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Carbapenem Resistance amongEnterobacterSpecies in a Tertiary Care Hospital in Central India

机译：印度中部三级医院的肠道细菌对碳青霉烯的耐药性

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Objective. To detect genes encoding carbapenem resistance amongEnterobacterspecies in a tertiary care hospital in central India.Methods. Bacterial identification ofEnterobacterspp. isolates from various clinical specimens in patients admitted to intensive care units was performed by routine conventional microbial culture and biochemical tests using standard recommended techniques. Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique. PCR amplification and automated sequencing was carried out. Transfer of resistance genes was determined by conjugation.Results. A total of 70/130 (53.84%) isolates ofEnterobacterspp. were found to exhibit reduced susceptibility to imipenem (diameter of zones of inhibition ≤13 mm) by disc diffusion method. Among 70 isolates tested, 48 (68.57%) isolates showed MIC values for imipenem and meropenem ranging from 32 to 64 mg/L as per CLSI breakpoints. All of these 70 isolates were found susceptible to colistinin vitroas per MIC breakpoints (<0.5 mg/L). PCR carried out on these 48 MBL (IP/IPI)E-test positive isolates (12Enterobacter aerogenes, 31Enterobacter cloacae, and 05Enterobacter cloacaecomplex) was validated by sequencing for beta-lactam resistance genes and result was interpreted accordingly.Conclusion. The study showed MBL production as an important mechanism in carbapenem resistance inEnterobacterspp. and interspecies transfer of these genes through plasmids suggesting early detection by molecular methods.
机译：目的。在印度中部三级医院的肠杆菌种中检测编码碳青霉烯抗性的基因。肠杆菌的细菌鉴定。通过常规常规微生物培养和生化测试，使用标准推荐技术对重症监护病房的患者从各种临床标本中分离出来。通过标准Kirby Bauer椎间盘扩散技术进行抗生素敏感性测试。进行PCR扩增和自动测序。通过结合确定抗性基因的转移。共有70/130（53.84％）的肠杆菌属菌株。通过圆盘扩散法发现对亚胺培南的敏感性降低（抑制区直径≤13mm）。在测试的70个分离株中，有48个（68.57％）分离株显示亚胺培南和美洛培南的MIC值根据CLSI断点在32至64μmg/ L之间。根据MIC断点（<0.5µmg / L），发现所有这70种分离株均对粘菌素体外敏感。通过对β-内酰胺抗性基因进行测序验证了对这48个MBL（IP / IPI）E测试阳性分离株（12产气肠杆菌，泄殖腔31肠杆菌和泄殖腔05肠杆菌复合体）进行的PCR验证，并据此进行了解释。研究表明MBL产生是肠杆菌对碳青霉烯耐药的重要机制。以及这些基因通过质粒的种间转移暗示了通过分子方法的早期检测。

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