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  Table of Contents  
CORRESPONDENCE
Year : 2015  |  Volume : 33  |  Issue : 1  |  Page : 180-181
 

A preliminary study screening cephalosporin-resistant Enterobacteriaceae for blaCTX-M and blaampC isolated from Kumaun region, India


1 Department of Microbiology, Government Medical College, Haldwani, Uttarakhand, India
2 Department of Medical Microbiology, Section of Antimicrobial Agents and Drug Resistance Research and Molecular Biology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

Date of Submission02-Oct-2013
Date of Acceptance03-Dec-2013
Date of Web Publication5-Jan-2015

Correspondence Address:
M Shahid
Department of Medical Microbiology, Section of Antimicrobial Agents and Drug Resistance Research and Molecular Biology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.148422

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How to cite this article:
Umesh, Shahid M, Rawat V, Khan H M, Singh A, Sobia F. A preliminary study screening cephalosporin-resistant Enterobacteriaceae for blaCTX-M and blaampC isolated from Kumaun region, India. Indian J Med Microbiol 2015;33:180-1

How to cite this URL:
Umesh, Shahid M, Rawat V, Khan H M, Singh A, Sobia F. A preliminary study screening cephalosporin-resistant Enterobacteriaceae for blaCTX-M and blaampC isolated from Kumaun region, India. Indian J Med Microbiol [serial online] 2015 [cited 2019 Nov 15];33:180-1. Available from: http://www.ijmm.org/text.asp?2015/33/1/180/148422


Dear Editor,

In recent years many concerns were given to Enterobacteriaceae isolates producing CTX-M (class A) and AmpC (class C) beta-lactamases [1] and have evolved and spread quickly all over the world, including in India. [2] These beta-lactamases were discussed in various members of the Enterobacteriaceae family; however, they are most often reported in  Escherichia More Details coli and Klebsiella pneumoniae.[3],[4] There were reports describing the molecular epidemiology of these organisms from several geographical regions of India, but there is a paucity of such molecular reports from Kumaun region of India. Therefore the present preliminary study was designed to find out the occurrence of blaCTX-M and blaampC in cephalosporin-resistant Enterobacteriaceae isolates obtained from Kumaun region.

A total of 41 third-generation cephalosporins-resistant (3GCR) Enterobacteriaceae isolates obtained from the urine and stool samples subjected to the department of Microbiology of Government Medical College, Haldwani were screened for blaCTX-M and blaampC by multiplex and monoplex PCRs, respectively. Screening for CTX-M geno-groups was performed by multiplex PCR using specific primers for CTXM-1, -2, -8, -9 and -25/26 groups (amplicon sizes: 415 bp, 552 bp, 666 bp, 205 bp and 327 bp, respectively), and the presence of blaampC was determined by a monoplex PCR (amplicon size of 634 bp) according to the methods described previously. [5] The primers used in the present study (for both multiplex and monoplex PCRs) were synthesised by OPERON, Alabama, USA. The control strain for CTX-M and blaampC were kindly provided by Prof. Daniel Jonas, Freiberg, Germany.

Of these 41 3GCR isolates, 33 were isolated from urine samples of the patients tentatively diagnosed as cases of urinary tract infection (UTI) and eight isolates were obtained from stool samples of the patients presenting with diarrhoea. From the urine samples, 24 isolates were of E. coli and nine were K. pneumoniae, whereas from stool samples six were E. coli and 2 were K. pneumoniae. Of the 33 urinary isolates, 22 (66.7%) demonstrated the presence of blaCTX-M of the geno-group-1. No other CTX-M group (2, 8, 9, 25/26) was noticed in this collection of bacterial isolates. Of these blaCTX-M harbouring isolates, 68.1% (15/22) were E. coli and 31.8% (7/22) were K. pneumoniae. blaampC was noticed in 27.3% (9/33) urinary isolates and of which 88.9% (8/9) were E. coli and one isolate (11.1%) was K. pneumoniae, whereas, in the isolates from stool samples, 50% (4/8) demonstrated the presence of blaCTX-M (geno-group-1) and 25% demonstrated the presence of blaampC .

In the present collection, significant percentage (66.7%) of urinary isolates demonstrated the presence of CTX-M ESBLs; E. coli surpassed in occurrence than K. pneumoniae. Interestingly, isolates from stool samples also demonstrated the occurrence of CTX-M ESBLs in significant percentage of isolates (50%). Although the distribution of CTX-M-occurrence was equal in E. coli and K. pneumoniae from stool samples, we could not comment on this finding due to small number of stool samples available for this study. The occurrence of AmpC beta-lactamases was in comparable frequency in urinary and stool isolates; 27.3% vs. 25%, respectively. Simultaneous occurrence of blaCTX-M and blaampC was also noticed in the present collection, notably in both E. coli and K. pneumoniae.

Of particular concern was the presence of these antibiotics resistance genes in the coliforms that are present as normal bacterial flora in gastrointestinal tract of humans and suggests their possible dissemination in the population in Kumaun region of India as well. Although it was a pilot study to analyse the current situation (existence of blaCTX-M and blaampC ) in gut flora of population from Kumaun region, getting the positive results prompts us to perform large-scale studies in this region to analyse the real burden. In nutshell, blaCTX-M (of geno-group-1) and blaampC were prevalent in bacterial population of Kumaun region. To the best of our knowledge, we did not find any molecular study from this region that characterised the geno-groups of CTX-M ESBLs therefore, this is one of the premier molecular reports describing their occurrence from Kumaun region; however, further large-scale studies are needed to address the situation properly.


 ~ Acknowledgement Top


The secretarial assistance provided by Tomy Kaitharath is deeply appreciated.

 
 ~ References Top

1.
Shahid M, Sobia F, Singh A, Khan HM. Concurrent occurrence of blaampC families and blaCTX-M genogroups and association with mobile genetic elements ISEcp1, IS26, ISCR1, and sul1-type class 1 integrons in Escherichia coli and Klebsiella pneumoniae isolates originating from India. J Clin Microbiol 2012;50:1779-82.  Back to cited text no. 1
    
2.
Singh A, Shahid M, Sobia F, Umesh, Khan HM. Comparative study on occurrence of class A and class C β-lactamase genes and their co-occurrence in Indian Enterobacteriaceae during years 2009 and 2010. Asian Pac J Trop Med 2011;4:764-8.  Back to cited text no. 2
    
3.
Hawkey PM, Jones AM. The changing epidemiology of resistance. J Antimicrob Chemother 2009;64:i3-10.  Back to cited text no. 3
    
4.
Shahid M, Singh A, Sobia F, Patel M, Khan HM, Malik A, et al. An overview of CTX-M β-lactamases. Rev Medical Microbiol 2011;22:28-40.  Back to cited text no. 4
    
5.
Shahid M. Citrobacter spp. simultaneously harboring blaCTX-M , blaTEM, blaSHV, blaampC , and insertion sequences IS26 and orf513: An evolutionary phenomenon of recent concern for antibiotic resistance. J Clin Microbiol 2010;48:1833-8.  Back to cited text no. 5
    




 

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