1887

Abstract

Extended-spectrum -lactamases (ESBLs) are bacterial enzymes that confer resistance to advanced generation cephalosporins and can lead to therapeutic failures. There has been no analysis of factors associated with the risk of acquisition of ESBLs in neonates in an intensive care unit from northern India. The CTX-M ESBL enzymes impart resistance against advanced generation cephalosporins (e.g. cefotaxime) and CTX-M variants have become the most prevalent ESBLs worldwide. The CTX-M-15 enzyme in particular is increasingly being reported from isolates from northern India together with TEM-1. Moreover, is the most common cause of neonatal sepsis. Accordingly, this study aimed to: (i) characterize the mode of transmission of and among ESBL-producing strains isolated from patients admitted to a neonatal intensive care unit (NICU), and (ii) identify factors associated with the acquisition of the said strains in male and female neonates. A total of 97 ESBL-producers was identified among 266 strains isolated from 238 neonates. The isolates were screened for , , , and , the last three genes being responsible for aminoglycoside resistance. PCR amplified genes were cloned and sequenced. Five , two , two and thirteen class1 integrons were detected. All the positive isolates, except one, were clonally related. Both univariate and multivariate analyses of factors for the acquisition of the said strains were performed with respect to the sex of the neonates. ‘Length of stay in the NICU’ was found to be the single independent factor associated with ESBL acquisition. In conclusion, our data suggest that male neonates who are colonized or infected by ESBL-producing have a longer stay in the NICU compared to their female counterparts. This prolonged stay may be due to male neonates becoming colonized/infected earlier than their female counterparts. Plasmid-mediated-conjugal transfer was found to be the mechanism of transfer of the resistance marker in the described setting.

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2010-08-01
2019-10-16
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