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Zhang W, Zhou CL, Hu Y, Lin L, Li J, Xu Y, Cui S. Dissemination of Multiple Drug-Resistant Shigella flexneri 2a Isolates Among Pediatric Outpatients in Urumqi, China. Foodborne Pathog Dis 2022; 19:522-528. [PMID: 35917515 DOI: 10.1089/fpd.2021.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Multiple drug-resistant (MDR) Shigella isolates have been reported worldwide. Between May 2017 and September 2018, 55 Shigella flexneri 2a isolates were collected from 3322 stool samples of 0-10-year-old outpatients with diarrhea at the Children's Hospital of Urumqi, China. All isolates were characterized using serotyping, antimicrobial susceptibility testing, and whole-genome sequencing. A total of 54 of 55 (98.2%) isolates exhibited MDR phenotypes and had accumulated multiple resistance determinants, particularly of fluoroquinolones and cephalosporins preferred for shigellosis treatment: point mutations in quinolone resistance-determining regions (QRDRs) of topoisomerases (GyrA (S83L, D87N) and ParC (S80I) [n = 9]; GyrA (S83L) and ParC (S80I) [n = 45]) and acquisition of qnrS1 (n = 3) and blaCTX-M (n = 8). Over 70% of isolates acquired two point mutations of GyrA (S83L) and ParC (S80I) in QRDRs and 11 highly resistant isolates accumulated three point mutations in QRDRs or acquired qnrS1. Four S. flexneri 2a isolates from three single-nucleotide polymorphism clusters exhibited coresistance to ciprofloxacin, cefotaxime, or azithromycin (AZM), which are used as first- and second-line shigellosis treatment antimicrobials in clinics. Our data indicated that fluoroquinolones should be terminated in shigellosis treatment for outpatients in Urumqi. The transferable antimicrobial resistance determinants have been identified for third-generation cephalosporins and AZM. Novel strategies are urgently required for developing empirical medication to reduce the antimicrobial selective pressure and prevent dissemination of MDR S. flexneri 2a isolates.
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Affiliation(s)
- Wenli Zhang
- Department of Clinical Examination, The Children's Hospital, Urumqi, Xinjiang, China
| | - Christine L Zhou
- Department of Biology, University of Maryland, College Park, Maryland, USA
| | - Ying Hu
- Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China
| | - Lan Lin
- Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China
| | - Jingyun Li
- Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China
| | - Yinghua Xu
- Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China
| | - Shenghui Cui
- Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China
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Kar B, Sharma M, Peter A, Chetia P, Neog B, Borah A, Pati S, Bhattacharya D. Prevalence and molecular characterization of β-lactamase producers and fluoroquinolone resistant clinical isolates from North East India. J Infect Public Health 2021; 14:628-637. [PMID: 33848892 DOI: 10.1016/j.jiph.2021.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/26/2021] [Accepted: 02/14/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The rapid emergence and variations of antibiotic resistance among common gram negative bacteria cause a significant concern specially in India and all over the world because of high mortality and morbidity rates. METHODS In our study, we screened 189 bacterial isolates from Assam Medical College & Hospital, Dibrugarh for antibiotic resistance pattern and tried to identify the resistant genes causing responsible for β-lactam and fluoroquinolones resistance. RESULTS More than 80% and 45% strains were resistant to all the 3rd generation cephalosporins, fluoroquinolones respectively. Among the 3rd generation cephalosporin resistant strains, 38% and 24% isolates were only ESBL and MBL producers respectively and 11% were reported to have both ESBL and MBL genes. The ESBL positive isolates have shown the dominance of CTX-M3 gene. VIM-1 gene was mostly reported in MBL producers. Our study probably for the first time reporting SIM-1 and SPM-1 MBL gene from India. Mutations in QRDR is found to be the primary cause of fluoroquinolone resistance along with efflux pump and PMQR presence. CONCLUSION The study represents the first detailed study on antibiotic resistance from NE India this could help to take control measures for the emerging antibiotic resistance in hospital and community based infections in North East India.
