&lt;p&gt;Detection of OXA-48 Gene in Carbapenem-Resistant &lt;em&gt;Escherichia coli&lt;/em&gt; and &lt;em&gt;Klebsiella pneumoniae&lt;/em&gt; from Urine Samples&lt;/p&gt;

Gurung, Sushma; Kafle, Sonali; Dhungel, Binod; Adhikari, Nabaraj; Shrestha, Upendra Thapa; Adhikari, Bipin; Banjara, Megha Raj; Rijal, Komal Raj; Ghimire, Prakash

doi:10.2147/idr.s259967

Cited by 65 publications

(68 citation statements)

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“…Another study from Pakistan reported higher resistance to gentamicin (77%) and ciprofloxacin (65%) in clinical isolates of Enterobacteriaceae [40]. Higher (79%) prevalence of multi-drug resistant isolates in our study is consistent with previous studies from Nepal [21,41] and Pakistan [40]. The higher load of MDR isolates may be due to significant antibiotic pressure in the environment, irrational dose regimens, use in food animals and transmission of resistant isolates between people, animal and the environment [40].…”

Section: Discussionsupporting

confidence: 89%

“…Recent studies reported from Nepal showed 26.66% of colistin-resistant E. coli harbored mcr -1 gene isolated from the chicken meats [ 20 ] and 33.3% of carbapenem resistant E . coli harbored OXA-48 isolated from urine samples [ 21 ]. The main objective of this study was to explore the prevalence and co-existence of colistin resistance gene, mcr -1 along with carbapenemase resistance gene, OXA -48 in Escherichia coli isolated from poultry farms located in Kathmandu, Kavrepalanchok and Bhaktapur and human specimens (urine) from patients attending Kantipur Hospital, Tinkune, Kathmandu between August, 2018 and March, 2019.…”

Section: Introductionmentioning

confidence: 99%

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Plasmid mediated colistin resistant mcr-1 and co-existence of OXA-48 among Escherichia coli from clinical and poultry isolates: first report from Nepal

et al. 2020

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Background Plasmid-mediated resistance to the last-resort drugs: carbapenems and colistin is an emerging public health threat. The studies on the prevalence and co-expression of resistant genes among livestock and human pathogens are rare in Nepal. This is the first study in Nepal exploring the prevalence and co-existence of colistin resistance gene, mcr-1 along with carbapenemase resistance gene, OXA-48 in Escherichia coli isolated from poultry and clinical specimens. Methods A total of 240 rectal swabs from chickens of five different poultry farms of Kathmandu valley and 705 mid-stream urine samples from human subjects attending Kantipur Hospital, Kathmandu were collected between August, 2018 and March, 2019. Rectal swabs and urine specimens were cultured. E. coli isolated from the specimens were screened for antimicrobial susceptibility testing (AST) using disk diffusion method’. Minimum inhibitory concentration (MIC) of colistin was determined by agar dilution method using 0.5 µg/ml to 32 µg/ml. The E. coli isolates were first screened for mcr-1 followed by screening for OXA-48 genes using conventional Polymerase chain reaction (PCR). Results Of the total samples analyzed, E. coli was isolated from 31.7% (76/240) of poultry and 7.9% (56/705) of clinical specimens. In AST, 80% (61/76) of E. coli from poultry and 79% (44/56) from clinical specimens were MDR. The phenotypic prevalence of colistin resistance in poultry specimens were 31.6% (24/76) and clinical specimens were 21.4% (12/56). In PCR assay, 27.6% (21/76) of poultry and 19.6% (11/56) of clinical isolates had colistin resistant mcr-1 gene. MICs value of E. coli isolates ranged from 4 to 32 (µg/ml) in both clinical and poultry isolates. Prevalence of co-existing carbapenem resistance gene, OXA-48, among colistin resistant mcr-1 positive isolates was 38% (8/21) in poultry specimens and 18.2% (2/11) in clinical specimens. Conclusions The high prevalence of colistin and carbapenem resistant genes, and their co-existence in plasmid DNA of E. coli isolates in this study suggests the possible spread to other animal, human and environmental pathogens. Molecular methods in addition to the conventional diagnostics in laboratories can help in early diagnosis, effective management and control of their potential transmission.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Plasmid mediated colistin resistant mcr-1 and co-existence of OXA-48 among Escherichia coli from clinical and poultry isolates: first report from Nepal

et al. 2020

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“…E. coli alone constituted almost one-fifth of the total isolates and more than one-third of the GNB alone. Our findings are consistent with the previous studies from Everest Hospital, Kathmandu [20], Alka Hospital, Lalitpur [28], International Friendship Hospital, Kathmandu [3], Padma Nursing Hospital, Pokhara [36], National Public Health Laboratory, Kathmandu [37], B.P. Koirala Institute of Health Sciences, Dharan [38], and Alka Hospital, Lalitpur [39].…”

