title: Molecular characterisation of antimicrobial resistance inPseudomonas aeruginosaandAcinetobacter baumanniiduring 2014 and 2015 collected across India.
abstract: BACKGROUND
  Surveillance of antimicrobial resistance (AMR) is of great importance. Pseudomonas aeruginosa and Acinetobacter baumannii are important pathogens and emergence of resistance in these have increased the morbidity and mortality rates. This surveillance study was initiated by the Government of India - Indian Council of Medical Research. The aim of this study is to determine the antimicrobial susceptibility profile and to characterise the enzyme mediated antimicrobial resistance such as extended spectrum beta-lactamases (ESBLs) and carbapenemases among multidrug-resistant (MDR) P. aeruginosa and A. baumannii.
  
  
  METHODS
  A multi-centric study was conducted from January 2014 to December 2015 with a total number of 240 MDR P. aeruginosa and 312 MDR A. baumannii isolated from blood, cerebrospinal fluid, respiratory, pus, urine and intra-abdominal infections. Kirby-Bauer disc diffusion was done to determine the antimicrobial susceptibility profile. Further, MDR isolates were characterised by multiplex polymerase chain reaction to determine the resistance genes for ESBLs and carbapenemases.
  
  
  RESULTS
  Among the ESBLs, blaVEB (23%), blaTEM (5%) and blaSHV (0.4%) in P. aeruginosa and blaPER (54%), blaTEM (16%) and blaSHV (1%) in A. baumannii were the most prevalent. Likewise, blaVIM (37%), blaNDM (14%), blaGES (8%) and blaIMP (2%) in P. aeruginosa and blaOXA-23like (98%), blaOXA-58like (2%), blaNDM (22%) and blaVIM (3%) in A. baumannii were found to be the most prevalent carbapenemases. blaOXA-51like gene, intrinsic to A. baumannii was present in all the isolates tested.
  
  
  CONCLUSIONS
  The data shown highlight the wide difference in the molecular mechanisms of AMR profile between P. aeruginosa and A. baumannii. In P. aeruginosa, plasmid-mediated mechanisms are much lesser than the chromosomal mediated mechanisms. In A. baumannii, class D oxacillinases are more common than other mechanisms. Continuous surveillance to monitor the trends in AMR among MDR pathogens is important for implementation of infection control and to guide appropriate empirical antimicrobial therapy.
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Pragasam
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: S
authors.initials: S
authors.lastname: Vijayakumar
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Y D
authors.initials: YD
authors.lastname: Bakthavatchalam
authors.affiliation: Department of Microbiology, All Institute of Medical Sciences, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Kapil
authors.affiliation: Department of Microbiology, All Institute of Medical Sciences, New Delhi, India.
authors.forename: B K
authors.initials: BK
authors.lastname: Das
authors.affiliation: Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: P
authors.initials: P
authors.lastname: Ray
authors.affiliation: Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: V
authors.initials: V
authors.lastname: Gautam
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: S
authors.initials: S
authors.lastname: Sistla
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: S C
authors.initials: SC
authors.lastname: Parija
authors.affiliation: Division of Epidemiology and Communicable Diseases, n Council for Medical Research, New Delhi, India.
authors.forename: K
authors.initials: K
authors.lastname: Walia
authors.affiliation: Division of Epidemiology and Communicable Diseases, n Council for Medical Research, New Delhi, India.
authors.forename: V C
authors.initials: VC
authors.lastname: Ohri
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: S
authors.initials: S
authors.lastname: Anandan
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: B
authors.initials: B
authors.lastname: Veeraraghavan
mesh_terms: D000151:Acinetobacter Infections / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D002876:Chromosomes, Bacterial; D052978:Disk Diffusion Antimicrobial Tests; D024881:Drug Resistance, Bacterial; D005798:Genes, Bacterial; D005838:Genotype; D006801:Humans; D007194:India; D060885:Multiplex Polymerase Chain Reaction; D010957:Plasmids; D011552:Pseudomonas Infections / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001618:beta-Lactamases