{"title":"流行和分子洞察碳青霉烯耐药性：在印度南部超级细菌的2年回顾性分析。","authors":"Rahul Harikumar Lathakumari, Leela Kakithakara Vajravelu, Jayaprakash Thulukanam, Dakshina M Nair, Poornima Baskar Vimala, Vishnupriya Panneerselvam","doi":"10.3389/fmed.2025.1571231","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a serious global health threat, especially in low- and middle-income countries. Local surveillance is crucial for informing antimicrobial stewardship and infection control strategies. This study aimed to evaluate the prevalence, demographic distribution, and temporal fluctuations of carbapenem resistance among key Gram-negative pathogens in a South Indian tertiary care center over a two-year period.</p><p><strong>Methods: </strong>A retrospective study was conducted on 8,359 non-duplicate Gram-negative isolates obtained from clinical specimens between July 2022 and July 2024. Organisms were identified, and antimicrobial susceptibility was determined using the VITEK<sup>®</sup> 2 Compact system (BioMérieux). Resistance to imipenem (IPM) and meropenem (MEM) was assessed. Data were stratified by age, sex, ward type, specimen source, and quarterly distribution. A subset of resistant isolates underwent molecular screening for carbapenemase genes using real time PCR.</p><p><strong>Results: </strong>Carbapenem resistance was observed in 24% (2007) of Gram-negative isolates. <i>Acinetobacter baumannii</i> (48.0%) and <i>Klebsiella pneumoniae</i> (38.6%) accounted for the majority of resistant cases. Resistance was significantly higher in males (64.3%) and in patients aged 61-80 years (<i>p</i> < 0.001). Surgical wards showed greater resistance rates compared to medical departments. A peak in resistance was identified during January-March 2023, particularly for <i>A. baumannii</i> (76.3%). IPM-MEM resistance discrepancies were found in <i>Citrobacter</i> and <i>Proteus</i> species. Gene profiling of resistant strains revealed the predominance of <i>bla</i> <sub>NDM</sub>, <i>bla</i> <sub>VIM</sub> in <i>all organism.</i></p><p><strong>Conclusion: </strong>The findings reveal a high and fluctuating burden of carbapenem resistance, especially in elderly males and surgical settings. Continuous surveillance and targeted interventions are vital to curbing the spread of CR-GNB in high-risk healthcare environments.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1571231"},"PeriodicalIF":3.1000,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162471/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence and molecular insights into carbapenem resistance: a 2-year retrospective analysis of superbugs in South India.\",\"authors\":\"Rahul Harikumar Lathakumari, Leela Kakithakara Vajravelu, Jayaprakash Thulukanam, Dakshina M Nair, Poornima Baskar Vimala, Vishnupriya Panneerselvam\",\"doi\":\"10.3389/fmed.2025.1571231\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a serious global health threat, especially in low- and middle-income countries. Local surveillance is crucial for informing antimicrobial stewardship and infection control strategies. This study aimed to evaluate the prevalence, demographic distribution, and temporal fluctuations of carbapenem resistance among key Gram-negative pathogens in a South Indian tertiary care center over a two-year period.</p><p><strong>Methods: </strong>A retrospective study was conducted on 8,359 non-duplicate Gram-negative isolates obtained from clinical specimens between July 2022 and July 2024. Organisms were identified, and antimicrobial susceptibility was determined using the VITEK<sup>®</sup> 2 Compact system (BioMérieux). Resistance to imipenem (IPM) and meropenem (MEM) was assessed. Data were stratified by age, sex, ward type, specimen source, and quarterly distribution. A subset of resistant isolates underwent molecular screening for carbapenemase genes using real time PCR.</p><p><strong>Results: </strong>Carbapenem resistance was observed in 24% (2007) of Gram-negative isolates. <i>Acinetobacter baumannii</i> (48.0%) and <i>Klebsiella pneumoniae</i> (38.6%) accounted for the majority of resistant cases. Resistance was significantly higher in males (64.3%) and in patients aged 61-80 years (<i>p</i> < 0.001). Surgical wards showed greater resistance rates compared to medical departments. A peak in resistance was identified during January-March 2023, particularly for <i>A. baumannii</i> (76.3%). IPM-MEM resistance discrepancies were found in <i>Citrobacter</i> and <i>Proteus</i> species. Gene profiling of resistant strains revealed the predominance of <i>bla</i> <sub>NDM</sub>, <i>bla</i> <sub>VIM</sub> in <i>all organism.</i></p><p><strong>Conclusion: </strong>The findings reveal a high and fluctuating burden of carbapenem resistance, especially in elderly males and surgical settings. Continuous surveillance and targeted interventions are vital to curbing the spread of CR-GNB in high-risk healthcare environments.</p>\",\"PeriodicalId\":12488,\"journal\":{\"name\":\"Frontiers in Medicine\",\"volume\":\"12 \",\"pages\":\"1571231\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-05-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162471/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fmed.2025.1571231\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1571231","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Prevalence and molecular insights into carbapenem resistance: a 2-year retrospective analysis of superbugs in South India.
Background: Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a serious global health threat, especially in low- and middle-income countries. Local surveillance is crucial for informing antimicrobial stewardship and infection control strategies. This study aimed to evaluate the prevalence, demographic distribution, and temporal fluctuations of carbapenem resistance among key Gram-negative pathogens in a South Indian tertiary care center over a two-year period.
Methods: A retrospective study was conducted on 8,359 non-duplicate Gram-negative isolates obtained from clinical specimens between July 2022 and July 2024. Organisms were identified, and antimicrobial susceptibility was determined using the VITEK® 2 Compact system (BioMérieux). Resistance to imipenem (IPM) and meropenem (MEM) was assessed. Data were stratified by age, sex, ward type, specimen source, and quarterly distribution. A subset of resistant isolates underwent molecular screening for carbapenemase genes using real time PCR.
Results: Carbapenem resistance was observed in 24% (2007) of Gram-negative isolates. Acinetobacter baumannii (48.0%) and Klebsiella pneumoniae (38.6%) accounted for the majority of resistant cases. Resistance was significantly higher in males (64.3%) and in patients aged 61-80 years (p < 0.001). Surgical wards showed greater resistance rates compared to medical departments. A peak in resistance was identified during January-March 2023, particularly for A. baumannii (76.3%). IPM-MEM resistance discrepancies were found in Citrobacter and Proteus species. Gene profiling of resistant strains revealed the predominance of blaNDM, blaVIM in all organism.
Conclusion: The findings reveal a high and fluctuating burden of carbapenem resistance, especially in elderly males and surgical settings. Continuous surveillance and targeted interventions are vital to curbing the spread of CR-GNB in high-risk healthcare environments.
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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