Genotypic and Phenotypic Expression of Antibiotic Resistance Patterns of Uropathogenic Enterobacteriaceae

Aim To determine the antibiotic resistance patterns, detection of carbapenemase genes in uropathogenic bacilli belonging to the Enterobacteriaceae family and to correlate it with clinical data. Materials and Methods Identification and antibiotic sensitivity testing of the uropathogenic Enterobacteriaceae was done by using VITEK2 Compact (C) system. Multiplex PCR was used to detect blaIMP, blaKPC, blaNDM1, blaOXA −48, and blaVIM genes. Results Out of 1602 urine samples, 417 (26%) showed significant growth, and in these 311 (74.6%) belonged to the Enterobacteriaceae family. Escherichia coli showed a relatively low rate of resistance to nitrofurantoin (17/205; 8.3%), with the majority of the isolates showing a MIC value of ≤16 µg/mL when compared to Klebsiella spp. (55/86; 64%), with MIC values for the majority of isolates being 128 µg/mL. Klebsiella spp. showed a relatively low rate of resistance to nalidixic acid (48/86; 55.8%) when compared with E. coli isolates (179/205; 87.3%). Out of 145 isolates tested, we found blaNDM in 11 (7.58%), bla OXA −48 in 8 (5.51%), bla VIM in 4 (2.75%), bla KPC in one (0.6%) and blaIMP in none of the isolates. Of these 3 isolates were carbapenem sensitive, the rest were resistant. Conclusion Most of the isolates were sensitive to fosfomycin, carbapenems and resistant to cephalosporins and nalidixic acid. We detected carbapenemase genes in 13 (59%) out of 22 carbapenem resistant isolates and 3 (2.4%) out of 123 carbapenem sensitive isolates.

[1]  R. Ranjbar,et al.  Phylogenetic Group Distribution of Uropathogenic Escherichia coli and Related Antimicrobial Resistance Pattern: A Meta-Analysis and Systematic Review , 2022, Frontiers in Cellular and Infection Microbiology.

[2]  F. Hu,et al.  Dissemination of Carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) Among Carbapenem-Resistant Enterobacteriaceae Isolated From Adult and Children Patients in China , 2020, Frontiers in Cellular and Infection Microbiology.

[3]  A. Feizi,et al.  Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic Escherichia coli Among Iranian Kidney Transplant Patients , 2020, Infection and drug resistance.

[4]  R. Ranjbar,et al.  Antibiotic resistance, virulence factors and genotyping of Uropathogenic Escherichia coli strains , 2018, Antimicrobial Resistance & Infection Control.

[5]  P. Rao,et al.  Clinicomicrobiological Study of Bacteraemia Caused by Coliforms in Adults , 2018 .

[6]  M. Webber,et al.  CTX-M-15 is Established in Most Multidrug-Resistant Uropathogenic Enterobacteriaceae and Pseudomonaceae from Hospitals in Nigeria , 2018, European journal of microbiology & immunology.

[7]  M. Motamedifar,et al.  Emerge of blaNDM‐1 and blaOXA‐48‐like harboring carbapenem‐resistant Klebsiella pneumoniae isolates from hospitalized patients in southwestern Iran , 2017, Journal of the Chinese Medical Association : JCMA.

[8]  R. Kumar,et al.  Antimicrobial susceptibility pattern of urine culture isolates in a tertiary care hospital of Jharkhand, India , 2017 .

[9]  R. Priyanka,et al.  A study on the bacteriological profile of urinary tract infection in adults and their antibiotic sensitivity pattern in a tertiary care hospital in central Kerala, India , 2017 .

[10]  B. Veeraraghavan,et al.  A Pilot Study on Carbapenemase Detection: Do We See the Same Level of Agreement as with the CLSI Observations. , 2016, Journal of clinical and diagnostic research : JCDR.

[11]  G. Meletis,et al.  Carbapenem resistance: overview of the problem and future perspectives , 2016, Therapeutic advances in infectious disease.

[12]  M. Emaneini,et al.  High Frequency of Class 1 Integrons in Escherichia coli Isolated From Patients With Urinary Tract Infections in Yasuj, Iran , 2016, Iranian Red Crescent medical journal.

[13]  K. Şahin,et al.  Evaluation of carbapenem resistance using phenotypic and genotypic techniques in Enterobacteriaceae isolates , 2015, Annals of Clinical Microbiology and Antimicrobials.

[14]  N. Taneja,et al.  Occurrence of blaNDM-1 & absence of blaKPC genes encoding carbapenem resistance in uropathogens from a tertiary care centre from north India , 2015, The Indian journal of medical research.

[15]  Shan-Chwen Chang,et al.  Carbapenem-Nonsusceptible Enterobacteriaceae in Taiwan , 2015, PloS one.

[16]  N. Taneja,et al.  occurrence of bla NDM-1 & absence of bla KPC genes encoding carbapenem resistance in uropathogens from a tertiary care centre from north India , 2015 .

[17]  R. Humphries,et al.  Phenotypic and Molecular Characteristics of Carbapenem-Resistant Enterobacteriaceae in a Health Care System in Los Angeles, California, from 2011 to 2013 , 2014, Journal of Clinical Microbiology.

[18]  S. Gatermann,et al.  Detection of Carbapenemases in Enterobacteriaceae by a Commercial Multiplex PCR , 2012, Journal of Clinical Microbiology.

[19]  M. Ferraro Performance standards for antimicrobial susceptibility testing , 2001 .

[20]  K J Ryan,et al.  Antimicrobial Susceptibility Testing , 2016, Advances in Experimental Medicine and Biology.