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Affiliation(s)
- Bipasa Kar
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
| | - Mohan Sharma
- Department of Life Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India.
| | - Annalisha Peter
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
| | - Pankaj Chetia
- Department of Life Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India.
| | - Bijoy Neog
- Department of Life Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India.
| | - Amrit Borah
- Department of Microbiology, Assam Medical College & Hospital, Dibrugarh 786002, Assam, India.
| | - Sanghamitra Pati
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
| | - Debdutta Bhattacharya
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
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Shigella sonnei: virulence and antibiotic resistance. Arch Microbiol 2020; 203:45-58. [PMID: 32929595 PMCID: PMC7489455 DOI: 10.1007/s00203-020-02034-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022]
Abstract
Shigella sonnei is the emerging pathogen globally, as it is the second common infectious species of shigellosis (bloody diarrhoea) in low- and middle-income countries (LMICs) and the leading one in developed world. The multifactorial processes and novel mechanisms have been identified in S. sonnei, that are collectively playing apart a substantial role in increasing its prevalence, while replacing the S. flexneri and other Gram-negative gut pathogens niche occupancy. Recently, studies suggest that due to improvement in sanitation S. sonnei has reduced cross-immunization from Plesiomonas shigelliodes (having same O-antigen as S. sonnei) and also found to outcompete the two major species of Enterobacteriaceae family (Shigella flexneri and Escherichia coli), due to encoding of type VI secretion system (T6SS). This review aimed to highlight S. sonnei as an emerging pathogen in the light of recent research with pondering aspects on its epidemiology, transmission, and pathogenic mechanisms. Additionally, this paper aimed to review S. sonnei disease pattern and related complications, symptoms, and laboratory diagnostic techniques. Furthermore, the available treatment reigns and antibiotic-resistance patterns of S. sonnei are also discussed, as the ciprofloxacin and fluoroquinolone-resistant S. sonnei has already intensified the global spread and burden of antimicrobial resistance. In last, prevention and controlling strategies are briefed to limit and tackle S. sonnei and possible future areas are also explored that needed more research to unravel the hidden mysteries surrounding S. sonnei.
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Moharana SS, Panda RK, Dash M, Chayani N, Bokade P, Pati S, Bhattacharya D. Etiology of childhood diarrhoea among under five children and molecular analysis of antibiotic resistance in isolated enteric bacterial pathogens from a tertiary care hospital, Eastern Odisha, India. BMC Infect Dis 2019; 19:1018. [PMID: 31791267 PMCID: PMC6889523 DOI: 10.1186/s12879-019-4501-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 09/24/2019] [Indexed: 01/03/2023] Open
Abstract
Background Although, India has made steady progress in reducing deaths in children younger than 5 years, the proportional mortality accounted by diarrhoeal diseases still remains high. The present hospital based cross sectional study was carried out to understand the prevalence of various bacterial pathogens associated with the diarrhoea cases in under 5 years age group. Methods During, 1st September, 2015 to 30th November 2017, all the childhood diarrhoea cases (≤5 yrs) of SCB Medical College in Odisha, India were included in the study. Stool samples were collected and processed for the isolation of causative bacterial pathogen and the isolated bacterial pathogens were subjected to antibiotic sensitivity testing, molecular analysis of drug resistance. Clinical and demographic data were collected and analyzed. Results Three hundred twenty patients were enrolled in the study during the study period from whom 82 bacterial isolates were obtained indicating a proportional causality of 25.6% for bacterial diarrhoea among children in this region. Entero toxigenic E.coli (ETEC) accounted for majority of the cases and and more than 50% of the strains were found to be multi-drug resistant (resistant to more than 3 class of antibiotics). More than 50% of the strains were resistant to current choice of treatment like ciprofloxacin, ofloxacin and ceftriaxone and 2.4% being resistant to Imipenem. ESBL production was also observed in some of the strains and one isolate harboured the NDM-1 gene. Fluoroquinolone resistance was found to be linked with multiple mutations in the QRDR region followed by PMQR determinants. Conclusion The current study, to the best of our knowledge is first of its kind which demonstrated the etiology of bacterial diarrhoea in children less than 5 years old and identified diarrheogenic E. coli as the predominant enteropathogen in Odisha. Majority of the isolates being multi-drug resistance calls for a continuous surveillance system in the region which will be helpfulin identifying emerging resistance pattern and for developing suitable intervention stategies.
