Occurrence of blaNDM-1and blaNDM-5in a Tertiary Referral Hospital of North India.
Antimicrobial resistance poses a great challenge to clinicians leaving very limited treatment options available. A panel of carbapenem-resistant bacterial isolates was selected based on Rapidec Carba NP test from a total of 900 samples, which were collected from different specialities hospitals of Kanpur, India. Carba NP-positive isolates were screened for carbapenemases, extended-spectrum beta-lactamases (ESBLs), quinolone resistance, and 16s methyltransferase genes. Presence of diverse blaNDM(blaNDM-1and blaNDM-5) were detected and horizontal transferability was determined by transformation and conjugation assay. Elimination of blaNDM-1and blaNDM-5harboring plasmid was done by treating the isolates with sodium dodecyl sulfate. The transcriptional response of blaNDM-1and blaNDM-5under the exposure of imipenem, meropenem, and ertapenem stress was determined by quantitative real-time polymerase chain reaction. blaNDMharboring isolates were found to be horizontally transferable through IncFrepB and K type plasmid and could be successfully eliminated after the single treatment with sodium dodecyl sulfate. A distinct pattern of transcriptional response was observed for blaNDM-1and blaNDM-5under the pressure of carbapenem antibiotics where an upregulated expression of both blaNDM-1and blaNDM-5was observed. Minimum inhibitory concentration (MIC) results revealed that blaNDMharboring strains showed a high MIC range against imipenem, meropenem, ertapenem, cefepime, and aztreonam. Thus, prudent action should be taken to control the spread of these multidrug-resistant determinants or at least slowing down their lateral transfer in the hospital settings.
1 Department of Microbiology, Assam University , Silchar, India .
Deepjyoti
D
Paul
2 Department of Microbiology, GSVM Medical College , Kanpur, India .
Atul
A
Garg
1 Department of Microbiology, Assam University , Silchar, India .
Amitabha
A
Bhattacharjee
D000150:Acinetobacter / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D003227:Conjugation, Genetic; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D005260:Female; D015964:Gene Expression Regulation, Bacterial; D022761:Gene Transfer, Horizontal; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D062606:Tertiary Care Centers; D014158:Transcription, Genetic; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
D000900:Anti-Bacterial Agents; D015780:Carbapenems; C000615639:beta lactamase NDM-5, E coli; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1
antimicrobial resistance; blaNDM; carba NP; carbapenem; horizontal transferability