RESUMEN
Introduction Antimicrobial resistance (AMR) has become a menace, spreading among bacterial species globally. AMR is now recognized as a silent pandemic responsible for treatment failures. Therefore, an effective surveillance mechanism is warranted to understand the bacterial species isolated from human clinical specimens. The present study employed next-generation sequencing (NGS) or whole-genome sequencing (WGS) to identify the resistance and virulence genes, sequence type, and serotypes. Methods This study included 18 multidrug-resistant (MDR) Klebsiella pneumoniae (K. pneumoniae) isolates obtained from patients suffering from different infections attending the Prathima Institute of Medical Sciences, Karimnagar, India. All isolates were identified, and antimicrobial susceptibility profiles were determined through conventional microbiological techniques and confirmed by automated systems. All the isolates were investigated using NGS or WGS to identify the genes coding for resistance, such as extended-spectrum beta-lactamases (ESBLs), metallo-beta-lactamases, and virulence genes. Multilocus sequence typing (MLST) was conducted to identify the sequence types, and Kleborate analysis was performed to confirm the species, genes for AMR, and virulence and evaluate the capsular polysaccharide (KL) and cell wall/lipopolysaccharide (O) serotypes carried by the isolates. Results The mean age of the patients was 46.11±20.35 years. Among the patients included, 12 (66.66%) were males and 6 (33.33%) were females. A high percentage (>50%) of hypervirulent K. pneumoniae (hvKp) strains that had genes coding for AMR and plasmids having the potential to carry blaNDM and resistance genes were observed. Among the isolates, 16 (88.88%) revealed the presence of multiple antibiotic-resistant genes with evidence of at least one gene coding for beta-lactamase resistance. There was a high prevalence of blaSHV (17/18; 94.44%) and blaCTX-M-15 (16/18; 88.88%) AMR genes. Other AMR genes identified included blaTEM (83.33%; 15/18) and blaOXA (14/18; 77.77%). Two (11.11%) strains each showed the presence of blaNDM-1 and blaNDM-5 genes. The virulence genes identified included gapA, infB, mdh, pgi, phoE, rpoB, tonB, and ybt. The most frequent K. pneumoniae serotypes found were KL51:O1v2 (3/18, 16.66%), KL17:O1v1 (3/18, 16.66%), and KL64:O2v1 (3/18, 16.66%). KL64 (4/18; 22.22%) was the most common capsular serotype identified among the isolates. The most frequent MLST-based sequence type (ST) identified included ST-147 (5/18, 27.77%), followed by ST-231 (3/18, 16.66%) and ST-101 (2/18, 11.11%). Conclusions The molecular analysis of K. pneumoniae isolates revealed multiple AMR, plasmid, and virulence genes. Additionally, many global STs were noticed by MLST. The results noted a high prevalence of hvKp strains. Molecular characterization of bacterial strains using NGS/WGS is important to understand the epidemiology of bacterial strains and the antibiotic resistance and virulence genes they are potentially carrying. The data obtained from this study may be utilized to devise careful antibiotic-prescribing approaches and improve patient management practices.
RESUMEN
Many parasitic infections essentially pose a significant public health problem throughout the world. However, the consequence of the issue is felt more among developing countries like India. This is majorly due to unsatisfactory hygienic practices and overcrowding, among others. Moreover, taeniasis caused by the parasites Taenia solium and Taenia saginata is a zoonotic infection transmitted via pigs and cattle, respectively. Even though the animals are the primary hosts where the parasite lives, humans also can suffer from infestation after consuming the eggs in contaminated food and water. Interestingly, there is a lower level of awareness regarding such types of Taenia infections in humans. On the contrary, most physicians and some people know that parasite transmission generally happens from the consumption of raw/undercooked pork and beef, which may result in a more serious consequence like neurocysticercosis. However, Taenia infestation in the intestines equally affects humans where people become reservoirs of infection, and suffer from severe morbidity. We present a case of worm infestation in a teenage girl who presented with severe peri-anal itching and motile worms in the stools.
RESUMEN
Background Staphylococci are Gram-positive cocci arranged in clusters. They are colonized in humans and animals. Also, Staphylococcus aureus (S. aureus) is frequently associated with various superficial to deep-seated infections in humans. Due to the potential for easy transmission, Staphylococci are associated with both hospital-acquired and community-associated infections. Strains of S. aureus resistant to methicillin (MRSA) pose treatment challenges. In such cases, vancomycin is the treatment of choice. Due to the indiscriminate use of vancomycin, recently, we are seeing the emergence of vancomycin-intermediate sensitive S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA). The present study aims to evaluate the minimum inhibitory concentrations (MICs) of vancomycin and daptomycin among MRSA strains isolated from human clinical specimens Methods The study included 115 MRSA isolates collected over 26 months from July 2010 to September 2012. The strains were isolated from pus, urine, wound swabs, catheters, blood, and sputum. The bacteria were acquired from different inpatient and outpatient departments of Prathima Institute of Medical Sciences, Karimnagar, Telangana, India. Kirby-Bauer disk diffusion method using cefoxitin was used to confirm the MRSA isolates. The agar dilution and the Epsilometer method (E-test) were used to test the MICs of MRSA isolates against vancomycin and daptomycin, respectively, by the standard procedures recommended by the clinical laboratory standards institute (CLSI). Results Of the 115 S. aureus isolates, seven (6.08%) strains were resistant to vancomycin (VRSA) and 53 (46.08%) were found to be VISA using the new CLSI breakpoints. The MIC of the daptomycin was found to be ≤1 µg/ml for all the MRSA isolates. Conclusion The study results depicted an increasing trend in the vancomycin MICs among the MRSA isolates. Several tested strains show MICs in the intermediate sensitive range (VISA). The daptomycin was effective against all the MRSA isolates.