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Affiliation(s)
- Sonam S Moharana
- Dept. of Microbiology, SCB Medical College (Govt. of Odisha), Manglabag, Cuttack, Odisha, 753007, India
| | - Rakesh K Panda
- Dept. of Microbiology, SCB Medical College (Govt. of Odisha), Manglabag, Cuttack, Odisha, 753007, India
| | - Muktikesh Dash
- Dept. of Microbiology, SCB Medical College (Govt. of Odisha), Manglabag, Cuttack, Odisha, 753007, India
| | - Nirupama Chayani
- Dept. of Microbiology, SCB Medical College (Govt. of Odisha), Manglabag, Cuttack, Odisha, 753007, India
| | - Priyanka Bokade
- Dept. of Bacteriology & One Health, ICMR-Regional Medical Research Centre (Dept. of Health Reserch, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar, 751023, India
| | - Sanghamitra Pati
- Dept. of Bacteriology & One Health, ICMR-Regional Medical Research Centre (Dept. of Health Reserch, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar, 751023, India
| | - Debdutta Bhattacharya
- Dept. of Bacteriology & One Health, ICMR-Regional Medical Research Centre (Dept. of Health Reserch, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar, 751023, India.
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Mitra S, Mukherjee S, Naha S, Chattopadhyay P, Dutta S, Basu S. Evaluation of co-transfer of plasmid-mediated fluoroquinolone resistance genes and bla NDM gene in Enterobacteriaceae causing neonatal septicaemia. Antimicrob Resist Infect Control 2019; 8:46. [PMID: 30858970 PMCID: PMC6391786 DOI: 10.1186/s13756-019-0477-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/23/2019] [Indexed: 12/16/2022] Open
Abstract
Background The blaNDM-1 (New Delhi Metallo-β-lactamase-1) gene has disseminated around the globe. NDM-1 producers are found to co-harbour resistance genes against many antimicrobials, including fluoroquinolones. The spread of large plasmids, carrying both blaNDM and plasmid-mediated fluoroquinolone resistance (PMQR) markers, is one of the main reasons for the failure of these essential antimicrobials. Methods Enterobacteriaceae (n = 73) isolated from the blood of septicaemic neonates, admitted at a neonatal intensive care unit (NICU) in Kolkata, India, were identified followed by PFGE, antibiotic susceptibility testing and determination of MIC values for meropenem and ciprofloxacin. Metallo-β-lactamases and PMQRs were identified by PCR. NDM-positive isolates were studied for mutations in GyrA & ParC and for co-transmission of blaNDM and PMQR genes (aac(6′)-Ib-cr, qnrB, qnrS) through conjugation or transformation. Plasmid types, integrons, plasmid addiction systems, and genetic environment of the blaNDM gene in NDM-positive isolates and their transconjugants/ transformants were studied. Results Isolated Enterobacteriaceae comprised of Klebsiella pneumoniae (n = 55), Escherichia coli (n = 16), Enterobacter cloacae (n = 1) and Enterobacter aerogenes (n = 1). The rates of ciprofloxacin (90%) and meropenem (49%) non-susceptibility were high. NDM was the only metallo-β-lactamase found in this study. NDM-1 was the predominant metallo-β-lactamase but NDM-5, NDM-7, and NDM-15 were also found. There was no significant difference in ciprofloxacin non-susceptibility (97% vs 85%) and the prevalence of PMQRs (85% vs 77%) between NDM-positive and NDM-negative isolates. Among the PMQRs, aac(6′)-Ib-cr was predominant followed by qnrB1 and qnrS1. Twenty-nine isolates (40%) co-harboured PMQRs and blaNDM, of which 12 co-transferred PMQRs along with blaNDM in large plasmids of IncFIIK, IncA/C, and IncN types. Eighty-two percent of NDM-positive isolates possessed GyrA and/or ParC