Occurrence of extended-spectrum β-lactamase, AmpC, and carbapenemase-producing genes in gram-negative bacterial isolates from human immunodeficiency virus infected patients

Rameshkumar MR 1 , Arunagirinathan N 2 , Senthamilselvan B 1 , Swathirajan CR 3 , Solomon SS 4 , Vignesh R 5 Show all authors , Balakrishnan P 3 , Aljowaie RM 6 , Almaary KS 6 , Chen TW 7

Affiliations 

  • 1 Department of Microbiology and Biotechnology, Presidency College (Autonomous), Affiliated to University of Madras, Chennai, Tamil Nadu, India
  • 2 Department of Microbiology and Biotechnology, Presidency College (Autonomous), Affiliated to University of Madras, Chennai, Tamil Nadu, India; Central Research Laboratory, Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, India. Electronic address: n_arunagiri@yahoo.co.in
  • 3 Infectious Diseases Laboratory, Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India
  • 4 HIV Clinic, Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
  • 5 Infectious Diseases Laboratory, Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, India; Preclinical Department, Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak (RCMP UniKL), Ipoh, Malaysia
  • 6 Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh, Saudi Arabia
  • 7 Department of Materials, Imperial College London, London, SW7 2AZ, United Kingdom
J Infect Public Health, 2021 Nov 10.
PMID: 34810142 DOI: 10.1016/j.jiph.2021.11.008

Abstract

BACKGROUND: Progressive decline of immune response in HIV patients makes them susceptible to frequent bacterial infections. High usage of antibiotics influences the emergence of multidrug-resistant bacteria and worsens the clinical outcomes. In this study, the occurrence of drug-resistant genes in Gram-negative bacterial isolates from HIV patients in South India was analyzed.

METHODS: A total of 173 Gram-negative bacterial (GNB) isolates from HIV patients were screened for antibiotic susceptibility profile using the Kirby-Bauer diskdiffusion method. Positivity of drug-resistant genes was analyzed using polymerase chain reaction method.

RESULTS: In this study, 72.8% of bacterial isolates were obtained from urine specimens, and Escherichia coli (47.4%) was the predominantly isolated bacterium. Overall, 87.3% and 83.2% of GNB were resistant to 3rd generation cephalosporin antibiotics such as cefotaxime and ceftazidime, respectively, 56.6% were resistant to cephamycin (cefoxitin) and 43% to carbapenem (imipenem) antibiotics. Extended-spectrum β-lactamases (ESBL) production was noted among 79.5% of GNB isolates, followed by AmpC (57.1%) and Metallo β-lactamases (37.3%). Molecular analysis revealed that ESBL genes such as blaTEM (94.1%), blaCTX-M (89.2%), and blaSHV (24.2%) were detected at higher levels among GNB isolates. Carbapenemase-producing genes such as blaOXA-48 (20%), blaOXA-23 (2.6%), and both blaOXA-23 and blaOXA-51 like genes (2.6%) and AmpC producing genes such as blaCIT (26.7%), blaDHA (3.6%), and blaACC (1.8%) were detected at low-level.

CONCLUSIONS: This study concludes that ESBL producing genes are detected at high level among gram-negative bacterial isolates from HIV patients in South India.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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