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CORRESPONDENCE
Year : 2013  |  Volume : 31  |  Issue : 4  |  Page : 419-420
 

In-vitro susceptibility to colistin and tigecycline in New Delhi metallo-beta-lactamase-1 producing Enterobacteriaceae


1 Department of Microbiology, St. Johnís Medical College; Division of Infectious Disease, St. Johnís Research Institute, Bangalore, Karnataka, India
2 Department of Microbiology, St. Johnís Medical College, Bangalore, Karnataka, India
3 Division of Infectious Disease, St. Johnís Research Institute, Bangalore, Karnataka, India

Date of Submission14-Mar-2013
Date of Acceptance11-Jul-2013
Date of Web Publication25-Sep-2013

Correspondence Address:
R Macaden
Division of Infectious Disease, St. Johnís Research Institute, Bangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.118889

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How to cite this article:
Chandran S P, Nagaraj S, Kalal B S, Muralidharan S, Macaden R. In-vitro susceptibility to colistin and tigecycline in New Delhi metallo-beta-lactamase-1 producing Enterobacteriaceae. Indian J Med Microbiol 2013;31:419-20

How to cite this URL:
Chandran S P, Nagaraj S, Kalal B S, Muralidharan S, Macaden R. In-vitro susceptibility to colistin and tigecycline in New Delhi metallo-beta-lactamase-1 producing Enterobacteriaceae. Indian J Med Microbiol [serial online] 2013 [cited 2019 Sep 19];31:419-20. Available from: http://www.ijmm.org/text.asp?2013/31/4/419/118889


Dear Sir,

Carbapenem-resistance in Enterobacteriaceae is mediated by the New Delhi metallo-beta-lactamase (NDM) and was first reported in a patient hospitalized in New Delhi, India, in 2007. [1] Colistin and tigecycline have excellent bactericidal activity against most gram-negative aerobic bacilli. This study was conducted to evaluate the in-vitro activity of colistin and tigecycline against NDM-1 producing Enterobacteriaceae.

A total of 97 carbapenem-resistant non-repetitive isolates were collected and the presence of NDM-1 gene was detected in 44 isolates in a previous study. [2] These isolates were K. pneumoniae (n = 26), E. coli (n = 16), Enterobacter aerogenes (n = 1) and Enterobacter cloacae complex (n = 1). The resistance to carbapenems was confirmed by MIC assays using automated system (VITEK 2C, Marcy l'Etoile, France). The in-vitro activity of colistin and tigecycline against these NDM-1 producing isolates were analyzed using E-strips (AB bioMerieux, Solna, Sweden) and VITEK 2C, AST-GN 25 cards (bioMexrieux) according to the manufacturer's guidelines and were interpreted by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria and the U.S. Food and Drug Administration (FDA) criteria, respectively. [3],[4]

The MICs of tigecycline and colistin for NDM-1 producing isolates are shown in [Table 1]. Enterobacter cloacae complex showed colistin and tigecycline MICs of 0.125 mg/L and 1 mg/L respectively. For Enterobacter aerogenes, colistin MIC was 0.125 mg/L and tigecycline MIC was ≤5 mg/L. In our observation, MIC 90 for tigecycline and colistin for K. pneumoniae and E. coli was lesser than those in the previous reports. [5] Although colistin and tigecycline have side effects, they are the only therapeutic options available currently for treating NDM-1 producing gram-negative infections. Colistin and tigecycline have potential against carbapenem-resistant gram-negative bacilli and as reserve antibiotics.
Table 1: Carbapenems, tigecycline, and colistin MICs (mg/L) against NDM‑1 producing Enterobacteriaceae

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 ~ References Top

1.Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-beta-lactamase gene, bla NDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother 2009;53:5046-54.  Back to cited text no. 1
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2.Nagaraj S, Chandran SP, Shamanna P, Macaden R. Carbapenem resistance among Escherichia coli and Klebsiella pneumoniae in a tertiary care hospital in south India. Indian J Med Microbiol 2012;30:93-5.  Back to cited text no. 2
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3.European Committee on Antimicrobial Susceptibility Testing. 2011. Breakpoint tables for interpretation of MICs and zone diameters, version 1.3, January 5, 2011. European Committee on Antimicrobial Susceptibility Testing, Växjö, Sweden. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Disk_test_documents/EUCAST_breakpoints_v1.3_pdf [Last accessed in 2011 Nov].  Back to cited text no. 3
    
4.Kronvall G, Karlsson I, Walder M, Sörberg M, Nilsson LE. Epidemiological MIC cut-off values for tigecycline calculated from Etest MIC values using normalized resistance interpretation. J Antimicrob Chemother 2006;57:498-505.  Back to cited text no. 4
    
5.Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet Infect Dis 2010;10:597-602.  Back to cited text no. 5
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