title: Emergence of carbapenem-resistant Acinetobacter in a temperate north Indian State.
abstract: This study aims to determine drug sensitivity, metallo-beta-lactamase (MBL) production and elaboration of bla(OXA)-type carbapenemases in Acinetobacter spp. in a temperate climate area in north India with a heavy influx of tourists. Antimicrobial sensitivity of 165 isolates was performed. Imipenem-resistant isolates were subjected to combined disk (CDT) and double-disk diffusion tests (DDT) for MBL detection. Minimum inhibitory concentration (MIC) and MBL production were tested by Etest. A multiplex polymerase chain reaction (PCR) was performed for the detection of genes encoding bla(OXA)-23 like, bla(OXA-24) like, bla(OXA-51) like and bla(OXA-58) like genes. Ninety-nine (60%) isolates were imipenem-resistant (MICs 2-96 microg/mL). Fifty (50.5%) of the 99 carbapenem-resistant isolates were MBL producers by CDT and 26 (26.3%) by DDT. The majority (77%) of the isolates elaborated bla(OXA-23) and bla(OXA-51) like genes. Forty seven of the 50 MBL-positive isolates harboured bla(OXA-23) like and bla(OXA-51) like genes. MBL-producing Acinetobacter has emerged as a major pathogen in Kashmir with elaboration of bla(OXA-23) and bla(OXA-51) related carbapenemases. This poses a significant challenge for healthcare professionals and policy planners, and needs to be addressed immediately. Primary care physicians treating visitors to Kashmir need to be aware of the situation.
authors.affiliation: Department of Clinical Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: N K
authors.initials: NK
authors.lastname: Bali
authors.affiliation: Department of Clinical Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: B A
authors.initials: BA
authors.lastname: Fomda
authors.affiliation: Department of Clinical Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: H
authors.initials: H
authors.lastname: Bashir
authors.affiliation: Department of Clinical Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: D
authors.initials: D
authors.lastname: Zahoor
authors.affiliation: Department of Clinical Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: S
authors.initials: S
authors.lastname: Lone
authors.affiliation: Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: P A
authors.initials: PA
authors.lastname: Koul
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000235:genetics*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000378:metabolism; D015780:Carbapenems / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D017931:DNA Primers; D004058:Diffusion; D024881:Drug Resistance, Bacterial; D006801:Humans; D007194:India; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010641:Phenotype; D016133:Polymerase Chain Reaction; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D017931:DNA Primers; D001618:beta-Lactamases; C063912:carbapenemase