The distribution of carbapenem- and colistin-resistance in Gram-negative bacteria from the Tamil Nadu region in India

Prasanth Manohar, Thamaraiselvan Shanthini, Ramankannan Ayyanar, Bulent Bozdogan, Aruni Wilson, Ashok J Tamhankar, Ramesh Nachimuthu, Bruno S Lopes

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Abstract

Purpose. The occurrence of carbapenem- and colistin-resistance among Gram-negative bacteria is increasing worldwide. The aim of this study was to understand the distribution of carbapenem- and colistin-resistance in two areas in Tamil Nadu, India.

Methodology. The clinical isolates (n=89) used in this study were collected from two diagnostic centres in Tamil Nadu, India. The bacterial isolates were screened for meropenem- and colistin-resistance. Further, resistance genes bla NDM-1, bla OXA-48-like, bla IMP, bla VIM, bla KPC, mcr-1 and mcr-2 and integrons were studied. The synergistic effect of meropenem in combination with colistin was assessed.

Results. A total of 89 bacterial isolates were studied which included Escherichia coli (n=43), Klebsiella pneumoniae (n=18), Pseudomonas aeruginosa (n=10), Enterobacter cloacae (n=6), Acinetobacter baumannii (n=5), Klebsiella oxytoca (n=4), Proteus mirabilis (n=2) and Salmonella paratyphi (n=1). MIC testing showed that 58/89 (65 %) and 29/89 (32 %) isolates were resistant to meropenem and colistin, respectively, whereas 27/89 (30 %) isolates were resistant to both antibiotics. Escherichia coli, K. pneumoniae, K. oxytoca, Pseudomonas aeruginosa, and Enterobacter cloacae isolates were bla NDM-1-positive (n=20). Some strains of Escherichia coli, K. pneumoniae and K. oxytoca were bla OXA-181-positive (n=4). Class 1, 2 and 3 integrons were found in 24, 20 and 3 isolates, respectively. Nine NDM-1-positive Escherichia coli strains could transfer carbapenem resistance via plasmids to susceptible Escherichia coli AB1157. Meropenem and colistin showed synergy in 10/20 (50 %) isolates by 24 h time-kill studies.

Conclusion. Our results highlight the distribution of carbapenem- and colistin-resistance in Gram-negative bacteria isolated from the Tamil Nadu region in South India.
Original languageEnglish
Pages (from-to)874-883
Number of pages9
JournalJournal of Medical Microbiology
Volume66
Early online date3 Jul 2017
DOIs
Publication statusPublished - Jul 2017

Keywords

  • integron
  • plasmid-bound resistance
  • transferability
  • New Delhi metallo-beta lactamases
  • carbapenemases

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    Manohar, P., Shanthini, T., Ayyanar, R., Bozdogan, B., Wilson, A., Tamhankar, A. J., Nachimuthu, R., & Lopes, B. S. (2017). The distribution of carbapenem- and colistin-resistance in Gram-negative bacteria from the Tamil Nadu region in India. Journal of Medical Microbiology, 66, 874-883. https://doi.org/10.1099/jmm.0.000508