Antimicrobial Susceptibility Profiles of Gram-Negative Bacteria Causing Infections Collected Across India during 2014–2016: Study for Monitoring Antimicrobial Resistance Trend Report

Veeraraghavan, Balaji; Jesudason, Mark Ranjan; Prakasah, John Antony Jude; Anandan, Shalini; Sahni, Rani Diana; Pragasam, Agila Kumari; Bakthavatchalam, Yamuna Devi; Selvakumar, Rajesh Joseph; Dhole, T.N.; Rodrigues, Camilla; Roy, Indranil; Joshi, Sangeeta; Chaudhuri, Bhaskar Narayan; Chitnis, DS

doi:10.4103/ijmm.ijmm_17_415

Cited by 50 publications

(30 citation statements)

References 9 publications

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“…The increasing use of third-generation β-lactams and β-lactam inhibitors was accompanied with increases in prevalence of the MDR phenotype among E. coli. The susceptibility profiles noted in invasive E. coli isolates of our study were similar to the previously (2014-2016) reported susceptibility to cefoxitin 53%, ceftazidime 33%, cefotaxime 26%, ceftriaxone 25%, cefepime 29%, piperacillin tazobactam 66%, imipenem and meropenem 89%, aztreonam 36%, ciprofloxacin 19%, levofloxavin 23%, and amikacin 91% [16]. Among these, about 64% of E. coli were found to be ESBL producers.…”

Section: Discussionsupporting

confidence: 90%

First Indian report on genome-wide comparison of multidrug-resistant Escherichia coli from blood stream infections

et al. 2020

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BackgroundMultidrug-resistant (MDR) E. coli with extended-spectrum β-lactamases (ESBLs) is becoming endemic in health care settings around the world. Baseline data on virulence and antimicrobial resistance (AMR) of specific lineages of E. coli circulating in developing countries like India is currently lacking. MethodsWhole-genome sequencing was performed for 60 MDR E. coli isolates. The analysis was performed at single nucleotide polymorphism (SNP) level resolution to identify the presence of their virulence and AMR genes. ResultsGenome comparison revealed the presence of ST-131 global MDR and ST410 as emerging-MDR clades of E. coli in India. AMR gene profile for cephalosporin and carbapenem resistance differed between the clades. Genotypes bla CTX-M-15 and bla NDM-5 were common among cephalosporinases and carbapenemases, respectively. For aminoglycoside resistance, rmtB was positive for 31.7% of the isolates, of which 95% were co-harboring carbapenemases. In addition, the FimH types and virulence gene profile positively correlated with the SNP based phylogeny, and also revealed the evolution of MDR clones among the study population with temporal accumulation of SNPs. The predominant clone was ST167 (bla NDM lineage) followed by ST405 (global clone ST131 equivalent) and ST410 (fast spreading high risk clone).

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Section: Discussionsupporting

confidence: 90%

First Indian report on genome-wide comparison of multidrug-resistant Escherichia coli from blood stream infections

et al. 2020

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“…This study reported prevalence of ESBL increased from 22% in 2009 to 33% in 2014, which is a lot lower than our study. Increasing trends of AMR was observed among gram negative samples collected across seven hospitals in India over a four-year period, but the reported carbapenem resistance prevalence in Klebsiella 'spp' (39%) and E. coli (12%) were lower than our study 15 . Another observational study among intensive care unit (ICU) patients in a tertiary care hospital in Delhi showed 80% of Klebsiella 'spp' were resistant to beta-lactam group of antimicrobials, which is similar to our study 16 .…”

Section: Discussioncontrasting

confidence: 89%

Antimicrobial resistance patterns of WHO priority pathogens isolated in children from a tertiary care hospital in Southern India: A descriptive and time trend analysis

Mogasale

Saldanha

Pai

et al. 2020

Preprint

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Background There is global consensus that Antimicrobial Resistance (AMR) poses an unprecedented challenge to modern medicine as we know it today; and the lack of new antibiotics in the pipeline is compounding the threat to contain emerging drug-resistant infections. In 2017, the World Health Organization (WHO) has articulated a priority pathogens list (PPL) to provide strategic direction to research and development of new anti-microbials. Anti-microbial resistance patterns of selected ‘drug-bug’ combinations based on the WHO-PPL in one tertiary health care facility in India are explored in this paper. Methods Culture reports of laboratory specimens, collected between 1st January 2014 and 31st October 2019 from paediatric patients in a tertiary care hospital in India, were retrospectively extracted. The antimicrobial susceptibility patterns for selected antimicrobials based on the WHO-PPL are analysed and reported. Results Of 12,256 culture specimens screened, 2,335 (19%) showed culture positivity; of which 1,556 were organisms from the WHO-PPL. E. coli was the most common organism isolated (37%) followed by Staphylococcus aureus (16%). Total 72% of E. coli were extended-spectrum beta-lactamases producers, 55% of Enterobacteriaceae were resistant to 3rd generation cephalosporins, and 53% of Staphylococcus aureus were Methicillin resistant. Time-trend analysis of the data showed continued high resistance to carbapenem in E coli, Klebsiella pneumoniae and Enterobacter cloacae. Conclusions The AMR trends and prevalence patterns are likely to be different, across various local settings, than as defined at the national level or the WHO-PPL. This difference needs to be recognised in decision and policy making. It is critical, that the evidence used at national and global levels, have reasonable geographical and population representation through standardised and more granular AMR surveillance, in order to improve the effectiveness of the overall national AMR response.

