1887

Abstract

Antibiotic resistance patterns often exhibit geographical variations. Periodic analyses of resistance spectra and phylogenetic trends are important guides for facilitating judicious use of therapeutic interventions. The present study retrospectively analysed the infection trends, resistance patterns, and clonal relationships between isolates of spp. from a tertiary care hospital.

Bacterial isolates were collected from January 2013 to June 2014 and their resistance profiles were identified using an automated bacterial identification system. A phylogenetic tree was constructed using housekeeping genes with Molecular Evolutionary Genetic Analysis software. The / ratio was determined by the Synonymous Non-synonymous Analysis Program while polymorphic sites, and the difference per site was calculated using DNA Sequence Polymorphism software. Statistical Package for Social Science software was used to perform all statistical analyses.

The results of this study indicated the prevalence of community-acquired urinary tract and lower respiratory tract infections caused by spp. among geriatric patients. The occurrence of new allelic profiles, a low / ratio and the lack of strong evolutionary descent between isolates indicated that mutations play a major role in the evolution of the organism.

The findings of this study highlight the consequences of antimicrobial agents exerting a silent and strong selective force on the evolution of spp. The expansion of such analyses is of great importance for addressing rapidly emerging antibiotic-resistant opportunistic pathogens.

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2018-05-01
2024-12-09
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References

