The Emergence of Carbapenem-Resistant Gram-Negative Bacteria in Mizoram, Northeast India

Abstract

(Background) Numerous reports on carbapenem resistance in different parts of India have been published, yet there are insufficient studies on the prevalence of antibiotic resistance in the northeast region of the country. This study evaluated the emergence of carbapenem resistance in the clinical isolates collected in Mizoram. (Results) A total of 141 Gram-negative clinical isolates were collected from the two hospitals, including the Civil Hospital in Lunglei and the Synod Hospital in Aizawl. The isolates include Escherichia coli (n = 62, 43.9%), Klebsiella spp. (n = 43, 30.4%), Pseudomonas aeruginosa (n = 9, 6.3%), Serratia marcescens (n = 3, 2.1%), Proteus mirabilis (n = 2, 1.4%), Shigella spp. (n = 4, 2.8%), Enterobacter spp. (n = 6, 4.2%) and Acinetobacter spp. (n = 12, 8.5%). The isolates were found to be resistant to meropenem (11%), colistin (48%), tigecycline (25%) and cefotaxime (50%). A total of four E. coli and one Shigella sonnei encoded the blaOXA-48-like gene. The blaCTX-M-1 gene was detected in 13 isolates, of which eight were E. coli, two Shigella flexneri, and one isolates each of K. pneumoniae, K. oxytoca and Shigella sonnei, respectively. (Conclusion) Carbapenem-resistant Enterobacteriaceae are common among other parts of India, despite limited access to antibiotics, the emergence of resistance in the northeastern region is worrying.

Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK

“…This low level of resistance is similar to that from another study in China [40], where, of 100 E. coli strains isolated from different clinical samples, there were no isolates resistant to imipenem. In another study in Northeast India, the resistance levels to carbapenem were higher than in our findings, where, out of 62 E. coli isolates, 4 (6.4%) isolates were found to be carbapenem-resistant [53]. This variation in the level of resistance might be due to different treatment regimes followed in different hospitals and countries.…”

Limited evidence of spill over of antimicrobial resistantKlebsiella pneumoniaefrom animal/environmental reservoirs to humans in India

“…28, 29 Several previous studies have demonstrated that the proportion of carbapenemase-producing isolates varies by location and study, ranging from 22% to 66%. 27, 30, 31 In contrast, characterisation of K. pneumoniae from non-clinical sources has been poorly documented apart form a few small localized studies. 32, 33 In the present study we detected phenotypic carbapenem resistance in 41.75% of clinical isolates during 2020 - 2022.…”

“…28,29 Several previous studies have demonstrated that the proportion of carbapenemase-producing isolates varies by location and study, ranging from 22% to 66%. 27,30,31 In contrast, characterisation of K.…”

Schooling the Gospel: Village School Teachers as Agents of Mission in the Early Mizo Church

“…Their work, apart from teaching, consisted of preaching the Gospel, planting churches as well as looking after these churches. 30 Often they would be travelling, preaching the Gospel in far off places. These first mission teachers were one of the most important foundations of the Church in Mizoram as well of the slowly changing society.…”

“…By 1927 Mizo mission teachers received training at the Mission station in Aizawl. 31 The training was a one-year course. The first of those trained Mizo teacher was Pasena.…”