mutations. Plasmids carrying only blaNDM were of IncHIB-M type predominantly. Most of the isolates had ISAba125 in the upstream region of the blaNDM gene. Conclusion We hypothesize that the spread of PMQRs was independent of the spread of NDM-1 as their co-transfer was confirmed only in a few isolates. However, the co-occurrence of these genes poses a great threat to the treatment of neonates. Electronic supplementary material The online version of this article (10.1186/s13756-019-0477-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shravani Mitra
- 1Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, P33, CIT Road, Scheme XM, Beliaghata, Kolkata, 700010 India
| | - Suchandra Mukherjee
- 2Department of Neonatology, Institute of Post-Graduate Medical Education & Research and SSKM Hospital, Kolkata, 700020 India
| | - Sharmi Naha
- 1Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, P33, CIT Road, Scheme XM, Beliaghata, Kolkata, 700010 India
| | - Pinaki Chattopadhyay
- 2Department of Neonatology, Institute of Post-Graduate Medical Education & Research and SSKM Hospital, Kolkata, 700020 India
| | - Shanta Dutta
- 1Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, P33, CIT Road, Scheme XM, Beliaghata, Kolkata, 700010 India
| | - Sulagna Basu
- 1Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, P33, CIT Road, Scheme XM, Beliaghata, Kolkata, 700010 India
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Qin T, Gu B. Prevalence of Plasmid-Mediated Quinolone Resistance among Different Serotypes of <i>Shigella flexneri</i> Isolated from Jiangsu Province of China During 2001–2011. Jpn J Infect Dis 2018; 71:256-257. [DOI: 10.7883/yoken.jjid.2017.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tingting Qin
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University
| | - Bing Gu
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University
- Medical Technology School, Xuzhou Medical University
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Abstract
Shigellosis is one of the major causes of diarrhoea in India. The accurate estimates of morbidity and mortality due to shigellosis are lacking, though it is endemic in the country and has been reported to cause many outbreaks. The limited information available indicates Shigella to be an important food-borne pathogen in India. S. flexneri is the most common species, S. sonnei and non-agglutinable shigellae seem to be steadily surfacing, while S. dysenteriae has temporarily disappeared from the northern and eastern regions. Antibiotic-resistant strains of different Shigella species and serotypes have emerged all over the world. Especially important is the global emergence of multidrug resistant shigellae, notably the increasing resistance to third generation cephalosporins and fluoroquinolones, and also azithromycin. This calls for a continuous and strong surveillance of antibiotic resistance across the country for periodic updation of the local antibiograms. The prevention of shigellosis is desirable as it will substantially reduce the morbidity associated with diarrhoea in the country. Public health measures like provision of safe water and adequate sanitation are of immense importance to reduce the burden of shigellosis, however, the provision of resources to develop such an infrastructure in India is a complex issue and will take time to resolve. Thus, the scientific thrust should be focused towards development of a safe and affordable multivalent vaccine. This review is focused upon the epidemiology, disease burden and the therapeutic challenges of shigellosis in Indian perspective.
