Prevalence and characterization of beta-lactamase-producing Escherichia coli isolates from a tertiary care hospital in India

Abstract

BACKGROUND: The purpose of the study was to determine the prevalence and characterize the resistance profiles of Escherichia coli isolated from various clinical specimens by various phenotypic and genotypic methods. MATERIALS AND METHODS: A total of 196 consecutive, nonduplicate strains of clinically significant E. coli isolated from various clinical specimens were included in the study. Identification and antimicrobial susceptibility testing was performed by using Vitek-2 system (Biomerieux, France). Phenotypic detection of extended spectrum beta-lactamase (ESBLs), Amp-C-β lactamase (Amp C), and carbapenemase production was done by various combination of disc diffusion methods, minimum inhibitory concentration determination by E-test, followed by polymerase-chain-reaction for the detection of β-lactamase-encoding genes. RESULTS: Overall prevalence of ESBLs, Amp C, and carbapenemase production was found to be 88.3%, 42.2%, and 65.1% by the phenotypic detection methods. Our study also revealed high resistance rates against other antibiotics such as cefepime (89%), cefotaxime (95.4%), ceftazidime (85.4%), ceftriaxone (91.8%), cefpodoxime (92.7%), aztreonam (56.3%), piperacillin/tazobactam (89.2%), and ticarcillin/clavulanic acid (76.3%). The most prevalent ESBL gene was blaTEM(67.30%), and least prevalent ESBL gene was blaVEB(2.61%). In case of Amp C, blaFOXgene (21.9%) was predominant. Among the genes encoding for carbapenemases, the most common gene was blaNDM(61.7%) followed by blaVIM(30.8%), blaKPC(10.6%), blaOXA-48 (5.3%), and blaIMP(2.1%). CONCLUSION: Our findings suggest a high rate of ESBLs, Amp C, and carbapenemase production among the E. coli isolates. A combination of both phenotypic and genotypic methods would be ideal for better characterization of resistance patterns among the E. coli isolates.

Prevalence of various Beta-lactamases in Enterobacteriaceae in a tertiary care hospital in South India: A Cross-sectional study

“…[13][14][15][16][17] Among Escherichia coli, ESBL production was found in 31.05% of the isolates which is lower compared to other similar studies done in India. 17,18 In our study, 16.67% of the Klebsiella isolates were ESBL positive. In comparison, study done in Bangalore showed a higher prevalence of 46.6% among Klebsiella pneumoniae isolates.…”

Clinical Outcomes in Carbapenem-Resistant Enterobacteriaceae Infections Treated With Ceftazidime-Avibactam: A Single-Center Observational Study

“…South-Asia has become the hotbed of antimicrobial resistance, with some studies from India reporting a prevalence ranging from a modest 3% to an extremely high rate of around 65% CREs in clinical isolates [3][4][12][13]. Tigecycline and colistin are used as agents of choice for the treatment of CRE infections but treatment is complicated by uncertainties regarding the efficacy and adverse effects [14].…”

Increasing prevalence of Escherichia coli and Klebsiella pneumoniae producing CTX-M-type extended-spectrum beta-lactamase, carbapenemase, and NDM-1 in patients from a rural community with community acquired infections: A 3-year study

“…Studies in urban tertiary care hospitals of Northern Indian states, namely Delhi and Haryana reported a high prevalence of carbapenemase-producing E. coli detected by phenotypic methods as 65.1% and 44%, respectively. [ 29 30 ] However, there are few studies on the magnitude of the problem of CRE carbapenem resistance in the rural population reported from India. A pilot study conducted for a period of 1 year (January–December 2015) by the present laboratory reported lower prevalence of carbapenemase-producing E. coli and K. pneumoniae , i.e., 7.8%[ 9 ] compared to studies from rural Southern India reporting 19.4%–22.1% carbapenemase production among similar isolates.…”