  1. Michael CA, Dominey-Howes D, Labbate M. The antimicrobial resistance crisis: causes, consequences, and management. Front Public Health 2014; 2:145 [View Article][PubMed]
    [Google Scholar]
  2. Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T 2015; 40:277[PubMed]
    [Google Scholar]
  3. Holt KE, Wertheim H, Zadoks RN, Baker S, Whitehouse CA et al. Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health. Proc Natl Acad Sci USA 2015; 112:E3574E3581 [View Article][PubMed]
    [Google Scholar]
  4. Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 1998; 11:589–603[PubMed]
    [Google Scholar]
  5. Durdu B, Hakyemez IN, Bolukcu S, Okay G, Gultepe B et al. Mortality markers in nosocomial Klebsiella pneumoniae bloodstream infection. Springerplus 2016; 5:1892 [View Article][PubMed]
    [Google Scholar]
  6. Capone A, Giannella M, Fortini D, Giordano A, Meledandri M et al. High rate of colistin resistance among patients with carbapenem-resistant Klebsiella pneumoniae infection accounts for an excess of mortality. Clin Microbiol Infect 2013; 19:E23E30 [View Article][PubMed]
    [Google Scholar]
  7. Siu LK, Yeh KM, Lin JC, Fung CP, Chang FY. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis 2012; 12:881–887 [View Article][PubMed]
    [Google Scholar]
  8. Cho KT, Park BJ. Gas-forming brain abscess caused by Klebsiella pneumoniae . J Korean Neurosurg Soc 2008; 44:382–384 [View Article][PubMed]
    [Google Scholar]
  9. Lee SS, Chen YS, Tsai HC, Wann SR, Lin HH et al. Predictors of septic metastatic infection and mortality among patients with Klebsiella pneumoniae liver abscess. Clin Infect Dis 2008; 47:642–650 [View Article][PubMed]
    [Google Scholar]
  10. Seale M, Lee WK, Daffy J, Tan Y, Trost N. Fulminant endogenous Klebsiella pneumoniae endophthalmitis: imaging findings. Emerg Radiol 2007; 13:209–212 [View Article][PubMed]
    [Google Scholar]
  11. Bouza E, Cercenado E. Klebsiella and enterobacter: antibiotic resistance and treatment implications. Semin Respir Infect 2002; 17:215–230 [View Article][PubMed]
    [Google Scholar]
  12. Malloy AM, Campos JM. Extended-spectrum beta-lactamases: a brief clinical update. Pediatr Infect Dis J 2011; 30:1092–1093 [View Article][PubMed]
    [Google Scholar]
  13. Slama TG. Gram-negative antibiotic resistance: there is a price to pay. Crit Care 2008; 12:S4 [View Article][PubMed]
    [Google Scholar]
  14. Neidell MJ, Cohen B, Furuya Y, Hill J, Jeon CY et al. Costs of healthcare- and community-associated infections with antimicrobial-resistant versus antimicrobial-susceptible organisms. Clin Infect Dis 2012; 55:807–815 [View Article][PubMed]
    [Google Scholar]
  15. Masterton R. The importance and future of antimicrobial surveillance studies. Clin Infect Dis 2008; 47:S21–S31 [View Article][PubMed]
    [Google Scholar]
  16. Cardoso T, Almeida M, Friedman ND, Aragão I, Costa-Pereira A et al. Classification of healthcare-associated infection: a systematic review 10 years after the first proposal. BMC Med 2014; 12:40 [View Article][PubMed]
    [Google Scholar]
  17. Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S. Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol 2005; 43:4178–4182 [View Article][PubMed]
    [Google Scholar]
  18. Librado P, Rozas J. DnaSP v5: a software for comprehensive analysis of DNA polymorphism data. Bioinformatics 2009; 25:1451–1452 [View Article][PubMed]
    [Google Scholar]
  19. Vijay S, Dalela G. Prevalence of LRTI in patients presenting with productive cough and their antibiotic resistance pattern. J Clin Diagn Res 2016; 10:DC09 [View Article][PubMed]
    [Google Scholar]
  20. Ahmed SM, Jakribettu RP, Meletath SK, B A, Vpa S. Lower respiratory tract infections (LTRIs): an insight into the prevalence and the antibiogram of the gram negative, respiratory, bacterial agents. J Clin Diagn Res 2013; 7:253 [View Article][PubMed]
    [Google Scholar]
  21. Jean SS, Coombs G, Ling T, Balaji V, Rodrigues C et al. Epidemiology and antimicrobial susceptibility profiles of pathogens causing urinary tract infections in the Asia-Pacific region: results from the study for monitoring antimicrobial resistance trends (SMART), 2010–2013. Int J Antimicrob Agents 2016; 47:328–334 [View Article][PubMed]
    [Google Scholar]
  22. Sharma N, Gupta AK, Walia G, Bakhshi R. A retrospective study of the changing trends of antimicrobial resistance of Klebsiella pneumoniae isolated from urine samples over last 3 years (2012– 2014). J Nat Sci Biol Med 2016; 7:39 [View Article][PubMed]
    [Google Scholar]
  23. Singh NP, Rani M, Gupta K, Sagar T, Kaur IR. Changing trends in antimicrobial susceptibility pattern of bacterial isolates in a burn unit. Burns 2017; 43:1083–1087 [View Article][PubMed]
    [Google Scholar]
  24. Trojan R, Razdan L, Singh N. Antibiotic susceptibility patterns of bacterial isolates from Pus samples in a Tertiary Care Hospital of Punjab, India. Int J Microbiol 2016; 2016:1–4 [View Article]
    [Google Scholar]
  25. Mauldin PD, Salgado CD, Hansen IS, Durup DT, Bosso JA. Attributable hospital cost and length of stay associated with health care-associated infections caused by antibiotic-resistant gram-negative bacteria. Antimicrob Agents Chemother 2010; 54:109–115 [View Article][PubMed]