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Affiliation(s)
- Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Abhishek Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Muthuirulandi Sethuvel DP, Devanga Ragupathi NK, Anandan S, Veeraraghavan B. Update on: Shigella new serogroups/serotypes and their antimicrobial resistance. Lett Appl Microbiol 2016; 64:8-18. [PMID: 27783408 DOI: 10.1111/lam.12690] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 02/02/2023]
Abstract
Shigellosis represents a major burden of disease in developing countries. A low infectious dose allows the disease to be spread effectively. Although shigellosis is mostly a self-limiting disease, antibiotics are recommended to reduce deaths, disease symptoms and organism-shedding time. However, in India, antimicrobial resistance among the genus Shigella is more common than among any other enteric bacteria. Notably, new serotypes or subserotypes in Shigella are reported from various parts of the world. Identification of new subserotypes of Shigella spp. is becoming a major issue as these strains are nontypeable by conventional serotyping. The commercially available antisera may not cover all possible epitopes of the O lipopolysaccharide antigen of Shigella serotypes. Therefore, molecular methods which most closely approach the resolution of full serotyping are necessary to identify such strains. In addition, the knowledge of a prevalent serotype in various geographic regions may assist in formulating strategies such as the development of a vaccine to prevent infection especially when the immunity to disease is serotype specific, and to understand the disease burden caused by new Shigella serotypes.
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Affiliation(s)
| | | | - S Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - B Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
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Yugendran T, Harish BN. High incidence of plasmid-mediated quinolone resistance genes among ciprofloxacin-resistant clinical isolates of Enterobacteriaceae at a tertiary care hospital in Puducherry, India. PeerJ 2016; 4:e1995. [PMID: 27168994 PMCID: PMC4860338 DOI: 10.7717/peerj.1995] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/10/2016] [Indexed: 11/20/2022] Open
Abstract
Background. Plasmid-mediated quinolone resistance (PMQR) has received considerable attention recently. Data analysis in Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) revealed 75% of the Enterobacteriaceae isolates to be ciprofloxacin-resistant in 2012. Few reports regarding the prevalence of PMQR are available from India. Hence, the present study was carried out to ascertain the prevalence of PMQR genes among clinical isolates of ciprofloxacin-resistant Enterobacteriaceae in JIPMER. Methods. The study included 642 ciprofloxacin-resistant clinical Enterobacteriaceae isolates. JIPMER hospital's annual consumption data for fluoroquinolones were retrieved from the Department of Pharmacy. The test isolates were screened for the presence of qnr A, B, D, S and aac(6')-Ib-cr genes. PMQR-positive isolates alone were tested for the presence of class I (intI1) and class II (intI2) integrons. Randomly selected PCR amplicons were sequenced and analysed using MEGA software. A total of 30 PMQR strains chosen at random were assessed for the transferability of the PMQR genes. Results. A majority of the strains exhibited high MIC values with 106 strains exhibiting MIC values >256 µg/mL. The aac(6')-Ib-cr gene had the highest prevalence at 64% (414) while, qnrB and qnrS genes were present in 15% (97) and 10% (64) of the isolates respectively. None of the strains were positive for qnrA and qnrD. All PMQR-positive isolates were screened for class I (intI1) and class II (intI2) integrons. Class I integron was found to be predominant among the test isolates with a few of them carrying both the classes of integrons. Transferability of PMQR genes to transconjugants was identified. Conclusion. The incidence of PMQR genes in the tertiary-care setup of the JIPMER hospital was found to be high which could be probably due to the increased prescription of fluoroquinolones. Thus, there is a need for rational usage of fluoroquinolones.
