Detection of colistin susceptibility in extended spectrum β lactamases positive Klebsiella pneumoniae and Escherichia coli clinical isolates by broth disc elution method

Authors

  • Aiswarya Sivadas Department of Medical Microbiology, School of Medical Education, Centre for Professional and Advanced Studies, Kottayam, Kerala, India
  • Anakha Sajeev Department of Medical Microbiology, School of Medical Education, Centre for Professional and Advanced Studies, Kottayam, Kerala, India
  • Harish Kumar K. S. Department of Medical Microbiology, School of Medical Education, Centre for Professional and Advanced Studies, Kottayam, Kerala, India https://orcid.org/0000-0002-0504-7794
  • Shinu Krishnan Department of Medical Microbiology, School of Medical Education, Centre for Professional and Advanced Studies, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240844

Keywords:

Klebsiella pneumoniae, Escherichia coli, Extensively drug resistant, Colistin, Multi-drug resistance, Extensively-drug resistance, Extended spectrum β lactamases

Abstract

Background: Antibiotic resistance is one of the greatest threats in human health. Extended spectrum β lactamases mediated resistance is prevalent worldwide, Klebsiella pneumoniae and Escherichia coli leap out as this significant ESBL producers conferring resistance to the expanded spectrum cephalosporins. Colistin is being administered as last line therapy for patients that have failed to respond to other available antibiotics that are active against Gram-negative bacteria.

Methods: The present study was conducted at school of medical education Kottayam, Kerala from January 2023 to November 2023.During the period of study 150 isolates of K. pneumoniae and 136 isolates of E. coli were collected from various diagnostic microbiology laboratories in Kerala. The colistin susceptibility pattern of ESBL producing isolates was detected by broth disc elution method recommended by CLSI.

Results: In this study prevalence of multi-drug resistant is 6% and 9.6% and Extensively-drug resistant is 62% and 63.9% for K. pneumoniae and E. coli respectively. ESBL production was detected as 72% in K. pneumoniae and 79% in E. coli. The colistin susceptibility pattern of ESBL producing K. pneumoniae and E. coli was detected as 76.9% and 87.9% respectively

Conclusions: Our result demonstrated that the recent use of colistin as last resort treatment for extensively drug resistant gram-negative bacilli, it is essential to know the prevalence of susceptibility pattern to this antibiotic.

References

Afzal AMS. Antibiotic resistant pattern of E. coli and Klebsiella species in Pakistan: brief over-view. J Microb Biochem Tech. 2017;9:6.

Kibret M, Abera B. Antimicrobial susceptibility patterns of E. coli from clinical sources in northeast Ethiopia. Afr Health Sci. 2011;11:S40-5.

Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev. 1998;11:589-603.

Allocati N, Masulli M, Alexeyev MF, Di Ilio C. Escherichia coli in Europe: an overview. Int J Environ Res Public Health. 2013;10:6235-6254.

Global antimicrobial resistance and use surveillance system (GLASS) report. Available at: http://www. who.int/glass/resources/publications/early-implementation-report-2020/en/. Accessed on 20 November 2023.

Onduru OG, Mkakosya RS, Aboud S, Rumisha SF. Genetic determinants of resistance among esbl-producing enterobacteriaceae in community and hospital settings in East, Central, and Southern Africa: A Systematic Review and Meta-Analysis of Prevalence. Can J Infect Dis Med Microbiol. 2021.

Li Q, Chang W, Zhang H, Hu D, Wang X. The role of plasmids in the multiple antibiotic resistance transfer in ESBLs-producing Escherichia coli isolated from wastewater treatment plants. Front Microbiol. 2019; 10:633.

Chong Y, Shimoda S, Shimono N. Current epidemiology, genetic evolution and clinical impact of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Infect Genet Evol. 2018;61:185-8.

Obeng-Nkrumah N, Labi A-K, Addison NO, Labi JEM, Awuah-Mensah G. Trends in paediatric and adult bloodstream infections at a ghanaian referral hospital: a retrospective study. Ann Clin Microbiol Antimicrob. 2016;15(1):49.

