RESUMO
PURPOSE: Faecal carriage of carbapenemase-producing Enterobacterales (CPE) has been extensively investigated in hospitalized patients, but limited data is available on the carriage rate in healthy individuals in India. METHODS: A total of 1000 stool samples were screened for CPE from healthy individuals in Chennai (n â= â50), Hyderabad (n â= â184) and Mumbai (n â= â766). Diluted stool samples were cultured on chromID CARBA SMART plates. Growing colonies were screened for CPE by RAPIDEC® CARBA NP Test and minimum inhibitory concentration (MIC) of imipenem by E-Test. PCR was performed for confirmation of CPE genes. RESULTS: Out of the 1000 stool samples tested, 6.1% were positive for CPE. A total of 64 carbapenem resistant isolates (56 âE.coli, 4 Klebsiella pneumoniae, 3 Enterobacter cloacae and 1 Citrobacter freundii) were recovered from ChromID CARBA SMART biplate. Carbapenemase production was identified in 57/64 isolates by RAPIDEC® CARBA NP test. PCR analysis showed 28 blaNDM-1 and 33 blaOXA48. Three remaining isolates (2 âE.coli, 1 âK.pneumoniae) were negative for the tested carbapenemase genes. Interestingly, out of these 61 PCR positive isolates, 49.1% displayed imipenem MIC within the susceptibility range on the basis of CLSI interpretative criteria. CONCLUSIONS: Faecal carriage of CPE among healthy individuals was 6.1%. Comprehensive measures to improve the sanitation scenario and implementation of National AMR action plan are needed to prevent further generation and dissemination of carbapenem resistant Enterobacterales (CRE).
Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Enterobacteriaceae , Proteínas de Bactérias/análise , Proteínas de Bactérias/genética , Enterobacteriáceas Resistentes a Carbapenêmicos/genética , Carbapenêmicos/farmacologia , Enterobacteriaceae/genética , Infecções por Enterobacteriaceae/epidemiologia , Escherichia coli , Humanos , Imipenem/farmacologia , Índia/epidemiologia , Klebsiella pneumoniae , Testes de Sensibilidade Microbiana , Prevalência , beta-Lactamases/análise , beta-Lactamases/genéticaRESUMO
Coccidioidomycosis is a deep mycosis caused by the fungus Coccidioides immitis. Disseminated disease can affect any part of the body. Coccidioidal synovitis is a rare manifestation of musculoskeletal coccidioidomycosis requiring aggressive treatment. We report a case of a 68 year old man who presented to our centre in Chennai with pain and restriction of movement of the elbow of 4 months duration. After being investigated, he was subjected to a synovectomy following which he was diagnosed to have coccidioidal synovitis of the elbow joint by histology and culture. He was treated with itraconazole. He was doing well on the most recent follow up. The case is presented for its rarity in India.
Assuntos
Coccidioides/isolamento & purificação , Coccidioidomicose/diagnóstico , Articulação do Cotovelo , Sinovite/diagnóstico , Idoso , Antifúngicos/uso terapêutico , Coccidioidomicose/tratamento farmacológico , Coccidioidomicose/microbiologia , Humanos , Índia , Itraconazol/uso terapêutico , Masculino , Resultado do TratamentoRESUMO
OBJECTIVES: Numerous previous publications on the detection of bacterial isolates harbouring the mcr-1 gene from animals and humans strongly suggest an underlying route of transmission of colistin resistance via the food chain. The aim of this study was to investigate the presence of colistin-resistant (Col-R) bacteria in Indian food samples and to identify the underlying mechanisms conferring colistin resistance. METHODS: Raw food material, including poultry meat, mutton meat, fish, fruit and vegetables, collected from food outlets in Chennai, India, were processed to identify Col-R bacteria using eosin methylene blue agar supplemented with colistin. Colistin minimum inhibitory concentrations (MICs) were determined by the broth microdilution method. PCR for the mcr-1 and mcr-3 genes was performed on Col-R Escherichia coli and Klebsiella pneumoniae isolates. Mutations in the mgrB gene were analysed in K. pneumoniae isolates. One representative mcr-1-positive E. coli was subjected to whole-genome sequencing. RESULTS: Of 110 food samples tested, 51 (46.4%) were positive for non-intrinsic Col-R Gram-negative bacteria. Three E. coli isolates were found to harbour mcr-1, whereas none were positive for mcr-3. Ten K. pneumoniae isolates had alterations in mgrB, with mutations in four and insertional inactivation in six. CONCLUSION: The presence of Col-R bacteria and the mcr-1 gene in raw food samples further complicates the antimicrobial resistance scenario in India. To the best of our knowledge, this is the first report in the global literature on mgrB mutation and its insertional inactivation conferring Col-R in K. pneumoniae from food samples.
Assuntos
Farmacorresistência Bacteriana/genética , Escherichia coli/genética , Microbiologia de Alimentos , Klebsiella pneumoniae/genética , Alimentos Crus/microbiologia , Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Cromossomos Bacterianos/genética , Colistina/farmacologia , Escherichia coli/efeitos dos fármacos , Proteínas de Escherichia coli/genética , Índia , Klebsiella pneumoniae/efeitos dos fármacos , Proteínas de Membrana/genética , Testes de Sensibilidade Microbiana , Mutação , Plasmídeos/genéticaRESUMO
It is known that nalidixic acid resistance is a relatively rare phenomenon among shigellae. Between June 1989 and May 1990, six strains of shigellae resistant to nalidixic acid were isolated. These strains also exhibited resistance to three newer fluoroquinolones, viz., ciprofloxacin, pefloxacin and enoxacin. In repeated experiments, nalidixic acid resistance did not transfer to a suitable recipient.