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CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(03): 206-211
DOI: 10.4103/JLP.JLP_22_19
Original Article

Phenotypic and genotypic characterization of multidrug-resistant isolates from patients with catheter-associated urinary tract infection in a tertiary care hospital

Jaison Jayakaran
Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
,
Nirupa Soundararajan
Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
,
Priyadarshini Shanmugam
Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India
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Abstract

INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country.

AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23.

MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23.

RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene.

CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.

Key words

Carbapenem resistance - catheter-associated urinary tract infection - hospital-acquired infection - multidrug-resistant bacteria - NDM-1 gene - OXA-23 gene - urinary catheter


Publication History

Received: 11 February 2019

Accepted: 31 May 2019

Article published online:
07 April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Jaggi N, Sissodia P. Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India. J Clin Diagn Res 2012;6:1372-6.
  • 2 Assadi F. Strategies for preventing catheterassociated urinary tract infections. Int J Prev Med 2018;9:50.
  • 3 Saranathan R, Vasanth V, Vasanth T, Shabareesh PR, Shashikala P, Devi CS, et al. Emergence of carbapenem nonsusceptible multidrug resistant Acinetobacter baumannii strains of clonal complexes 103(B) and 92(B) harboring OXA-type carbapenemases and metallo-β-lactamases in Southern India. Microbiol Immunol 2015;59:277-84.
  • 4 Parida S, Mishra SK. Urinary tract infections in the critical care unit: A brief review. Indian J Crit Care Med 2013;17:370-4.
  • 5 Khajuria A, Praharaj AK, Kumar M, Grover N. Emergence of NDM – 1 in the clinical isolates of Pseudomonas aeruginosa in India. J Clin Diagn Res 2013;7:1328-31.
  • 6 Khajuria A, Praharaj AK, Kumar M, Grover N, Aggarwal A. Multidrug resistant NDM1 metallobetalactamase producing Klebsiella pneumoniae sepsis outbreak in a neonatal intensive care unit in a tertiary care center at central India. Indian J Pathol Microbiol 2014;57:65-8.
  • 7 Bagchi I, Jaitly NK, Thombare VR. Microbiological evaluation of catheter associated urinary tract infection in a tertiary care hospital. People J Sci Res 2015;8:23-9.
  • 8 Kazi MM, Harshe A, Sale H, Mane D, Minal Y, Chabukswar S. Catheter associated urinary tract infections (CAUTI) and antibiotic sensitivity pattern from confirmed cases of CAUTI in a tertiary care hospital: A prospective study. Clin Microbiol 2015;4:193.
  • 9 Hanumantha S, Pilli HP. Catheter associated urinary tract infection (CAUTI)incidence and microbiological profile in a tertiary care hospital in Andhra Pradesh. Indian J Microbiol Res 2016;3:453-6.
  • 10 Vinoth M, Prabagaravarthanan R, Bhaskar M. Prevalence of microorganisms causing catheter associated urinary tract infections (CAUTI) among catheterized patients admitted in a tertiary care hospital. Int J Res Med Sci 2017;5:2367-72.
  • 11 Agarwal A, Srivastava J, Maheshwari U, Iftikhar M. Molecular characterization and antimicrobial susceptibility profile of New Delhi metallobetalactamase-1-producing Escherichia coli among hospitalized patients. J Lab Physicians 2018;10:149-54.
  • 12 Bora A, Ahmed GU, Hazarika NK, Prasad KN, Shukla SK, Randhawa V, et al. Incidence of bla NDM1 gene in Escherichia coli isolates at a tertiary care referral hospital in Northeast India. Indian J Med Microbiol 2013;31:250-6.
  • 13 Brennan BM, Coyle JR, Marchaim D, Pogue JM, Boehme M, Finks J, et al. Statewide surveillance of carbapenemresistant Enterobacteriaceae in Michigan. Infect Control Hosp Epidemiol 2014;35:3429.
  • 14 Rahman M, Mukhopadhyay C, Rai RP, Singh S, Gupta S, Singh A, et al. Novel variant NDM-11 and other NDM-1 variants in multidrug-resistant Escherichia coli from South India. Journal of global antimicrobial resistance 2018;14:154-7.
  • 15 Khurana S, Mathur P, Kapil A, Valsan C, Behera B. Molecular epidemiology of betalactamase producing nosocomial gram-negative pathogens from North and South Indian hospitals. J Med Microbiol 2017;66:999-1004.