Co-Carriage of bla (KPC-2) and bla (NDM-1) in Clinical Isolates of Pseudomonas aeruginosa Associated with Hospital Infections from India

Global spread of KPC poses to be a serious threat complicating treatment options in hospital settings. The present study investigates the genetic environment of bla (KPC-2) among clinical isolates of Pseudomonas aeruginosa from a tertiary referral hospital of India. The study isolates were collected from different wards and clinics of Silchar Medical College and Hospital, India, from 2012–2013. The presence of bla (KPC) was confirmed by genotypic characterization followed by sequencing. Cloning of the bla (KPC-2) gene was performed and the genetic environment of this gene was characterized as well. Transferability of the resistance gene was determined by transformation assay and Southern hybridization. Additionally, restriction mapping was also carried out. Two isolates of P. aeruginosa were found to harbor bla (KPC-2), were resistant towards aminoglycosides, quinolone and β-lactam-β-lactamase inhibitor combination. In both the isolates, the resistance determinant was associated with class 1 integron and horizontally transferable. Both the isolates were co-harboring bla (NDM-1). The first detection of this integron mediated bla (KPC-2) coexisting with bla (NDM-1) in P. aeruginosa from India is worrisome, and further investigation is required to track the gene cassette mediated bla (KPC-2) in terms of infection control and to prevent the spread of this gene in hospitals as well as in the community.