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CC BY-NC-ND 4.0 · J Lab Physicians 2011; 3(01): 037-042
DOI: 10.4103/0974-2727.78563
Original Article

Horizontal Transfer of Antimicrobial Resistance by Extended-Spectrum β Lactamase-Producing Enterobacteriaceae

Varsha K Vaidya
Department of Microbiology, Institute of Science, 15, Madam Cama Road, Mumbai, India
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ABSTRACT

Background: The purpose of this work was to study the acquisition of new antibiotic-resistant genes carried by extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae via horizontal transfer to understand their rampant spread in the hospitals and in the community.

Materials and Methods: A retrospective analysis of 120 ESBL screen-positive isolates of Escherichia coli and Klebsiella pneumoniae, which were subjected to antimicrobial susceptibility testing, was carried out. The Double Disc Synergy Test (DDST) and Inhibitor-Potentiation Disc Diffusion Test (IPDD) were employed for confirmation of ESBL activity. The transferability of the associated antibiotic resistance for amoxicillin, amikacin, gentamicin, cefotaxime and ceftriaxone was elucidated by intra- and intergenus conjugation in Escherichia coli under laboratory as well as under simulated environmental conditions. Transformation experiments using plasmids isolated by alkaline lysis method were performed to study the transferability of resistance genes in Klebsiella pneumoniae isolates.

Results : ESBL production was indicated in 20% each of the Escherichia coli and Klebsiella pneumoniae isolates. All the ESBL isolates showed co- resistance to various other groups of antibiotics, including 3GC antibiotics, though all the isolates were sensitive to both the carbapenems tested. Conjugation-mediated transfer of resistance under laboratory as well as environmental conditions at a frequency of 3-4 x 10-5 , and transformation-mediated dissemination of cefotaxime and gentamicin resistance shed light on the propensity of ESBL producers for horizontal transfer.

Conclusions: The transfer of resistant markers indicated availability of a large pool of resistance genes in the hospital setting as well as in the environment, facilitating long-term persistence of organisms.

Keywords

ESBL - horizontal transfer - conjugation - co-resistance - transformation


Publication History

Article published online:
29 January 2020

© 2011.

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  • REFERENCES

  • 1 Arpin C, Dubois V, Coulange L, Andre´ C, Fischer I, Noury P, et al. Extended-spectrum β-lactamase-producing Enterobacteriaceae in community and private health care centers. Antimicrob Agents Chemother 2003;47:3506-14.
  • 2 Nagulapally SR. Antibiotic resistance patterns in municipal wastewater bacteria. M.Sc. Thesis, Manhattan, Kansas, U.S.A: Kansas State University; 2007.
  • 3 Ash RJ, Mauck B, Morgan M. Antibiotic resistance of Gram-negative bacteria in rivers, United States. Emer Infect Dis 2002;8:713-6.
  • 4 Talbot GH, Bradley J, Edwards Jr. JE, Gilbert D, Scheld M, Bartlett JG. Bad bugs need drugs: An update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. Clin Infect Dis 2006;42:657-68.
  • 5 Navarro F. Acquisition and horizontal diffusion of β-lactam resistance among clinically relevant microorganisms. Internatl Microbiol 2006;9:79-81.
  • 6 Clinical and Laboratory standards institute (CLSI). Performance standards for antimicrobial susceptibility testing, 16th informational supplements. Wayne PA: CLSI Document M2-A9; 2006.
  • 7 Shukla T, Tiwari, R, Agrawal M. Prevalence of extended spectrum β- lactamase producing Klebsiella pneumoniae in a tertiary care hospital. Indian J Med Microbiol 2004;22:87-91.
  • 8 Dillon JR. Recombinant DNA Methodology. Canada: John Willey and Sons; 1985. p. 81-3.
  • 9 Mathur P, Kapil A, Das B, Dhawan B. Prevalence of extended spectrum beta lactamase producing Gram negative bacteria in a tertiary care hospital. Indian J Med Res 2002;115:153-7.
  • 10 Bell JM, Chitsaz M, Turnidge JD, Barton M, Walters LJ, Jones, RN. Prevalence and significance of a negative Extended-Spectrum β-Lactamase (ESBL) confirmation test result after a positive ESBL screening test result for isolates of Escherichia coli and Klebsiella pneumoniae: Results from the SENTRY Asia-Pacific Surveillance Program. J Clin Microbiol 2007;45:1478-82.
  • 11 Hyle EP, Lipworth AD, Zaoutis TE, Nachamkin I, Fishman NO, Bilker WB, et al. Risk factors for increasing multidrug resistance among Extended-Spectrum β-Lactamase-producing Escherichia coli and Klebsiella species. Clin Infect Dis 2005;40:1317-24.
  • 12 Taneja N, Rao P, Arora J, Dogra A. Occurrence of ESBL and Amp-C β-lactamases and susceptibility to newer antimicrobial agents in complicated UTI. Indian J Med Res 2008;127:85-8.
  • 13 Aggarwal R, Chaudhary U, Sikka R. Detection of Extended-Spectrum β-Lactamase production among uropathogens. J Lab Physicians 2009;1:7-10.
  • 14 Mammeri H, Nordmann P. Extended-spectrum cephalosporinases in Enterobacteriaceae. Anti-Infect Agents Med Chem 2007;6:71-82.
  • 15 Rodrigues C, Shukla U, Jog S, Mehta A. Extended-spectrum β-lactamase producing flora in healthy persons. Emer Infect Dis 2005;11:981.
  • 16 Mesa RJ, Blanc V, Blanch AR, Cortés P, González JJ, Lavilla S, et al. Extended-spectrum β-lactamase-producing Enterobacteriaceae in different environments (humans, food, animal farms and sewage). J Antimicrob Chemother 2006;58:211-5.
  • 17 Soilleux MJ, Morand AM, Arlet GJ, Scavizzi MR, Labia R. Survey of Klebsiella pneumoniae producing extended-spectrum β-lactamases: Prevalence of TEM-3 and first identification of TEM-26 in France. Antimicrob Agents Chemother 1996;40:1027-9.
  • 18 Wei ZQ, Chen YG, Yu YS, Lu WX, Li LJ. Nosocomial spread of multi-resistant Klebsiella pneumoniae containing a plasmid encoding multiple β-lactamases. J Med Microbiol 2005;54:885-8.
  • 19 Ali MM, Vaidya VK. Antibiotic resistance in pathogens isolated from the coastal marine environment of Mumbai. Bionano Frontier 2008;2:115-23.
  • 20 Piddock LJ, Walters RN, Jin YF, Turner HL, Gascoyne-Binzi DM, Hawkey PM. Prevalence and mechanism of resistance to ′third-generation′ cephalosporins in clinically relevant isolates of Enterobacteriaceae from 43 hospitals in the UK, 1990-1991. J Antimicrob Chemother 1997;39:177-87.