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Affiliation(s)
- Thiyagarajan Yugendran
- Department of Microbiology, Jawaharlal Institute for Post-graduate Medical Education and Research , Puducherry , India
| | - Belgode Narasimha Harish
- Department of Microbiology, Jawaharlal Institute for Post-graduate Medical Education and Research , Puducherry , India
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Molecular characterisation of quinolone-resistant Shigella strains isolated in Tehran, Iran. J Glob Antimicrob Resist 2016; 5:26-30. [PMID: 27436462 DOI: 10.1016/j.jgar.2016.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/19/2016] [Accepted: 01/25/2016] [Indexed: 11/20/2022] Open
Abstract
Over the past few years, the number of Shigella strains resistant to nalidixic acid has increased and has made the selection of effective antimicrobial therapy more difficult. The purpose of this study was to investigate the molecular mechanism of quinolone resistance in Shigella strains. Shigella strains isolated from 1100 diarrhoeal patients in Tehran, Iran, were assessed for their susceptibility to nalidixic acid prior to PCR-RFLP and sequence analysis of their quinolone resistance genes. Among 73 Shigella strains isolated, 23 (31.5%) were resistant to nalidixic acid. The most common Shigella spp. was Shigella sonnei (54; 74.0%). Of the 23 quinolone-resistant isolates, 4 (17.4%) (including 2 Shigella flexneri, 1 S. sonnei and 1 Shigella boydii) contained the qnrS gene. However, none of the isolates harboured qnrA or qnrB genes. PCR-RFLP analysis of gyrA showed a mutation profile in two nalidixic acid-resistant strains, including one S. sonnei and one S. flexneri. Sequencing of mutant gyrA genes revealed a point mutation at position 83, resulting in the replacement of serine by leucine. In conclusion, molecular mechanisms of resistance to quinolones were identified in 6 of 23 Shigella isolates. Other possible mechanisms of resistance should also be investigated for better characterisation of quinolone-resistant Shigella isolates.
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Qin TT, Kang HQ, Ma P, Li PP, Huang LY, Gu B. SOS response and its regulation on the fluoroquinolone resistance. ANNALS OF TRANSLATIONAL MEDICINE 2016; 3:358. [PMID: 26807413 DOI: 10.3978/j.issn.2305-5839.2015.12.09] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Bacteria can survive fluoroquinolone antibiotics (FQs) treatment by becoming resistant through a genetic change-mutation or gene acquisition. The SOS response is widespread among bacteria and exhibits considerable variation in its composition and regulation, which is repressed by LexA protein and derepressed by RecA protein. Here, we take a comprehensive review of the SOS gene network and its regulation on the fluoroquinolone resistance. As a unique survival mechanism, SOS may be an important factor influencing the outcome of antibiotic therapy in vivo.
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Affiliation(s)
- Ting-Ting Qin
- 1 Medical Technology Institute of Xuzhou Medical College, Xuzhou 221004, China ; 2 Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China
| | - Hai-Quan Kang
- 1 Medical Technology Institute of Xuzhou Medical College, Xuzhou 221004, China ; 2 Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China
| | - Ping Ma
- 1 Medical Technology Institute of Xuzhou Medical College, Xuzhou 221004, China ; 2 Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China
| | - Peng-Peng Li
- 1 Medical Technology Institute of Xuzhou Medical College, Xuzhou 221004, China ; 2 Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China
| | - Lin-Yan Huang
- 1 Medical Technology Institute of Xuzhou Medical College, Xuzhou 221004, China ; 2 Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China
| | - Bing Gu
- 1 Medical Technology Institute of Xuzhou Medical College, Xuzhou 221004, China ; 2 Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221006, China
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Ghosh S, Pazhani GP, Niyogi SK, Nataro JP, Ramamurthy T. Genetic characterization of Shigella spp. isolated from diarrhoeal and asymptomatic children. J Med Microbiol 2014; 63:903-910. [PMID: 24790083 DOI: 10.1099/jmm.0.070912-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Phenotypic and genetic characteristics of Shigella spp. isolated from diarrhoeal and asymptomatic children aged up to 5 years were analysed in this study. In total, 91 and 17 isolates were identified from diarrhoeal (case) and asymptomatic (control) children, respectively. All the isolates were tested for antimicrobial resistance, the presence of integrons, plasmid-mediated quinolone resistance (PMQR), virulence-associated genes and Shigella pathogenicity island (SH-PAI). The majority of the Shigella spp. from cases (68.1%) and controls (82.3%) were found to be resistant to fluoroquinolones. Integron carriage was detected more in cases (76.9%) than in controls (35.5%). Atypical class 1 integron was detected exclusively in Shigella flexneri from cases but not from the controls. PMQR genes such as aac(6')-Ib-cr and qnrS1 were detected in 82.4 and 14.3% of the isolates from cases and in 53 and 17.6% in controls, respectively. Shigella isolates from cases as well as from controls were positive for the invasive plasmid antigen H-encoding gene ipaH. The other virulence genes such as virF, sat, setA, setB, sen and ial were detected in Shigella isolates in 80.2, 49.4, 27.4, 27.4, 80.2 and 79.1% of cases and in 64.7, 52.9, 17.6, 17.6, 64.7 and 64.7% of controls, respectively. The entire SH-PAI was detected in S. flexneri serotype 2a from cases and controls. In an isolate from a control child, the SH-PAI was truncated. Integrons, PMQR and virulence-encoding genes were detected more frequently in cases than in controls. In diarrhoea endemic areas, asymptomatic carriers may play a crucial role in the transmission of multidrug-resistant Shigella spp. with all the putative virulence genes.
