Multidrug-Resistant Enterobacteriaceae Colonising the Gut of Adult Rural Population in South India

Antony, Sherly; Ravichandran, K.; Kanungo, Reba

doi:10.4103/ijmm.ijmm_18_388

Cited by 9 publications

(12 citation statements)

References 20 publications

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“…Previous reports of bla NDM neonatal carriage in Africa are few and show low-frequency rates among children and pregnant women 12 , 20 , 27 – 29 . Although bla KPC is widely disseminated throughout America and Europe, it is not common in south Asia or Africa 11 , 12 , 18 , 21 , 24 , 25 , as affirmed by the present study.…”

Section: Resultssupporting

confidence: 83%

“…The bla OXA-48 -like genes are reportedly widespread throughout south Asia 21 , but in our study this was observed only in Pakistan among BRs. It is interesting that bla NDM prevalence was higher than previously reported in Pakistan 14,22,23 , India 11,24,25 and Bangladesh 26 . Previous reports of bla NDM neonatal carriage in Africa are few and show low-frequency rates among children and pregnant women 12,20,[27][28][29] .…”

Section: Prevalence Of β-Lactamase Genes Among Mothers and Neonatesmentioning

confidence: 61%

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Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries

et al. 2022

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Early development of the microbiome has been shown to affect general health and physical development of the infant and, although some studies have been undertaken in high-income countries, there are few studies from low- and middle-income countries. As part of the BARNARDS study, we examined the rectal microbiota of 2,931 neonates (term used up to 60 d) with clinical signs of sepsis and of 15,217 mothers screening for blaCTX-M-15, blaNDM, blaKPC and blaOXA-48-like genes, which were detected in 56.1%, 18.5%, 0% and 4.1% of neonates’ rectal swabs and 47.1%, 4.6%, 0% and 1.6% of mothers’ rectal swabs, respectively. Carbapenemase-positive bacteria were identified by MALDI-TOF MS and showed a high diversity of bacterial species (57 distinct species/genera) which exhibited resistance to most of the antibiotics tested. Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae/E. cloacae complex, the most commonly found isolates, were subjected to whole-genome sequencing analysis and revealed close relationships between isolates from different samples, suggesting transmission of bacteria between neonates, and between neonates and mothers. Associations between the carriage of antimicrobial resistance genes (ARGs) and healthcare/environmental factors were identified, and the presence of ARGs was a predictor of neonatal sepsis and adverse birth outcomes.

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Section: Resultssupporting

confidence: 83%

Section: Prevalence Of β-Lactamase Genes Among Mothers and Neonatesmentioning

confidence: 61%

Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries

et al. 2022

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“…Ten of the included studies were cohort studies [ 33 , 36 , 38 , 39 , 41 , 42 , 45 , 48 , 58 ] and 4 of them case-control [ 32 , 37 , 44 , 62 ], while the rest were cross-sectional studies. Two studies [ 34 , 35 ] have included outpatients while the rest were conducted upon admission and after admission to a setting. Studies were ranked using the Joanna Briggs Institute assessment system, and their average quality scores varied from 5 to 8 ( Supplementary file ).…”

Section: Resultsmentioning

confidence: 99%

Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis

et al. 2022

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Background Klebsiella pneumoniae is a gram-negative rod belonging to the order Enterobacterales and having a wide distribution in the environment, including the human colon. Recently, the bacterium is one of the known problems in the healthcare setting as it has become resistant to last-resort drugs like carbapenems. The colonized person can serve as a reservoir for his/herself and others, especially in the healthcare setting leading to nosocomial and opportunistic infections. Therefore, we aimed to quantitatively estimate the rate of prevalence and incidence of colonization with carbapenem-resistant K. pneumoniae. Methods A literature search was conducted on PubMed/MEDLINE, Google Scholar, Science Direct, Cochrane Library, WHO Index Medicus, and university databases. The study includes all published and unpublished papers that addressed the prevalence or incidence of K. pneumoniae colonization. Data were extracted onto format in Microsoft Excel and pooled estimates with a 95% confidence interval calculated using Der-Simonian-Laird random-effects model. With the use of I2 statistics and prediction intervals, the level of heterogeneity was displayed. Egger’s tests and funnel plots of standard error were used to demonstrate the publication bias. Results A total of 35 studies were included in the review and 32 records with 37,661 patients for assessment of prevalence, while ten studies with 3643 patients for incidence of colonization. The prevalence of carbapenem-resistant K. pneumoniae colonization varies by location and ranges from 0.13 to 22%, with a pooled prevalence of 5.43%. (3.73–7.42). Whereas the incidence of colonization ranges from 2 to 73% with a pooled incidence of 22.3% (CI 12.74–31.87), both prevalence and incidence reports are majorly from developed countries. There was a variation in the distribution of carbapenem resistance genes among colonizing isolates with KPC as a prominent gene reported from many studies and NDM being reported mainly by studies from Asian countries. A univariate meta-regression analysis indicated continent, patient type, study design, and admission ward do not affect the heterogeneity (p value>0.05). Conclusion The review revealed that colonization with K. pneumoniae is higher in a healthcare setting with variable distribution in different localities, and resistance genes for carbapenem drugs also have unstable distribution in different geographic areas.

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“…Distribution of AMR and colistin resistant pathogenic strains have also been isolated from Tamil Nadu, West Bengal, Punjab 30 31 32 . In a study conducted in south India, MDR Enterobacteriaceae colonizing the gut of adult rural population was observed indicating faecal carriage of AMR strains with a threat of rapid spread in the community 33 .…”

Section: Acquiring the Ndm-1 Gene And Its Proliferation: A Multifacet...mentioning

confidence: 99%

NDM-beta-lactamase-1: Where do we stand?

2022

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Multidrug-resistant (MDR) Gram-negative bacilli (GNB) have been playing havoc in the field of nosocomial as well as community-acquired infections. Of particular concern are the carbapenem-resistant GNBs, belonging to Enterobacteriaceae and encoding for New Delhi metallo-beta-lactamase-1 ( NDM-1 ) gene. These strains spread rapidly and horizontally in the population, thus exhibiting MDR traits as these can harbour several resistance encoding genes to almost all antimicrobial groups. Several predisposing factors are responsible towards its spread, viz . excessive antibiotic usage, improper aseptic conditions by healthcare workers, lack of awareness, abruptly discontinuing medication course, alternative medications and vector-borne factors contributing to the unchecked harbouring of these super bugs in India. Thus, a bugle call has already been sounded worldwide especially in India, where the country has taken serious cognizance to build up strategy via implementation of several national programs to combat antimicrobial resistance covering human, animal, agriculture and environmental aspects. As there is an exponential rise in variants of NDM-1 harbouring strains, molecular epidemiological investigations of these strains using genotyping techniques are of paramount importance for a better understanding of this rampant spread and curbing resistance thereafter. This review explores the urgent need to develop a cost-effective, rapid molecular assay, viz . the loop-mediated isothermal amplification method for field detection of MBL harbouring bacterial strains, especially NDM-1 and its variants, thus targeting specific carbapenemase genes at a grass root level even to the remote and rural regions of the country.

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Multidrug-Resistant Enterobacteriaceae Colonising the Gut of Adult Rural Population in South India

Cited by 9 publications

References 20 publications

Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries

Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries

Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis

NDM-beta-lactamase-1: Where do we stand?

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