MULTIDRUG RESISTANT BACTERIA CREEPING INTO A NEWLY SET UP TEACHING HOSPITAL-TIME TO INTERVENE

B.M. UMA¹, A. DHANALAXMI²*
¹The Oxford Medical College Hospital and Research Centre, Bangalore, 562107, Rajiv Gandhi University of Health Sciences, Bangalore, 560041, Karnataka, India
²The Oxford Medical College Hospital and Research Centre, Bangalore, 562107, Rajiv Gandhi University of Health Sciences, Bangalore, 560041, Karnataka, India
* Corresponding Author : drdhanu12@gmail.com

Received : 02-05-2019     Accepted : 26-05-2019     Published : 30-05-2019
Volume : 11     Issue : 5       Pages : 1565 - 1568
Int J Microbiol Res 11.5 (2019):1565-1568

Keywords : Beta lactamases, Drug resistance, MRSA, Gram negative, Gram positive
Conflict of Interest : None declared
Acknowledgements/Funding : Authors are thankful to The Oxford Medical College Hospital and Research Centre, Bangalore, 562107, Rajiv Gandhi University of Health Sciences, Bangalore, 560041, Karnataka, India
Author Contribution : All authors equally contributed

Introduction: Antimicrobial Resistance (AMR) has been on continuous rise and drug resistant bacteria are the commonest etiology in hospitalized and community acquired infections. The objective of this study was to detect multidrug resistant organisms isolated from various clinical specimen, and their antibiotic profile. Materials and Methods: 750 Clinical samples were cultured; organisms were isolated and identified. Antibiotic susceptibility test was done based on Kirby Bauer disc diffusion method. ESBL production was tested by phenotypic double disc potentiation test. AmpC ß-lactamse production was tested by disc antagonism method. Detection of serine carbapenamases and MBLs was performed by Modified Carbapenem Inactivation method and EDTA Modified Carbapenem Inactivation method respectively as described by new CLSI guidelines. Among the Gram positive cocci, Methicillin and Inducible Clindamycin resistance was detected by cefoxitin disc diffusion and D-test respectively. Results: Among the resistant gram-negative bacteria, 33(10.9%) were ESBLs, 11(3.65%) Amp C, 3(1%) each were ESBL+Amp C, inducible AmpC and MBLs. Out of 150 resistant staphylococcal isolates, 103(68.6%) showed methicillin resistance and 26 (17.3%) showed inducible clindamycin resistance. Multidrug resistance (MDR) was observed in 4.8% of Gram negative and 2% of Gram positive bacteria. Extremely drug resistant bacteria (XDR) were found in 2% and 1% of Gram negative and Gram positive bacteria. Conclusion: Rising levels of AMR mandates routine detection of various types of resistance patterns. Routine detection of ESBLs, screening for Amp C beta lactamases, inducible Amp C, and confirmation of MBLs will help in providing authentic antibiotic susceptibility testing reports.

1. Bhuyan B., Sargiary P. and Nath R. (2018) Int J Med Res Prof, 4(4), 64-68.
2. Vijaya S., Achyut R. (2017) Indian J Microbiol Res,4(1),64-67.
3. Gupta V. (2007) Ind J Med Res, 12,417-27.
4. Bush K., Jacoby G. and Medeiros A. (1995) Antimicrob Agents Chemother, 39(6), 1211–1233.
5. Haider M., Rizvi M., Fatima N., Shukla I. and Malik A. (2014) Muller Journal of Medical Science and Research, 5(1), 23-28.
6. Tewari R., Mitra S.D., Ganaie F.,Venugopal N., Das S., Shome R., Rahman H. and Shome B.R. (201 Int J Res Med Sci, 6(4),1308-1313.
7. Rawat V., Singhai M. and Verma P. K. (2013) Journal of Laboratory Physicians, 5 (1), 21-25.
8. Wadekar M.D., Anuradha K. and Venkatesha D. (2013) Int J Curr Res Acs Rev, 1(3), 89-95.
9. Vandana K.E. and Honnavar P. (2009) J Clin Diagn Res,4(3),1653-1656.
10. Jayakumar S. and Appalaraju B. (2007) Indian J Pathol Microbiol, 50(4), 922-925.
11. Soumya S. and Nagmoti M. (2017) Int J Microbiol Res, 9(12), 981-983.
12. Banerjee T., Mishra A., Das A., Sharma S., Barman H. and Yadav G. (2018) Journal of Pathogens, 1-8.
13. Shahandeh Z., Sadighian F. and Rekabpou K. B. (2015) Int J Health System and Disaster Management, 3(2), 74-78.
14. Collee J.G., Miles R.S., Watt B. (2006) Mackie and McCartney Practical Medical Microbiology. 14th edn, London:Churchill Livingstone, p131-49.
15. Clinical and Laboratory Standards Institute, Performance Standards for antimicrobial susceptibility testing;17th informational supplement. M100-S17 (2007), M2-A9, 27(1), 32-8.
16. Shahid S., Malik A., Agrawal M. and Singhal S. (2004) J Antimicrobial Chemother, 54,684-687.
17. Ashok A.K., Jaryal S.C., Thakur A., Sood P.K, Gupta, Thakur S. (2016) Int.J.Curr. Microbiol. App. Sci, 5(4),133-139.
18. Clinical and Laboratory Standards Institute, Performance Standards for Antimicrobial Susceptibility Testing (2017) 27th ed. CLSI document M100S.
19. Wassef M., Behiry I., Younan M., Guindy E N., Mostafa S., Abada E. (2014) Genotypic Identification Jundishapur J Microbiol, 7(1), 8556.
20. Nasir K.M., Preeti S., Vikili C., Singh N.P. (2015) Int. Res J Med Sci, 3 (8), 1-6.
21. Dar J.A., Thoker M.A., Khan J.A., Ali A., Khan M.A., Rizwan M. et al. (2006) Ann Clin Microbiol Antimicrobial, 5(1),22.
22. Borg M., Scicluna E., De Kraker M., Van de Sande-Bruinsma N., Tiemersma E., Gur D et al. (2006) European surveillance, 11(7),639.
23. Sasirekha B., Usha M.S., Amruta J.A. (2014) Biotech, 4, 85.
24. Shittu A.O., Lin J. (2006) BMC Infect Dis, 6,125.
25. Mehta M., Dutta P., Gupta V. (2007) Indian J Plast Surg, 40:25–28
26. Schreckenberger P.C., Ilendo E., Ristow K.L. (2004) J Clin Microbiol, 42, 2777–2779.
27. Levin T.P., Suh B., Axelrod P., Truant A.L., Fekete T. (2005) Antimicrob Agents Chemother, 49,1222-1224.
28. Ajantha G.S., Kulkarni R.D., Shetty J., Shubhada C., Jain P. (2008) Indian J Pathol Microbiol, 51,376-378.