Summary
Zika virus (ZIKV) outbreaks and their adverse clinical consequences have raised concerns throughout the world. ZIKV was little known during the initial outbreaks in Yap islands and French Polynesia, but it came to attention after the series of Brazil outbreaks in which severe complications like microcephaly in newborn babies was detected. During 2018, outbreaks of ZIKV occurred in two states of India which, being a tropical country, has congenial climatic conditions, abundance of highly competent mosquito vectors such as Aedes aegypti and Aedes albopictus, and an immunologically naïve population. In this review, we will briefly discuss the history, epidemiology, evolution, transmission (vector‐borne and non‐vector borne), pathogenesis, clinical signs and unusual presentations, laboratory diagnosis, treatment, prevention and control of ZIKV. Finally, we suggest priorities for urgent research required to address unanswered questions about Zika infections and help bring this virus under control.
Purpose
Multidrug-resistant (MDR) organisms are being increasingly reported from India. This study aimed to determine the antibiotic susceptibility pattern of non-fermenting Gram-negative bacilli (NF-GNB) isolated from all the clinical samples to estimate the prevalence of MDR MDR NF-GNB and to screen for colistin-resistance genes among all colistin-resistant strains.
Materials and methods
This prospective study conducted from January 2021 to July 2022 at a tertiary care teaching hospital in central India identified MDR NF-GNB from clinical samples using standard procedures and antimicrobial susceptibility testing conducted as per Clinical Laboratory Standards Institute (CLSI) guidelines. Colistin-resistant strains identified by broth microdilution were further subjected to detection of plasmid-mediated colistin-resistant genes (
mcr-1
,
mcr-2
,
mcr-3
) by polymerase chain reaction (PCR).
Results
A total 2,106 NF-GNB were isolated from 21,019 culture positive clinical samples, of which 743 (35%) were MDR. Majority of MDR NF-GNB isolated were from pus (45.50%) followed by blood (20.50%). Out of 743 non-duplicate MDR non-fermenters,the most common were
Pseudomonas aeruginosa
(51.7%)
, Acinetobacter baumannii
(23.4%),and others (24.9%).Around5.2%
Pseudomonas aeruginosa
and 2.3%
Acinetobacter baumannii
were resistant to colistin, and 88.2% were resistant to ceftazidime.
Burkholderia cepacia
complexwas 100% susceptible to minocycline and least susceptible to ceftazidime (28.6%). Out of 11, 10 (90.9%)
Stenotrophomonas maltophilia
were susceptible to colistin and least susceptible to ceftazidime and minocycline (27.3%). All 33 colistin-resistant strains (minimal inhibitory concentration ≥ 4 µg/mL) were found to be negative for
mcr-1
,
mcr-2
, and
mcr-3
genes.
Conclusion
Our study showed a significantly wide variety of NF-GNB, ranging from
Pseudomonas aeruginosa
(51.7%),
Acinetobacter baumannii
(23.4%),to
Acinetobacter haemolyticus
(4.6%),
Pseudomonas putida
(0.9%),
Elizabethkingia meningoseptica
(0.7%),
Pseudomonas luteola
(0.5%), and
Ralstonia pickettii
(0.4%), which have not been commonly reported in literature. Of all the non-fermenters isolated in the present study, 35.28% were MDR, raising the concern for rationalizing antibiotic use and improving infection control measures to avert or slow the emergence of antibiotic resistance.
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