IDENTIFICATION AND MOLECULAR CHARACTERISATION OF ESBL PRODUCING UROPATHOGENIC ESCHERICHIA COLI STRAINS ISOLATED FROM A TERTIARY CARE HOSPITAL OF TRIPURA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 24
Abstract
BACKGROUND Infections caused by Escherichia coli (E. coli) have become a significant worldwide public health problem. Furthermore,the situation is worsening due to advent of increased antibiotic resistance due to the evolution of plasmid mediated multi-resistant antibiotic genes, mainly Extended Spectrum B-lactamases (ESBLs). These enzyme producing organisms are also co-resistant to other different classes of antibiotics. Aims and Objectives- The aim of the study was to determine the antibiotic resistance pattern of Uropathogenic E. coli isolated from tertiary care hospital of Tripura with an objective of plasmid profiling of multidrug resistant isolates and to determine the blaTEM and blaCTX-M producers by molecular methods, mainly by PCR using gene specific primer. MATERIALS AND METHODS This study was undertaken to identify the presence of ESBLs enzyme by phenotypic method and presence of blaTEM and blaCTX-M gene among the ESBL-producing Uropathogenic Escherichia coli (UPEC) by polymerase chain reaction using gene specific primers at our setup. RESULTS Out of 150 clinical isolates from patients of the tertiary care hospital, 85 strains were identified as E. coli strains. These isolates were further screened for ESBL production by phenotypic methods using drug-inhibitor combination disks, namely ceftazidimeclavulanate (30 + 10 μg) and cefotaxime-clavulanate (30 + 10 μg) as per CLSI guidelines. Out of 85 isolates, 52 were detected as ESBL producers. Further analysis for plasmid isolation showed that all of them harbour plasmids of size ranging from ~0.5 to 20 kb. Molecular analysis of ESBL gene indicated predominance of blaTEM 42% followed by blaCTX-M 35%, blaOXA + blaTEM 15% and blaCTX-M +blaTEM 8% respectively. CONCLUSION This study highlights increased proportion of ESBL producers among uropathogenic E. coli isolated from the tertiary care setup of Tripura. These ESBL producers were simultaneously resistant to three or more than three groups of other antibiotics and were assigned as multidrug resistant (MDR) E. coli. The isolates harboured plasmids of varied size and numbers. Molecular analysis of ESBL gene indicated predominance of blaTEM and blaCTX-M, which can be successfully detected by PCR. Detection of ESBL by phenotypic tests if supplemented with molecular methods may provide a valuable diagnostic and research tool. These will strengthen the antibiotic stewardship programme of the hospital and aid in preserving the efficacy of life saving antibiotics.
Authors and Affiliations
Arunabha Dasgupta, Tapan Majumdar, Rajesh Bhowmik
Keywords
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- EP ID EP450513
- DOI 10.14260/jemds/2018/638
- Views 57
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