Emergence of vanA gene among vancomycin-resistant enterococci in a tertiary care hospital of North - East India

Phukan, Chimanjita; Lahkar, Mangala; Ranotkar, Swapnil; Saikia, Kandarpa Kumar

doi:10.4103/0971-5916.182627

Cited by 17 publications

(18 citation statements)

References 20 publications

(19 reference statements)

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“…18 Van A is the most common mechanism for resistance among clinical isolates, so identification of any intermediate susceptibility to vancomycin warrants detailed molecular investigation. 19,20 In this study, Vancomycin intermediate susceptibility was noted among 11 (3.03%) isolates, which is in concordance with other studies. 19,20 Linezolid resistance was detected in 4 (1.10%) Enterococcus isolates, whereas 3(0.82%) isolates demonstrated intermediate susceptibility.…”

Section: Discussionsupporting

confidence: 92%

“…19,20 In this study, Vancomycin intermediate susceptibility was noted among 11 (3.03%) isolates, which is in concordance with other studies. 19,20 Linezolid resistance was detected in 4 (1.10%) Enterococcus isolates, whereas 3(0.82%) isolates demonstrated intermediate susceptibility. Linezolid resistance in Enterococcus has been reported earlier by other researchers also.…”

Section: Discussionsupporting

confidence: 92%

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Determination of vancomycin, linezolid and daptomycin resistance among Eenterococcus isolates from a tertiary care hospital

Gill¹

2020

IJMR

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The clinical importance of the genus species relates to its intrinsic antibiotic resistance. Synergistic activity of penicillin and aminoglycosides against is preferred treatment. However, Infectious Diseases Society of America (IDSA) recommends usage of linezolid and daptomycin against emerging vancomycin resistant (VRE) isolates. In this study, we sought to measure the prevalence of vancomycin, linezolid and daptomycin resistance in clinical isolates from patients in a tertiary hospital of Western Maharashtra. A total of 363 clinical isolates of species isolated from different clinical samples over the last three years and three months study period were analyzed for antibiotic susceptibility pattern against vancomycin, linezolid and daptomycin. Study demonstrated low prevalence of vancomycin (4.95%) and linezolid resistance (1.10%) among clinical isolates. Combined resistance to vancomycin and linezolid was also noted in few isolates. No daptomycin resistance was detected in this study, however in vitro daptomycin susceptible and vancomycin heteroresistance isolates may not respond to daptomycin monotherapy. Our study, demonstrated relatively low prevalence of vancomycin and linezolid resistance, but emergence of combined newer drug resistance in species is cause of concern and reiterates the importance of importance of judicious use of antibiotics.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Determination of vancomycin, linezolid and daptomycin resistance among Eenterococcus isolates from a tertiary care hospital

Gill¹

2020

IJMR

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“…Treatment issues for another emerging pathogen, Burkholderia cepacia complex were evaluated in a systematic review (Gautam et al, 2015) Antimicrobial susceptibility data analysis showed a high incidence of resistance among uropathogens (Chatterjee et al, 2016). Antibiograms were a source of information showing rising trend of vancomycinresistant enterococci with nearly 24% isolates demonstrating resistance (Phukan et al, 2016). Importantly, three of the isolates were found to be resistant to linezolid.…”

Section: Prescription Audits and Drug Utilizationmentioning

confidence: 99%

Clinical Pharmacology in India-A Systematic Review of Research in the Past 5 Years

Shafiq

Kakkar²,

Malhotra³

2018

Proceedings of the Indian National Science Academy

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The Indian National Science Academy has published two Status Reports on Pharmacological Research (1984 & 2000). The International Council for Science (ICSU) National Committee for Pharmacology has commissioned the third status report on Pharmacological Research in India covering the last 5 years. This report covers research done in chemotherapy of infectious diseases barring tropical diseases. The areas covered in chemotherapy included drug-discovery, observational studies, pharmacokinetics-pharmacodynamics and safety studies. We largely relied on Pubmed for our search. Work conducted in India and where at least one of the authors was affiliated to the Department of Pharmacology was included. Salient features of the studies were summarized. Lacunae in the current scene of research were explored and way forward suggested.

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“…In India, the proportion of MRSA pathogen has increased from 29% in 2009 to 47% in 2014, 7 and minimum inhibitory concentration (MIC) of vancomycin is also increasing. 8,9 This necessitates rational use of vancomycin. Pharmacokinetics–pharmacodynamics (PK–PD) assessment and therapeutic drug monitoring (TDM) of vancomycin have been recommended for better clinical outcome and dosing optimization.…”

Section: Introductionmentioning

confidence: 99%

Single-dose and Steady-state Pharmacokinetics of Vancomycin in Critically Ill Patients Admitted to Medical Intensive Care Unit of India

Mali

Deshpande

Wandalkar

et al. 2019

Indian Journal of Critical Care Medicine

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RationaleVancomycin remains the standard of care for gram-positive bacterial infections, though there are significant developments in newer antibacterial agents. Efficacy can be improved by linking pharmacokinetic with pharmacodynamic principles, thus leading to optimum antibiotic exposure. There is scarcity of pharmacokinetic data in Indian intensive care unit (ICU) population.Materials and methodsFifteen subjects with suspected or proven gram-positive bacterial infection of either gender between 18 years and 65 years of age were enrolled. Vancomycin at the dose of 1 g every 12 hours was administered over 1-hour period and pharmacokinetic assessments performed on blood samples collected on days 1 and 3. Vancomycin concentrations were measured on validated liquid chromatography mass spectrometry method. Pharmacokinetic parameters were calculated using Winnonlin (Version 6.3; Pharsight, St. Louis, MO).ResultsThe mean Cmax, elimination half-life, AUC0–12hours, volume of distribution, and clearance of single dose were 36.46 μg/mL (±14.87), 3.98 hours (±1.31), 113.51 μg/mL (±49.51), 52.01 L (±31.31), and 8.90 mL/minute (±3.29), respectively, and at steady state were 40.87 μg/mL (±19.29), 6.27 hours (±3.39), 147.94 μg/mL (±72.89), 56.39 L (±42.13), and 6.98 mL/minute (±4.48), respectively. The elimination half-life increased almost two-fold at steady state. The steady state mean AUC0–24 was 295.89 µg/mL (±153.82). Out of 45 trough levels, 32 (71.11%) concentrations were below recommended range.ConclusionRecommended AUC0–24hours and trough concentrations were not achieved in majority of patients with current dosing, suggesting reevaluation of current vancomycin dosing. Individualized treatment based on close monitoring of vancomycin serum concentrations in critically ill patients is imperative.How to cite this articleMali NB, Deshpande SP, Wandalkar PP, Gupta VA, Karnik ND, Gogtay NJ, et al. Single-dose and Steady-state Pharmacokinetics of Vancomycin in Critically Ill Patients Admitted to Medical Intensive Care Unit of India. IJCCM 2019;23(11):513–517.

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Emergence of vanA gene among vancomycin-resistant enterococci in a tertiary care hospital of North - East India

Cited by 17 publications

References 20 publications

Determination of vancomycin, linezolid and daptomycin resistance among Eenterococcus isolates from a tertiary care hospital

Determination of vancomycin, linezolid and daptomycin resistance among Eenterococcus isolates from a tertiary care hospital

Clinical Pharmacology in India-A Systematic Review of Research in the Past 5 Years

Single-dose and Steady-state Pharmacokinetics of Vancomycin in Critically Ill Patients Admitted to Medical Intensive Care Unit of India

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