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Affiliation(s)
- Santanu Ghosh
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Gururaja P Pazhani
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Swapan Kumar Niyogi
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - James P Nataro
- University of Virginia, School of Medicine, Charlottesville, VA, USA
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13
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Taneja N, Kumar A, Appannanavar S, Verma G, Sharma M. Plasmid-mediated quinolone resistance in Shigella isolates over a decade in India. J Glob Antimicrob Resist 2013; 2:59-60. [PMID: 27873641 DOI: 10.1016/j.jgar.2013.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 10/15/2013] [Accepted: 10/30/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Neelam Taneja
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Ajay Kumar
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Suma Appannanavar
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Garima Verma
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Meera Sharma
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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14
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Bhattacharya D, Thamizhmani R, Bhattacharya H, Sayi DS, Muruganandam N, Roy S, Sugunan AP. Emergence of New Delhi metallo-β-lactamase 1 (NDM-1) producing and multidrug resistant uropathogens causing urinary tract infections in Andaman Islands, India. Microb Drug Resist 2013; 19:457-62. [PMID: 23862639 DOI: 10.1089/mdr.2013.0070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The present study was undertaken to understand the distribution and the antimicrobial susceptibility patterns of the uropathogens in the remote islands of India. Patients' demographical data, urine culture results, and resistance rates were analyzed and multidrug resistant isolates were characterized. Significant bacteriuria was found in 16 (17.7%, 95% confidence interval [CI] 8.47-23.53%) samples, which includes Escherichia coli 9 (56.3%); Klebsiella pneumoniae 3 (18.8%); Enterobacter sp. 2 (12.5%) and Proteus mirabilis 2 (12.5%). The uropathogens showed a wide resistance involving 3-21 drugs with 15 different resistance patterns. Among the 16 isolates, 13 (81.3%, 95% CI 62.13-100.37%) and 11 (68.8%, 95% CI 46.04-91.46%) isolates were resistant to fluoroquinolones and third generation cephalosporins, respectively. Multiple mutations were detected in quinolone resistance determining region (QRDR) of the fluoroquinolone resistant isolates and all third generation cephalosporin resistant isolates producing extended-spectrum beta-lactamase. A total of 7 (44%, 95% CI 17.02-70.98%) isolates was found to harbor plasmid mediated quinolone resistance determinants The present study reports for the first time the presence of the New Delhi metallo-β-lactamase (NDM-1) gene in two isolates of P. mirabilis in these islands. Detection of multidrug resistant and NDM-1 producing isolates from cases of urinary tract infection in these remote islands lends support to the belief that the existence of these highly resistant strains is perhaps more widespread than previously thought and underscores the need for immediate implementation of antibiotic policy integrated with a continuous surveillance system. The study strengthens the need for a continuous surveillance system of antibiotic resistance in these remote Islands.
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Affiliation(s)
- Debdutta Bhattacharya
- 1 Department of Health, Ministry of Health and Family, Regional Medical Research Centre (Indian Council of Medical Research) , Port Blair, India
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