Section: Overall Findingssupporting

confidence: 93%

“…An axenic culture of ESBL producer E. coli isolates were preserved in 20% glycerol containing tryptic soya broth and kept at −70 °C until further processing for molecular assay [ 28 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

Detection of TEM and CTX-M Genes in Escherichia coli Isolated from Clinical Specimens at Tertiary Care Heart Hospital, Kathmandu, Nepal

et al. 2021

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Background: Antimicrobial resistance (AMR) among Gram-negative pathogens, predominantly ESBL-producing clinical isolates, are increasing worldwide. The main aim of this study was to determine the prevalence of ESBL-producing clinical isolates, their antibiogram, and the frequency of ESBL genes (blaTEM and blaCTX-M) in the clinical samples from patients. Methods: A total of 1065 clinical specimens from patients suspected of heart infections were collected between February and August 2019. Bacterial isolates were identified on colony morphology and biochemical properties. Thus, obtained clinical isolates were screened for antimicrobial susceptibility testing (AST) using modified Kirby–Bauer disk diffusion method, while ESBL producers were identified by using a combination disk diffusion method. ESBL positive isolates were further assessed using conventional polymerase chain reaction (PCR) to detect the ESBL genes blaTEM and blaCTX-M. Results: Out of 1065 clinical specimens, 17.8% (190/1065) showed bacterial growth. Among 190 bacterial isolates, 57.4% (109/190) were Gram-negative bacteria. Among 109 Gram-negative bacteria, 40.3% (44/109) were E. coli, and 30.2% (33/109) were K. pneumoniae. In AST, 57.7% (n = 63) Gram-negative bacterial isolates were resistant to ampicillin and 47.7% (n = 52) were resistant to nalidixic acid. Over half of the isolates (51.3%; 56/109) were multidrug resistant (MDR). Of 44 E. coli, 27.3% (12/44) were ESBL producers. Among ESBL producer E. coli isolates, 58.4% (7/12) tested positive for the blaCTX-M gene and 41.6% (5/12) tested positive for the blaTEM gene. Conclusion: Half of the Gram-negative bacteria in our study were MDR. Routine identification of an infectious agent followed by AST is critical to optimize the treatment and prevent antimicrobial resistance.

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“…However, higher rates of growth positivity have been reported in similar studies in Nepal [20,21,22,23]. In this study, the highest number of growth was observed in the urine sample which was in agreement with that reported by GC et al [21] and Gurung et al [24]. K. pneumoniae was the dominant isolate, followed by E. coli and Acinetobacter spp.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of MDR and ESBL producing Gram-negative isolates from various clinical samples from patients visiting a tertiary care hospital in Kathmandu, Nepal

Shilpakar¹,

Ansari²,

Raj³

et al. 2021

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BackgroundThe existence of multi-drug resistance organisms, including extended-spectrum beta-lactamases (ESBLs), is on the rise and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile.MethodsA cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified by using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the Kirby Bauer disc diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test.ResultsOut of 92 isolates, 84 (91.3%) isolates were multidrug resistant, and 47 (51.1%) isolates were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers.ConclusionMultidrug resistance was very high, however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

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<p>Detection of OXA-48 Gene in Carbapenem-Resistant <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> from Urine Samples</p>

Cited by 65 publications

References 58 publications

Plasmid mediated colistin resistant mcr-1 and co-existence of OXA-48 among Escherichia coli from clinical and poultry isolates: first report from Nepal

Plasmid mediated colistin resistant mcr-1 and co-existence of OXA-48 among Escherichia coli from clinical and poultry isolates: first report from Nepal

Detection of TEM and CTX-M Genes in Escherichia coli Isolated from Clinical Specimens at Tertiary Care Heart Hospital, Kathmandu, Nepal

Prevalence of MDR and ESBL producing Gram-negative isolates from various clinical samples from patients visiting a tertiary care hospital in Kathmandu, Nepal

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