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Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community

BACKGROUND & OBJECTIVES: Rampant use of β-lactam antibiotics in both community and hospitals has transformed the human healthy intestinal gut flora into a reservoir of antibiotic-resistant organisms. This study was conducted to find the faecal presence of antibiotic-resistant Enterobacteriaceae...

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Autores principales: Gupta, Madhu, Didwal, Gunjan, Bansal, Shruti, Kaushal, Kanica, Batra, Nitya, Gautam, Vikas, Ray, Pallab
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563735/
https://www.ncbi.nlm.nih.gov/pubmed/31219094
http://dx.doi.org/10.4103/ijmr.IJMR_207_18
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author Gupta, Madhu
Didwal, Gunjan
Bansal, Shruti
Kaushal, Kanica
Batra, Nitya
Gautam, Vikas
Ray, Pallab
author_facet Gupta, Madhu
Didwal, Gunjan
Bansal, Shruti
Kaushal, Kanica
Batra, Nitya
Gautam, Vikas
Ray, Pallab
author_sort Gupta, Madhu
collection PubMed
description BACKGROUND & OBJECTIVES: Rampant use of β-lactam antibiotics in both community and hospitals has transformed the human healthy intestinal gut flora into a reservoir of antibiotic-resistant organisms. This study was conducted to find the faecal presence of antibiotic-resistant Enterobacteriaceae in faecal samples in the community in north India. METHODS: In this prospective study, 207 stool samples were collected from apparently healthy individuals residing in a semiurban community in Chandigarh, India, from August to October, 2015. Isolates belonging to family Enterobacteriaceae were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and antibiotic susceptibility was determined using Clinical Laboratory Standard Institute disc diffusion method. Detection of extended spectrum β-lactamases (TEM, SHV, OXA-1, CTXM 1, CTXM 2, CTXM 9 and CTXM 8/25), carbapenemases (IMP, VIM and KPC) and New Delhi metallo-β-lactamase was done by multiplex PCR. RESULTS: Of the population studied, 55.5 per cent were females and 60 per cent were illiterate or had only primary education; 43.4 per cent individuals were aged <20 yr. Overall, 70.5 per cent of stool samples had antibiotic-resistant isolates. Maximum resistance was seen for cephalosporins (60.4%) followed by fluoroquinolones (41.5%). The multidrug-resistant (MDR) isolates were 2.4 per cent. The most commonly detected genes were TEM, SHV, OXA-1, CTXM-1, CTXM-2, CTXM-9 and CTXM-8/25 β-lactamases. Escherichia coli was the most common resistant isolate, and TEM was the most common gene detected. INTERPRETATION & CONCLUSIONS: Overall, 70.5 per cent members of Enterobacteriaceae had antibiotic resistance in the community and 2.4 per cent were MDR. Higher resistance rates were observed for most commonly used drugs such as cephalosporins and fluoroquinolones. High rate of antibiotic-resistant Enterobacteriaceae in gut of healthy individuals points towards the need for active screening and prevention of dissemination.
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spelling pubmed-65637352019-06-14 Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community Gupta, Madhu Didwal, Gunjan Bansal, Shruti Kaushal, Kanica Batra, Nitya Gautam, Vikas Ray, Pallab Indian J Med Res Original Article BACKGROUND & OBJECTIVES: Rampant use of β-lactam antibiotics in both community and hospitals has transformed the human healthy intestinal gut flora into a reservoir of antibiotic-resistant organisms. This study was conducted to find the faecal presence of antibiotic-resistant Enterobacteriaceae in faecal samples in the community in north India. METHODS: In this prospective study, 207 stool samples were collected from apparently healthy individuals residing in a semiurban community in Chandigarh, India, from August to October, 2015. Isolates belonging to family Enterobacteriaceae were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and antibiotic susceptibility was determined using Clinical Laboratory Standard Institute disc diffusion method. Detection of extended spectrum β-lactamases (TEM, SHV, OXA-1, CTXM 1, CTXM 2, CTXM 9 and CTXM 8/25), carbapenemases (IMP, VIM and KPC) and New Delhi metallo-β-lactamase was done by multiplex PCR. RESULTS: Of the population studied, 55.5 per cent were females and 60 per cent were illiterate or had only primary education; 43.4 per cent individuals were aged <20 yr. Overall, 70.5 per cent of stool samples had antibiotic-resistant isolates. Maximum resistance was seen for cephalosporins (60.4%) followed by fluoroquinolones (41.5%). The multidrug-resistant (MDR) isolates were 2.4 per cent. The most commonly detected genes were TEM, SHV, OXA-1, CTXM-1, CTXM-2, CTXM-9 and CTXM-8/25 β-lactamases. Escherichia coli was the most common resistant isolate, and TEM was the most common gene detected. INTERPRETATION & CONCLUSIONS: Overall, 70.5 per cent members of Enterobacteriaceae had antibiotic resistance in the community and 2.4 per cent were MDR. Higher resistance rates were observed for most commonly used drugs such as cephalosporins and fluoroquinolones. High rate of antibiotic-resistant Enterobacteriaceae in gut of healthy individuals points towards the need for active screening and prevention of dissemination. Wolters Kluwer - Medknow 2019-02 /pmc/articles/PMC6563735/ /pubmed/31219094 http://dx.doi.org/10.4103/ijmr.IJMR_207_18 Text en Copyright: © 2019 Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Gupta, Madhu
Didwal, Gunjan
Bansal, Shruti
Kaushal, Kanica
Batra, Nitya
Gautam, Vikas
Ray, Pallab
Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community
title Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community
title_full Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community
title_fullStr Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community
title_full_unstemmed Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community
title_short Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community
title_sort antibiotic-resistant enterobacteriaceae in healthy gut flora: a report from north indian semiurban community
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563735/
https://www.ncbi.nlm.nih.gov/pubmed/31219094
http://dx.doi.org/10.4103/ijmr.IJMR_207_18
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