Ceftazidime-Avibactam resistance in clinical isolates of carbapenem-resistant Klebsiella pneumoniae: A phenotypic and genotypic analysis

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology Pub Date : 2024-05-01 DOI:10.1016/j.ijmmb.2024.100603

Varshini M. Krithika, Vithiya Ganesan, T. Rajendran

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引用次数: 0

Abstract

Objective

To find the prevalence of Ceftazidime-Avibactam (CAZ-AVI) resistant Klebsiella pneumoniae in clinical isolates and to determine the genes responsible for Ceftazidime-Avibactam resistance using PCR.

Methods

A total of 89 carbapenem resistant Klebsiella pneumoniae from various clinical samples were included in the study. CAZ-AVI resistance was tested using E-test. CAZ-AVI resistant strains were subjected to conventional PCR for detection of carbapenamase genes bla_{NDM- 1}, bla_OXA-48, bla_VIM, bla_IMP, bla_KPC.

Results

Of the 89 isolates screened for CAZ-AVI resistance, 45(50.5%) isolates were found to be resistant. 42 isolates were subjected to PCR for detection of β lactamase genes.34 isolates were positive for bla_NDM-1 and all 42 isolates were positive for bla_OXA-48. Co-expression of NDM-1 and OXA-48 was seen in 34 isolates. Sensitivity of mCIM test to identify a carbapenamse compared to PCR was 61.9%. Sensitivity of eCIM test to identify NDM-1 was 80%.

Conclusion

CAZ-AVI was effective in vitro in 49.4% of the isolates. Indicating that CAZ-AVI is a promising addition to antibiotics against CRE as well as a carbapenem sparing drug in ESBL producing organisms. β-Lactamase-related mutations are the main mechanism leading to CAZ-AVI resistance.

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耐碳青霉烯类肺炎克雷伯菌临床分离株对头孢他啶-阿维菌素的耐药性：表型和基因型分析

方法本研究共纳入了来自不同临床样本的 89 例耐碳青霉烯类肺炎克雷伯菌。采用E-test检测对CAZ-AVI的耐药性。对 CAZ-AVI 耐药菌株进行常规 PCR，检测碳青霉烯酶基因 blaNDM- 1、blaOXA-48、blaVIM、blaIMP 和 blaKPC。其中 34 个分离株的 blaNDM-1 基因呈阳性，所有 42 个分离株的 blaOXA-48 基因呈阳性。在 34 个分离株中，NDM-1 和 OXA-48 基因同时表达。与 PCR 相比，mCIM 检验鉴定碳青霉烯类的灵敏度为 61.9%。结论 CAZ-AVI 在体外对 49.4% 的分离物有效。CAZ-AVI 对 49.4% 的分离菌体外有效，这表明 CAZ-AVI 是抗 CRE 抗生素的有望补充，也是 ESBL 产菌的碳青霉烯类稀释药物。与β-内酰胺酶相关的突变是导致CAZ-AVI耐药性的主要机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Medical Microbiology IMMUNOLOGY-

CiteScore

2.20

自引率

0.00%

发文量

154

审稿时长

73 days

期刊介绍： Manuscripts of high standard in the form of original research, multicentric studies, meta analysis, are accepted. Current reports can be submitted as brief communications. Case reports must include review of current literature, clinical details, outcome and follow up. Letters to the editor must be a comment on or pertain to a manuscript already published in the IJMM or in relation to preliminary communication of a larger study. Review articles, Special Articles or Guest Editorials are accepted on invitation.