Characterization of Antibiotic Resistance Profiles of Ocular Enterobacteriaceae Isolates

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Abstract

Emergence of extended-spectrum β-lactamase (ESBL) and fluoroquinolone resistance among ocular Enterobacteriaceae is increasing in higher frequency. Therefore, studies are being carried out to understand their multidrug resistance pattern. A total of 101 Enterobacteriaceae isolates recovered from various ocular diseases in a tertiary eye care center at Chennai, India during the period of January 2011 to June 2014 were studied. Forty one randomly chosen isolates were subjected to antibiotic susceptibility by minimum inhibitory concentration (MIC) and genotypic analysis. Of them, 16 were ESBL producers, one was carbapenemase producer and four were resistant to ertapenem which could be due to porin loss associated with AmpC production, and 17 were resistant to fluoroquinolones. Sixteen isolates harbored ESBL genes in which 14 had more than one gene and none of them were positive for blaNDM-1 gene. QNR genes were detected in 18 isolates.

ESBL producers were predominantly isolated from conjunctiva. A high degree of ESBL production and fluoroquinolone resistance is seen among the genus Klebsiella sp. Hence, monitoring the rate of ESBL prevalence plays a vital role in the administration of appropriate intravitreal antibiotics to save the vision and also to reduce the development of drug resistance in ocular pathogens.

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Most cited references 19

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Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates.

Vincent Cattoir, Laurent Poirel, Vincent O. Rotimi … (2007)

To develop a rapid and reliable single-tube-based PCR technique for detecting simultaneously the plasmid-mediated quinolone resistance qnrA, qnrB and qnrS genes. After multiple alignments, primers were designed to detect known qnr variants (six for qnrA-, six for qnrB- and two for qnrS-like genes). They were used for screening a collection of 64 expanded-spectrum beta-lactamase (ESBL)-producing enterobacterial isolates from Kuwait, collected from 2002 to 2004, as ESBL genes have been often associated with qnr genes. Sequencing was performed to identify qnr and associated ESBL genes. In optimized conditions, all positive controls (used separately or mixed) confirmed the specificity of the PCR primers. Out of 64 isolates, only 3 isolates were positive for a qnrB-like gene (4.7%), whereas no qnrA-like and qnrS-like gene was detected. A qnrB2 gene was detected in an Enterobacter cloacae K34 (SHV-12+) isolate, whereas qnrB1-like (termed qnrB7) and qnrB6-like (termed qnrB8) genes were identified from E. cloacae K37 (SHV-12+) and Citrobacter freundii K70 (VEB-1b+) isolates, respectively. We report here a fast and reliable technique for rapid screening of qnr-positive strains to be used for epidemiological surveys. A low prevalence of Qnr determinants among ESBL-producing Enterobacteriaceae was identified in the study with Kuwaiti isolates.

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Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe.

Francisco Cantón, F. Baquero, T Coque (2008)

Extended-spectrum beta-lactamases (ESBLs) have been increasingly reported in Europe since their first description in 1983. During the 1990s, they were described mainly as members of the TEM- and SHV-beta-lactamase families in Klebsiella pneumoniae causing nosocomial outbreaks. Nowadays, they are mostly found in Escherichia coli that cause community-acquired infections and with increasing frequency contain CTX-M enzymes. Dissemination of specific clones or clonal groups and epidemic plasmids in community and nosocomial settings has been the main reason for the increase in most of the widespread ESBLs belonging to the TEM (TEM-24, TEM-4, TEM-52), SHV (SHV-5, SHV-12) and CTX-M (CTX-M-9, CTX-M-3, CTX-M-14 or CTX-M-15) families in Europe. Co-selection with other resistances, especially to fluoroquinolones, aminoglycosides and sulfonamides, seems to have contributed to the problem. The emergence of epidemic clones harbouring several beta-lactamases simultaneously (ESBLs, metallo-beta-lactamases or cephamycinases) and of new mechanisms of resistance to fluoroquinolones and aminoglycosides warrants future surveillance studies.

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Emergence of plasmid-mediated resistance to quinolones in Enterobacteriaceae.

Laurent Poirel, Patrice Nordmann (2005)

Although quinolone resistance results mostly from chromosomal mutations in Enterobacteriaceae, it may also be mediated by plasmid-encoded Qnr determinants. Qnr proteins protect DNA from quinolone binding and compromise the efficacy of quinolones such as nalidixic acid. Qnr proteins (QnrA-like, QnrB and QnrS) have been identified worldwide with a quite high prevalence among Asian isolates with a frequent association with clavulanic acid inhibited expanded-spectrum beta-lactamases and plasmid-mediated cephalosporinases. The qnrA genes are embedded in complex sul1-type integrons. A very recent identification of the origin of QnrA determinants in the water-borne species Shewanella algae underlines the role of the environment as a reservoir for this emerging threat. It may help to determine the location of in vivo transfer of qnrA genes. Further analysis of the role (if any) of quinolones for enhancing this gene transfer may be conducted. This could prevent the spread, if still possible, of this novel antibiotic resistance mechanism.

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Author and article information

Journal

Journal ID (nlm-ta): Eur J Microbiol Immunol (Bp)

Journal ID (iso-abbrev): Eur J Microbiol Immunol (Bp)

Journal ID (publisher-id): EUJMI

Title: European Journal of Microbiology & Immunology

Publisher: Akadémiai Kiadó (Budapest )

ISSN (Print): 2062-509X

ISSN (Electronic): 2062-8633

Publication date (Electronic): 14 March 2016

Publication date Collection: March 2016

Volume: 6

Issue: 1

Pages: 40-48

Affiliations

[1 ]Orchid Chemicals and Pharmaceuticals Ltd., 476/14, OMR , Chennai, India

[2 ]Samrud Foundation for Health and Research , Bengaluru 560 001, India

[3 ]St. Martha’s Hospital, 5, Nrupatunga Road , Bengaluru 560 001, India

[4 ]L&T Microbiology Research Center, Kamal Nayan Bajaj Institute for Research in Vision and Ophthalmology Vision Research Foundation , Chennai, India

[5 ]Birla Institute of Technology and Science (BITS) , Pilani, Rajasthan, India

Author notes

* Department of Microbiology, L & T Microbiology Research Center, Sankara Nethralaya, New 41 (Old No. 18), College Road, Chennai 600 006, India. (off.) +91 44 28220709/(through board): +91 44 28271616; +91 44 28254180; drjm@ 123456snmail.org . Requests for reprints should be directed to Dr. J. Malathi.

** Current affiliation: Research Scientist, Aarupadai Veedu Medical College and Hospitals, Puducherry

Conflicts of interests

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Article

DOI: 10.1556/1886.2015.00047

PMC ID: 4838984

PubMed ID: 27141313

SO-VID: 095d5e0b-a2ff-4ad7-a183-1dc253313c27

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 13 November 2015

Date accepted : 15 December 2015

Page count

Figures: 5, Tables: 2, Equations: 0, References: 20, Pages: 9

Funding

Funding This study has received funding from Vision Research Foundation, Sankara Nethralaya, Chennai and Orchid Chemicals and Pharmaceuticals Ltd., Chennai.

The APC waiver has been extended to also apply to manuscripts submitted until March 31, 2024.

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Characterization of Antibiotic Resistance Profiles of Ocular Enterobacteriaceae Isolates

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Abstract

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European Journal of Microbiology and Immunology

Most cited references 19

Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates.

Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe.

Emergence of plasmid-mediated resistance to quinolones in Enterobacteriaceae.

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