CRE in ICU settings in the future.…”

Section: Discussionsupporting

confidence: 88%

Antimicrobial susceptibility pattern of colistin resistance Klebsiella pneumoniae from clinical Isolates

Gautam

Tomar

2022

ijhs

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Background: There is very little information available in India about the prevalence of colistin-resistant Klebsiella pneumonia in patients and their susceptibility pattern. The increased use of colistin to treat infections are caused by multidrug-resistant Gram-negative bacteria has resulted in an increase of colistin resistance in Klebsiella pneumoniae in numerous countries. Materials and Methods: These isolates were collected from distinct clinical specimens and analyzed using the broth micro-dilution technique to establish their colistin minimal inhibitory concentration (mic). Result: Of 116 Klebsiella species, Klebsiella pneumonia was 96.55% while Klebsiella oxytoca was 3.45%. Among isolates, 09 (7.76%) were colistin resistant Klebsiella pneumonia by broth-micro dilution. In total, 09 case-patients were identified, 62.93% males and 37.07% females. The mean±SD of the age was 45.93±18.15. Carbapenem, Piperacillin-tazobactam and tigecycline were the most effective drug used for combine therapy to colistin resistance gram negative infections. Conclusion: This is the first study to look at the incidence of colistin-resistant Klebsiella pneumoniae in individuals in Jaipur. Infection caused by Klebsiella pneumonia highly resistant to many drugs. However, various colistin-based combined strategies have indeed been proven to be effective in curing these problems. To minimise colistin use and avoid misuse, a comprehensive antibiotic stewardship policy must be implemented.

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Section: Discussionsupporting

confidence: 88%

Antimicrobial susceptibility pattern of colistin resistance Klebsiella pneumoniae from clinical Isolates

Gautam

Tomar

2022

ijhs

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“…Similar to our study results, literature also reports Klebsiella pneumoniae as the most common resistant isolates, followed by Escherichia coli and/or Enterobacter species. (Sodhi, et al, 2020) Journal and also similar to a study conducted at tertiary care hospital in Egypt by (Hassan, et al, 2020).…”

Section: Discussionsupporting

confidence: 80%

Patterns of Antimicrobial Use and Prevalence of Antibiotic Resistant Bacteria Study at Ain-Shams University Specialized Hospital (Asush)

Hussein

Zaki

Fahmy

2021

Journal of Environmental Science

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Introduction: Antibiotics are prescribed for treating bacterial infections. However, Excessive use of antibiotics leads to the development and spread of multidrug resistant bacteria, currently regarded as a global public health crisis threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability and death. Aim of the work:To analyze the use and prescribing patterns of antimicrobials by physicians at Ain-Shams University Specialized Hospital (ASUSH) for inpatients among different infections and to determine the prevalence of different types of bacterial resistance among hospital infections. Subjects and methods: A cross-sectional study was conducted at (ASUSH). A total of 339 microorganisms isolated from several samples types were identified and studied using VITEK® 2 system. Physicians' attitudes and knowledge were assessed using a questionnaire about antibiotic resistance problem. Results: Among (339) bacterial isolates Klebsiella pneumoniae was the most common isolate n=92 (27.1%), followed by E-coli n=60 (17.7%), Staph coag -ve (SCONs) n= 43 (12.7%) and Methecillin resistant staphylococcus aureas (MRSA), Pseudomonas aeruginosa and Acinetobacter baumanni n=33 (9.7%)

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“…In studies reported across the world, mcr-1 has been predominantly reported in E. coli whereas K. pneumoniae accounts for less than 5% of the total mcr positive isolates to date (Sun et al, 2018;Nang et al, 2019). In contrast to global data, studies from India indicate that colistin resistance is more common in K. pneumoniae than in any other bacterial species (Pragasam et al, 2016;Singh et al, 2018;Sodhi et al, 2020). Also, very few studies are available on genomic characterisation of colistin resistant isolates.…”

Section: Discussionmentioning

confidence: 99%

Genetic Characterisation of Colistin Resistant Klebsiella pneumoniae Clinical Isolates From North India

Singh

Pathak

Rahman

et al. 2021

Front. Cell. Infect. Microbiol.

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BackgroundIncreasing use of colistin has led to the world-wide emergence of mobile colistin resistant gene (mcr). The present study aimed to identify and characterise mcr and other drug-resistant genes in colistin resistant Klebsiella pneumoniae clinical isolates.MethodsTwenty-two colistin resistant K. pneumoniae were analysed for mcr and other drug-resistant genes, efflux pumps, and virulence genes, and for their biofilm forming ability. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were performed for all mcr-1 positive isolates. S1-PFGE and Southern hybridisation were performed for localisation of mcr-1 and blaNDM.ResultsNineteen colistin resistant K. pneumoniae harboured mcr-1 and 3 had mgrB disruption. All isolates harboured blaOXA-48-type and ESBL genes; eight strains (five with mcr-1 and three with mgrB disruption) co-harboured blaNDM. Efflux pumps genes AcrAB and mdtK were detected in all 22 and tol-C in 21 isolates. Virulence-related genes entB and irp-1 were detected in all 22, mrkD in 20, and fimH-1 in 18 isolates; 11 isolates were strong biofilm producers. PFGE clustered mcr-1 positive isolates into eight groups based on ≥90% similarity; MLST revealed diverse sequence types, predominant being ST-15 (n = 4) and ST-16 (n = 4). Both mcr-1 and blaNDM were localised on plasmid and chromosome; mcr-1 was present on IncFII type and blaNDM on IncFIB and IncA/C type plasmids.ConclusionsColistin resistance in K. pneumoniae was predominantly mediated by mcr-1. Co-existence of colistin, carbapenem, and other drug-resistant genes along with efflux pumps indicates towards enormous genomic plasticity in K. pneumoniae with ability to emerge as super-spreader of drug-resistance.

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Pattern of colistin resistance in Klebsiella isolates in an Intensive Care Unit of a tertiary care hospital in India

Cited by 16 publications

References 25 publications

Antimicrobial susceptibility pattern of colistin resistance Klebsiella pneumoniae from clinical Isolates

Antimicrobial susceptibility pattern of colistin resistance Klebsiella pneumoniae from clinical Isolates

Patterns of Antimicrobial Use and Prevalence of Antibiotic Resistant Bacteria Study at Ain-Shams University Specialized Hospital (Asush)

Genetic Characterisation of Colistin Resistant Klebsiella pneumoniae Clinical Isolates From North India

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