    [Google Scholar]
  26. Ben-David D, Kordevani R, Keller N, Tal I, Marzel A et al. Outcome of carbapenem resistant Klebsiella pneumoniae bloodstream infections. Clin Microbiol Infect 2012; 18:54–60 [View Article][PubMed]
    [Google Scholar]
  27. Tsay RW, Siu LK, Fung CP, Chang FY. Characteristics of bacteremia between community-acquired and nosocomial Klebsiella pneumoniae infection: risk factor for mortality and the impact of capsular serotypes as a herald for community-acquired infection. Arch Intern Med 2002; 162:1021–1027[PubMed] [Crossref]
    [Google Scholar]
  28. Alicino C, Giacobbe DR, Orsi A, Tassinari F, Trucchi C et al. Trends in the annual incidence of carbapenem-resistant Klebsiella pneumoniae bloodstream infections: a 8-year retrospective study in a large teaching hospital in northern Italy. BMC Infect Dis 2015; 15:415 [View Article][PubMed]
    [Google Scholar]
  29. Priyanka R, Jose P. A study on the bacteriological profile of urinary tract infection in adults and their antibiotic sensitivity pattern in a tertiary care hospital in central Kerala, India. Int J Res Med Sci 2017; 5:666–669 [Crossref]
    [Google Scholar]
  30. Chakraborty S. Prevalence, antibiotic susceptibility profiles and ESBL production in Klebsiella pneumoniae and Klebsiella oxytoca among hospitalized patients. Period Biol 2016; 118:53–58 [View Article]
    [Google Scholar]
  31. Akter J, Azad Chowd AMM, Forkan MA. Study on prevalence and antibiotic resistance pattern of Klebsiella isolated from clinical samples in South East region of Bangladesh. Am J Drug Disc Dev 2014; 4:73–79 [View Article]
    [Google Scholar]
  32. Singh AK, Jain S, Kumar D, Singh RP, Bhatt H. Antimicrobial susceptibility pattern of extended-spectrum beta-lactamase producing Klebsiella pneumoniae clinical isolates in an Indian tertiary hospital. J Res Pharm Pract 2015; 4:153 [View Article][PubMed]
    [Google Scholar]
  33. Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control 2014; 3:23 [View Article][PubMed]
    [Google Scholar]
  34. Tripathi A, Dutta SK, Majumdar M, Dhara L, Banerjee D et al. High prevalence and significant association of ESBL and QNR genes in pathogenic Klebsiella pneumoniae Isolates of Patients from Kolkata, India. Indian J Microbiol 2012; 52:557–564 [View Article][PubMed]
    [Google Scholar]
  35. Mohamudha Parveen R, Manivannan S, Harish BN, Parija SC. Study of CTX-M type of extended spectrum β-lactamase among nosocomial isolates of Escherichia coli and Klebsiella pneumoniae in South India. Indian J Microbiol 2012; 52:35–40 [View Article][PubMed]
    [Google Scholar]
  36. Hemalatha V, Padma M, Sekar U, Vinodh TM, Arunkumar AS. Detection of AmpC beta lactamases production in Escherichia coli and Klebsiella by an inhibitor based method. Indian J Med Res 2007; 126:220[PubMed]
    [Google Scholar]
  37. Tsakris A, Poulou A, Themeli-Digalaki K, Voulgari E, Pittaras T et al. Use of boronic acid disk tests to detect extended-spectrum β-lactamases in clinical isolates of KPC carbapenemase-possessing Enterobacteriaceae . J Clin Microbiol 2009; 47:3420–3426 [View Article][PubMed]
    [Google Scholar]
  38. Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D et al. Bad bugs, no drugs: no ESKAPE! an update from the Infectious Diseases Society of America. Clin Infect Dis 2009; 48:1–12 [View Article][PubMed]
    [Google Scholar]
  39. El-Mahallawy HA, Hassan SS, El-Wakil M, Moneer MM. Bacteremia due to ESKAPE pathogens: an emerging problem in cancer patients. J Egypt Natl Canc Inst 2016; 28:157–162 [View Article][PubMed]
    [Google Scholar]
  40. Hennequin C, Robin F. Correlation between antimicrobial resistance and virulence in Klebsiella pneumoniae . Eur J Clin Microbiol Infect Dis 2016; 35:333–341 [View Article][PubMed]
    [Google Scholar]
  41. Nielsen JB, Skov MN, Jørgensen RL, Heltberg O, Hansen DS et al. Identification of CTX-M15-, SHV-28-producing Klebsiella pneumoniae ST15 as an epidemic clone in the Copenhagen area using a semi-automated Rep-PCR typing assay. Eur J Clin Microbiol Infect Dis 2011; 30:773–778 [View Article][PubMed]
    [Google Scholar]
  42. Ewers C, Stamm I, Pfeifer Y, Wieler LH, Kopp PA et al. Clonal spread of highly successful ST15-CTX-M-15 Klebsiella pneumoniae in companion animals and horses. J Antimicrob Chemother 2014; 69:2676–2680 [View Article][PubMed]
    [Google Scholar]
  43. Francisco AP, Bugalho M, Ramirez M, Carriço JA. Global optimal eBURST analysis of multilocus typing data using a graphic matroid approach. BMC Bioinformatics 2009; 10:152 [View Article][PubMed]
    [Google Scholar]
  44. Breurec S, Guessennd N, Timinouni M, Le TA, Cao V et al. Klebsiella pneumoniae resistant to third-generation cephalosporins in five African and two Vietnamese major towns: multiclonal population structure with two major international clonal groups, CG15 and CG258. Clin Microbiol Infect 2013; 19:349–355 [View Article][PubMed]
    [Google Scholar]
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