Falagas ME, Kasiakou SK, Tsiodras AS. Michalopoulos The use of intravenous and aerosolized polymyxins for the treatment of infections in critically ill patients: a review of the recent literature. Clin Med Res. 2006;4:138-46.

Arnold TM, Forrest GN, Messmer KJ. Polymyxin antibiotics for Gram-negative infections. Am J Health Syst Pharm. 2007;64:819-26.

Li Z, Cao Y, Yi L, Liu J-H, Yang Q. Emergent Polymyxin Resistance: End of an Era? Open Forum Infect Dis. 2019;6(10):368.

Evans ME, Feola DJ, Rapp RP. Polymyxin B sulfate and colistin: old antibiotics for emerging multi-resistant Gram-negative bacteria. Ann Pharmacother. 1999;33:960-7.

Poirel L, Jayol A, Nordmann P. Polymyxins: antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes. Clin Microbiol Rev. 2017;30(2):557-96.

Gallardo-Godoy A, Muldoon C, Becker B, Elliott AG, Lash LH, Huang JX, et al. Activity and Predicted Nephrotoxicity of Synthetic Antibiotics Based on Polymyxin B. J Med Chem. 2016;59(3):1068-77.

Li Z, Cao Y, Yi L, Liu J-H, Yang Q. Emergent Polymyxin Resistance: End of an Era? Open Forum Infect Dis. 2019;6(10):368.

Levin AS, Barone AA, Penco J, Santos MV, Marinho IS, Manrique ES, et al. Intravenous colistin as therapy for nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Clin Infect Dis. 1999;28:1008-101.

Littlewood JM, Koch C, Lambert PA, Hoiby N, Elborn JS, Conway CS, et al. A tenyear review of colomycin. Respir Med. 2000;94:63-71.

Hogardt M, Schmoldt S, Gotzfried M, Adler K, Hessemann J. Pitfalls of polymyxin antimicrobial susceptibility testing of Pseudomonas aeruginosa isolated from cystic fibrosis patients. J Antimicrob Chemother. 2004;54:1057-61.

Performance standards for antimicrobial disk susceptibility tests. Available at: https://clsi.org/ standards/products/microbiology/documents/m100/. Accessed on 20 November 2023.

Performance Standards for antimicrobial susceptibility Testing. Available at: https://clsi.org/ standards/products/microbiology/documents/m100/. Accessed on 20 November 2023.

Magiorakos AP, Srinivasan A, Carey RB. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definition for aquired resistance. Clin Microbiol Infect. 2012;18(3):268-81.

Butaye P, Wang C. Colistin resistance, beyond the current knowledge. Bio Med. 2018;34:16-7.

Gogry FA, Siddiqui MT, Sultan I, Haq QMR. Current Update on Intrinsic and Acquired Colistin Resistance Mechanisms in Bacteria. Front Med. 2021;8:677.

National AMR Surveillance Net work. Available at: https://www.ncdc.gov.in/. Accessed on 20 November 2023.

Kirti N, Narendra PS, Krishna S, Nisha G, Seema G, Aditya ND. Colistin susceptibility testing by colistin broth disk elution MIC Method among carbapenem-resistant gram-negative blood culture clinical isolates in a tertiary care setting, East Delhi, India. Ethiop J Health Sci. 2023;33(5):743.

Chauha S, Kaur N, Saini AK, Chauhan J, Kumar H. Assessment of colistin resistance in Gram negative bacteria from clinical samples in resource-limited settings. Asian Pac J Trop Med. 2022;15(8):367-73.

Downloads

Published

2024-03-29

How to Cite

Sivadas, A., Sajeev, A., Kumar K. S., H., & Krishnan, S. (2024). Detection of colistin susceptibility in extended spectrum β lactamases positive Klebsiella pneumoniae and Escherichia coli clinical isolates by broth disc elution method. International Journal of Research in Medical Sciences, 12(4), 1203–1208. https://doi.org/10.18203/2320-6012.ijrms20240844

Issue

Section

Original Research Articles