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Multidrug resistant NDM-1 metallo-beta-lactamase producing Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit in a tertiary care center at central India.
Indian J Pathol Microbiol. 2014 Jan-Mar; 57(1):65-8.IJ

Abstract

OBJECTIVE

The objective of the following study is to detect genes encoding carbapenem resistance in Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit (NICU).

MATERIALS AND METHODS

Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique and minimum inhibitory concentrations of antibiotics was determined by VITEK-2. Polymerase chain reaction (PCR) assays and sequencing was used to determine the presence of beta-lactamase encoding genes. Conjugation experiments were performed to determine the transferability of beta-lactamase. Isolate relatedness were determined by repetitive-element PCR (REP), enterobacterial repetitive intergenic consensus (ERIC) PCR and random amplified polymorphic deoxyribonucleic acid (RAPD).

RESULTS

All the isolates were completely resistant to the second and third generation cephalosporins tested as well as carbapenems. Susceptibility profiling of the isolates indicated that 100% retained susceptibility to tigecycline and colistin. Conjugation experiments indicated that blaNDM-1 was transferable and likely through a plasmid-mediated event. All the isolates showed the presence of blaNDM-1 with co association of blaCTX-M-15. REP-PCR, ERIC-PCR and RAPD revealed a single clonal type circulating in NICU environment.

CONCLUSION

Co-production of NDM-1 with CTX-M-15 in K. pneumoniae isolates was detected for the first time in our NICU. Transmission of plasmid carrying these resistant genes to other members of Enterobacteriaceae will increase the incidence of multidrug resistance. Early detection of these genes will help in prevention and adequate infection control by limiting the spread of these organisms.

Authors+Show Affiliations

Department of Microbiology, Armed Forces Medical College, Pune, Maharashtra, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24739834

Citation

Khajuria, Atul, et al. "Multidrug Resistant NDM-1 Metallo-beta-lactamase Producing Klebsiella Pneumoniae Sepsis Outbreak in a Neonatal Intensive Care Unit in a Tertiary Care Center at Central India." Indian Journal of Pathology & Microbiology, vol. 57, no. 1, 2014, pp. 65-8.
Khajuria A, Praharaj AK, Kumar M, et al. Multidrug resistant NDM-1 metallo-beta-lactamase producing Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit in a tertiary care center at central India. Indian J Pathol Microbiol. 2014;57(1):65-8.
Khajuria, A., Praharaj, A. K., Kumar, M., Grover, N., & Aggarwal, A. (2014). Multidrug resistant NDM-1 metallo-beta-lactamase producing Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit in a tertiary care center at central India. Indian Journal of Pathology & Microbiology, 57(1), 65-8. https://doi.org/10.4103/0377-4929.130900
Khajuria A, et al. Multidrug Resistant NDM-1 Metallo-beta-lactamase Producing Klebsiella Pneumoniae Sepsis Outbreak in a Neonatal Intensive Care Unit in a Tertiary Care Center at Central India. Indian J Pathol Microbiol. 2014 Jan-Mar;57(1):65-8. PubMed PMID: 24739834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multidrug resistant NDM-1 metallo-beta-lactamase producing Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit in a tertiary care center at central India. AU - Khajuria,Atul, AU - Praharaj,Ashok Kumar, AU - Kumar,Mahadevan, AU - Grover,Naveen, AU - Aggarwal,Amit, PY - 2014/4/18/entrez PY - 2014/4/18/pubmed PY - 2015/4/8/medline SP - 65 EP - 8 JF - Indian journal of pathology & microbiology JO - Indian J Pathol Microbiol VL - 57 IS - 1 N2 - OBJECTIVE: The objective of the following study is to detect genes encoding carbapenem resistance in Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit (NICU). MATERIALS AND METHODS: Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique and minimum inhibitory concentrations of antibiotics was determined by VITEK-2. Polymerase chain reaction (PCR) assays and sequencing was used to determine the presence of beta-lactamase encoding genes. Conjugation experiments were performed to determine the transferability of beta-lactamase. Isolate relatedness were determined by repetitive-element PCR (REP), enterobacterial repetitive intergenic consensus (ERIC) PCR and random amplified polymorphic deoxyribonucleic acid (RAPD). RESULTS: All the isolates were completely resistant to the second and third generation cephalosporins tested as well as carbapenems. Susceptibility profiling of the isolates indicated that 100% retained susceptibility to tigecycline and colistin. Conjugation experiments indicated that blaNDM-1 was transferable and likely through a plasmid-mediated event. All the isolates showed the presence of blaNDM-1 with co association of blaCTX-M-15. REP-PCR, ERIC-PCR and RAPD revealed a single clonal type circulating in NICU environment. CONCLUSION: Co-production of NDM-1 with CTX-M-15 in K. pneumoniae isolates was detected for the first time in our NICU. Transmission of plasmid carrying these resistant genes to other members of Enterobacteriaceae will increase the incidence of multidrug resistance. Early detection of these genes will help in prevention and adequate infection control by limiting the spread of these organisms. SN - 0974-5130 UR - https://www.unboundmedicine.com/medline/citation/24739834/Multidrug_resistant_NDM_1_metallo_beta_lactamase_producing_Klebsiella_pneumoniae_sepsis_outbreak_in_a_neonatal_intensive_care_unit_in_a_tertiary_care_center_at_central_India_ L2 - http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2014;volume=57;issue=1;spage=65;epage=68;aulast=Khajuria DB - PRIME DP - Unbound Medicine ER -