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Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)

BACKGROUND & OBJECTIVES: Information about the genetic diversity of the extended-spectrum β-lactamases (ESBLs) and the clonal relationship of the organisms causing neonatal infections is limited, particularly from India where neonatal mortality is high. This study was undertaken to investigate t...

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Autores principales: Roy, Subhasree, Gaind, Rajni, Chellani, Harish, Mohanty, Srujana, Datta, Saswati, Singh, Arun K., Basu, Sulagna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724262/
https://www.ncbi.nlm.nih.gov/pubmed/23703349
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author Roy, Subhasree
Gaind, Rajni
Chellani, Harish
Mohanty, Srujana
Datta, Saswati
Singh, Arun K.
Basu, Sulagna
author_facet Roy, Subhasree
Gaind, Rajni
Chellani, Harish
Mohanty, Srujana
Datta, Saswati
Singh, Arun K.
Basu, Sulagna
author_sort Roy, Subhasree
collection PubMed
description BACKGROUND & OBJECTIVES: Information about the genetic diversity of the extended-spectrum β-lactamases (ESBLs) and the clonal relationship of the organisms causing neonatal infections is limited, particularly from India where neonatal mortality is high. This study was undertaken to investigate the molecular epidemiology and risk factors associated with neonatal septicaemia caused by ESBL-producing Klebsiella pneumoniae and Escherichia coli. METHODS: Bloodstream isolates (n=26) of K. pneumoniae (n=10) and E. coli (n=16) from the neonates admitted in a tertiary care hospital in New Delhi during January to May 2008 were characterized. Antimicrobial susceptibility tests were carried out and ESBL production was assessed phenotypically. PCR was carried out for ESBL and ampC genes. Genotyping was performed by pulsed-field gel electrophoresis (PFGE). Conjugation experiments were done to determine the mobility of ESBL genes. Risk factors associated with ESBL-producing K. pneumoniae and E. coli infections were analysed. RESULTS: Resistance rates to most of the antibiotics tested were high, except for imipenem. Among the isolates tested, 60 per cent of K. pneumoniae and 75 per cent of E. coli were ESBL producers. PFGE of the isolates demonstrated a vast diversity of genotypes with no epidemic clones. Despite the clonal diversity, bla(CTX-M-15) was detected in 100 per cent of ESBL-positive isolates. The other genes present in ESBL-positive isolates were bla(TEM-1,) bla(SHV-1), bla(SHV-28), bla(SHV-11), and bla(SHV-12). Class 1 integrons were detected in 7 of 18 ESBL-positive isolates. Moreover, the plasmid carrying bla(CTX-M-15), in E. coli and K. pneumoniae were self transferable. Feeding through an enteral tube was identified as the only risk factor for sepsis by ESBL-producing organisms. INTERPRETATION & CONCLUSIONS: The study emphasises the presence of bla(CTX-M-15) in clonally diverse isolates indicating probable horizontal transfer of this gene. The widespread dissemination of CTX-M-15 is of great concern as it further confines the limited therapeutic interventions available for neonates.
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spelling pubmed-37242622013-08-06 Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15) Roy, Subhasree Gaind, Rajni Chellani, Harish Mohanty, Srujana Datta, Saswati Singh, Arun K. Basu, Sulagna Indian J Med Res Original Article BACKGROUND & OBJECTIVES: Information about the genetic diversity of the extended-spectrum β-lactamases (ESBLs) and the clonal relationship of the organisms causing neonatal infections is limited, particularly from India where neonatal mortality is high. This study was undertaken to investigate the molecular epidemiology and risk factors associated with neonatal septicaemia caused by ESBL-producing Klebsiella pneumoniae and Escherichia coli. METHODS: Bloodstream isolates (n=26) of K. pneumoniae (n=10) and E. coli (n=16) from the neonates admitted in a tertiary care hospital in New Delhi during January to May 2008 were characterized. Antimicrobial susceptibility tests were carried out and ESBL production was assessed phenotypically. PCR was carried out for ESBL and ampC genes. Genotyping was performed by pulsed-field gel electrophoresis (PFGE). Conjugation experiments were done to determine the mobility of ESBL genes. Risk factors associated with ESBL-producing K. pneumoniae and E. coli infections were analysed. RESULTS: Resistance rates to most of the antibiotics tested were high, except for imipenem. Among the isolates tested, 60 per cent of K. pneumoniae and 75 per cent of E. coli were ESBL producers. PFGE of the isolates demonstrated a vast diversity of genotypes with no epidemic clones. Despite the clonal diversity, bla(CTX-M-15) was detected in 100 per cent of ESBL-positive isolates. The other genes present in ESBL-positive isolates were bla(TEM-1,) bla(SHV-1), bla(SHV-28), bla(SHV-11), and bla(SHV-12). Class 1 integrons were detected in 7 of 18 ESBL-positive isolates. Moreover, the plasmid carrying bla(CTX-M-15), in E. coli and K. pneumoniae were self transferable. Feeding through an enteral tube was identified as the only risk factor for sepsis by ESBL-producing organisms. INTERPRETATION & CONCLUSIONS: The study emphasises the presence of bla(CTX-M-15) in clonally diverse isolates indicating probable horizontal transfer of this gene. The widespread dissemination of CTX-M-15 is of great concern as it further confines the limited therapeutic interventions available for neonates. Medknow Publications & Media Pvt Ltd 2013-04 /pmc/articles/PMC3724262/ /pubmed/23703349 Text en Copyright: © The Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Roy, Subhasree
Gaind, Rajni
Chellani, Harish
Mohanty, Srujana
Datta, Saswati
Singh, Arun K.
Basu, Sulagna
Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)
title Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)
title_full Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)
title_fullStr Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)
title_full_unstemmed Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)
title_short Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring bla(CTX-M-15)
title_sort neonatal septicaemia caused by diverse clones of klebsiella pneumoniae & escherichia coli harbouring bla(ctx-m-15)
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724262/
https://www.ncbi.nlm.nih.gov/pubmed/23703349
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