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“…Similar observations have been made by others; Bhat et al and Shrestha et al 10,11 In this study, E. coli, Klebsiella spp, and P. aeruginosa are the most commonly isolated organism. The bacterial isolates were collected mainly from patients with urinary tract infections (30%), Pus and wound swab (44%) and bloodstream infections (12%) correlates with Veeraraghavan B et al 12 In this study, among 43% E. coli isolates, the sensitivity pattern towards, Cefepime Tazobactam was 90%, Cefepime -32%, Piperacillin Tazobactam -75%, Cefoperazone sulbactam -71%, Carbapenem-91%, and Amikacin-92%. Klebsiella Pneumoniae (24%) showed susceptibility to 42% on Cefepime Tazobactam, Cefepime-16%, Piperacillin Tazobactam -48%, Cefoperazone sulbactam -46%, Carbapenem-55%, and Amikacin 55%.…”

Section: Discussionmentioning

confidence: 56%

Antimicrobial Sensitivity of Gram-Negative Bacteria With Beta Lactam /Beta Lactamase Inhibitor Combination of Drugs in Comparison to Other Antibiotics in Tertiary Care Center

Rammurugan¹,

Sasireha²

2019

jemds

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BACKGROUND Objectives of the study were-1. isolation and speciation of Gram-negative bacteria from urine, pus sample, wound swab, blood, tissue, BAL and other body fluids. 2. To identify bacteria most commonly isolated in ICU and Non-ICU Samples. 3. To compare sensitivity and resistant patterns of beta lactam and beta lactamase inhibitor combination of drugs, carbapenem, and aminoglycosides in various Gram-negative bacterial isolates. Bacterial isolates are compared with MIC testing (E test) for Cefepime Tazobactam (CPT) and disc diffusion method. MATERIALS AND METHODS Gram negative bacterial pathogens from various clinical samples (urine, blood, broncho-alveolar lavage [BAL], other body fluids (bile, endometrial secretions), pus, wound swab, sputum and vaginal swab) were included in this study. The Isolates were identified with a battery of standard biochemical tests. Cefepime/tazobactam (CPT) (30/10 μg HiMedia, Mumbai) against various bacterial isolates and their susceptibility were compared with other β-lactam/β-lactamase inhibitor combinations like piperacillin/ tazobactam (PTZ), cefoperazone/sulbactam (CFS), carbapenems [imipenem (IMP), meropenem (MRP) and Amikacin]. MIC determination paper strip which is coated with Cefepime/Tazobactam on a single paper strip in a concentration gradient capable of showing MICs in the range of 0.016 mcg/ml to 256 mcg/ml, on testing against the test organism. RESULTS A total of 130 isolates from patients attending the tertiary care teaching hospital were included in the study. Most common age groups of isolation of Gram-negative bacilli was 40-60 yrs. and above 60 yrs. Out of 130 isolates isolated, 68 isolates were from male patients and 53 isolates were from female patients, 7 isolates were from male children and 2 isolates were from female children. Out of 130 isolates isolated, most common area of isolation of Gram-negative bacilli were from Inpatient (IP) from various wards, Out Patient (OP) and ICU. Out of 130 isolates isolated, most common samples were from urine, blood, pus and wound swab. Out of 130 samples isolated, 43% were from Escherichia coli, 24% were from Klebsiella pneumoniae, 18% were from Pseudomonas aeruginosa, 5% were from Enterobacter species and 3% were from Proteus species. Among 43% E. coli isolates, the sensitivity pattern towards, Cefepime Tazobactam was 90%, Cefepime-32%, Piperacillin Tazobactam-75%, Cefoperazone sulbactam-71%, Carbapenem-91%, and Amikacin-92%. Klebsiella Pneumoniae (24%) showed susceptibility of 42% on Cefepime Tazobactam, Cefepime-16%, Piperacillin Tazobactam-48%, Cefoperazone sulbactam-46%, Carbapenem-55%, and Amikacin 55%. Pseudomonas aeruginosa (18%) showed highest susceptibility of 87% Sensitivity to Cefepime Tazobactam, Cefepime, Carbapenem and Amikacin followed by 70% Sensitivity to Piperacillin Tazobactam and Cefoperazone sulbactam. Proteus spp. showed 100 % susceptibility to Cefepime Tazobactam, Cefoperazone sulbactam, Carbapenem and Amikacin followed by 80% sensitivity to Cefepime, Piperacillin Tazobactam. Citrobacter spp...

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Antimicrobial Susceptibility Profiles of Gram-Negative Bacteria Causing Infections Collected Across India during 2014–2016: Study for Monitoring Antimicrobial Resistance Trend Report

Cited by 50 publications

References 9 publications

First Indian report on genome-wide comparison of multidrug-resistant Escherichia coli from blood stream infections

First Indian report on genome-wide comparison of multidrug-resistant Escherichia coli from blood stream infections

Antimicrobial resistance patterns of WHO priority pathogens isolated in children from a tertiary care hospital in Southern India: A descriptive and time trend analysis

Antimicrobial Sensitivity of Gram-Negative Bacteria With Beta Lactam /Beta Lactamase Inhibitor Combination of Drugs in Comparison to Other Antibiotics in Tertiary Care Center

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