Co-existence of Extended Spectrum β-Lactamase and carbapenemase-producing genes from Diarrheagenic Enteric pathogens isolated in a tertiary care hospital

Archana A. Kharat; Nilesh Makwana; Dlip G. Kadam; Anusaya S. Chavan; Jeetendra A. Kulkarni; Arun S. Kharat

doi:10.18388/abp.2020_6188

Archana A. Kharat Department of Microbiology, DBF Dayanand College of Science, Solapur, MS, India
Nilesh Makwana Laboratory of Applied Microbiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
Dlip G. Kadam Department of Microbiology, DBF Dayanand College of Science, Solapur, MS, India
Anusaya S. Chavan Department of Chemistry, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad, MS, 431005, India
Jeetendra A. Kulkarni Department of Biotechnology, Dr. Babasaheb Ambedkar Marathwada University, Sub-campus Osmanabad, MS, India
Arun S. Kharat 1Laboratory of Applied Microbiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India; 2Department of Biotechnology, Dr. Babasaheb Ambedkar Marathwada University, Sub-campus Osmanabad, MS, India https://orcid.org/0000-0002-2571-4398

DOI: https://doi.org/10.18388/abp.2020_6188

Abstract

Multiple drug resistance (MDR) among bacterial pathogens is a growing concern that clinicians are facing worldwide. Diarrhea among infants is frequent and is caused by various bacterial and viral infectious agents. Two hundred and twelve stool specimens were collected from pediatric patients from a rural quaternary hospital in Barshi, Sholapur, India, between March and December 2017. Total 180 specimens were positive for various bacterial pathogens, while the remaining 32 diarrhea cases may have been caused by a viral or uncultured bacterial pathogen. Identification of the bacterium and its antibiotic susceptibility were primarily carried out with VITEK-2. Distribution of diarrhea-causing bacteria among the 180 samples was as follows: 61.11% (110) Escherichia coli, 30.55% (55) Klebsiella pneumoniae, 4.44% (8) Proteus mirabilis, 2.22% (4) Shigella spp. 1.11% (2) Morganella morganii and 0.55% (1) each for Enterobacter cloacae and Citrobacter koseri. There was a co-existence of multiple genetic traits conferring extreme drug resistance (XDR) status to 19 isolates, 17 of which were determined to be E. coli and one each of E. cloacae and C. koseri. Antibiotype determination using VITEK-2 and polymerase chain reaction (PCR) amplification of the genetic traits indicated the co-existence of blaTEM and blaCTX-M15 isolates in all 19 isolates, with the exception of E. cloacae. Results showed that 10 out of 19 strains expressed the AmpC cephalosporinase blaCMY-2 gene, whereas metallo-carbapenemase was expressed in four isolates. Distribution of blaNDM-11 and acquired penicillinase blaSHV-1 resistance among 180 clinical isolates is discussed in the light of ESBL traits. This is the first report from the rural part of Maharashtra India showing that as many as 10.55% of the pathogenic strains were XDR, a step ahead of MDR.