Prevalence of plasmid mediated bla_(TEM-1) and bla_(CTX-M-15) type extended spectrum beta-lactamases in patients with sepsis  

作　　者：Shahzad F Haque Saeedut-Z Ali Mohammed TP Asad U Khan 

机构地区：[1]Department of Medicine,J.N.Medical College,Aligarh,India [2]Interdisciplinary Biotechnology Unit,AMU,Aligarh Muslim University,Aligarh,India [3]Department of Medicine,J.N.Medical College.Aligarh,India

出　　处：《Asian Pacific Journal of Tropical Medicine》2012年第2期98-102,共5页亚太热带医药杂志（英文版）

基　　金：supported by internal funds of Biotechnology Unit.AMU and DBT grant,BT/PR11453/BID/07/296/2009 to AUK

摘　　要：Objective:To characterize the bacterial pathogens in patients having gram negative septicaemia. Further,to evaluate the antimicrobial resistance and underlying molecular mechanisms in these strains.Methods:A total number of 70 cases of gram negative sepsis were included in this prospective,open labeled,observational study.Standard methods for isolation and identification of bacteria were used.Antimicrobial susceptibility and ESBL testing was performed by the standard disc diffusion method.PCR amplification was performed to identify bla_CTX-M,bla_SHVand bla_TEM type ESBLs.Conjugation experiments were performed to show resistant marker transfer. Results:The most prevalent isolates Escherichia coli（E.coli） 58.6%,Klebsiella Spp.32.9%and Pseudomonas 8.6%,were resistant to most of the antimicrobials including cefazolin,ceftriaxone, cefuroxime,ampicillin and co-trimoxazole but sensitive to imipenem and meropenem.ESBL and MBL production was seen 7.3%and 12.2%of E.coli isolates respectively.Three isoaltes were found to have bla_CTX-M-15 and two of them also showed bla_TEM-1 type enxyme.Whereas, none of them showed bla_SHV.Conjugation experiments using J-53 cells confirmed these resistant markers as plasmid mediated.Conclusions:This work highlights the molecular epidemiology of escalating antimicrobial resistance and likely switch over of bla_CTX-M-15 type extended spectrum beta-lactamases by bla_TEM type ESBLs in India.Further,the antimicrobial resistance by horizontal gene transfer was predominant among Enterobacteraceae in the community setting.Objective:To characterize the bacterial pathogens in patients having gram negative septicaemia. Further,to evaluate the antimicrobial resistance and underlying molecular mechanisms in these strains.Methods:A total number of 70 cases of gram negative sepsis were included in this prospective,open labeled,observational study.Standard methods for isolation and identification of bacteria were used.Antimicrobial susceptibility and ESBL testing was performed by the standard disc diffusion method.PCR amplification was performed to identify bla_(CTX-M),bla_(SHV)and bla_(TEM) type ESBLs.Conjugation experiments were performed to show resistant marker transfer. Results:The most prevalent isolates Escherichia coli(E.coli) 58.6%,Klebsiella Spp.32.9%and Pseudomonas 8.6%,were resistant to most of the antimicrobials including cefazolin,ceftriaxone, cefuroxime,ampicillin and co-trimoxazole but sensitive to imipenem and meropenem.ESBL and MBL production was seen 7.3%and 12.2%of E.coli isolates respectively.Three isoaltes were found to have bla_(CTX-M-15) and two of them also showed bla_(TEM-1) type enxyme.Whereas, none of them showed bla_(SHV).Conjugation experiments using J-53 cells confirmed these resistant markers as plasmid mediated.Conclusions:This work highlights the molecular epidemiology of escalating antimicrobial resistance and likely switch over of bla_(CTX-M-15) type extended spectrum beta-lactamases by bla_(TEM) type ESBLs in India.Further,the antimicrobial resistance by horizontal gene transfer was predominant among Enterobacteraceae in the community setting.

关 键 词：Gram negative SEPSIS ESBL Antimicrobial resistance 

分 类 号：R515.3[医药卫生—内科学]