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LETTER TO EDITOR
J Res Med Sci 2018,  23:112

Detection of blaNDM-1 and blaNDM-5 genes among Gram-negative bacteria isolated from human immunodeficiency virus patients in South India


1 Department of Microbiology and Biotechnology, Presidency College (Autonomous); Infectious Diseases Laboratory, YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, Tamil Nadu, India
2 Department of Microbiology and Biotechnology, Presidency College (Autonomous); Central Research Laboratory, Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
3 Department of Microbiology and Biotechnology, Presidency College (Autonomous), Chennai, Tamil Nadu, India
4 Infectious Diseases Laboratory, YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, Tamil Nadu, India
5 Infectious Diseases Laboratory, YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, Tamil Nadu, India; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
6 Infectious Diseases Laboratory, YR Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital Campus, Chennai, Tamil Nadu, India; Preclinical Department, Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak (UNIKL RCMP), Ipoh, Malaysia

Date of Web Publication28-Dec-2018

Correspondence Address:
Narasingam Arunagirinathan
Department of Microbiology and Biotechnology, Presidency College (Autonomous), Chennai - 600 005, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrms.JRMS_627_18

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How to cite this article:
Rameshkumar MR, Arunagirinathan N, Indu P, Swathirajan CR, Solomon SS, Vignesh R, Balakrishnan P. Detection of blaNDM-1 and blaNDM-5 genes among Gram-negative bacteria isolated from human immunodeficiency virus patients in South India. J Res Med Sci 2018;23:112

How to cite this URL:
Rameshkumar MR, Arunagirinathan N, Indu P, Swathirajan CR, Solomon SS, Vignesh R, Balakrishnan P. Detection of blaNDM-1 and blaNDM-5 genes among Gram-negative bacteria isolated from human immunodeficiency virus patients in South India. J Res Med Sci [serial online] 2018 [cited 2019 Jan 22];23:112. Available from: http://www.jmsjournal.net/text.asp?2018/23/1/112/248995



Sir,

New Delhi metallo-β-lactamase (MBL)-1 (NDM-1) gene was first detected in extensively drug-resistant (XDR) Klebsiella pneumoniae from a Swedish patient of Indian origin.[1] Thereafter, NDM-1 emerged as a leading threat to the treatment of infections caused by Enterobacteriaceae. In this study, we aimed to study the positivity of blaNDM-1 among Gram-negative bacteria (GNB) isolated from human immunodeficiency virus (HIV) patients attending YR Gaitonde Centre, Chennai, India. Antibiotic susceptibility of bacterial isolates was tested using Kirby–Bauer disc diffusion method.[2] Bacterial DNA extracted by boiling lysis method was used as template in polymerase chain reaction to detect the drug-resistant genes such as blaNDM-1,blaNDM-5,[3] extended-spectrum β-lactamases, Class 1 integron, Class 2 integron, sulfamethoxazole (sul), and trimethoprim (dfr). In the present study, 45.1% (78/173) of GNB isolated from HIV patients showed resistance to imipenem (IPM) which was highly noted among  Escherichia More Details coli (73.1%; n = 57). In the E-test, 66.7% of IPM-resistant isolates were positive to MBL production. Among MBL producers, 17.3% (n = 9; P < 0.001) showed positive for blaNDM-1 gene, and among blaNDM-1 isolates, 77.7% showed XDR profile and 22.2% multidrug-resistant (MDR) profile. Phylogenetic analysis using Molecular Evolutionary Genetics Analysis Version 7.0 (The Pennsylvania State University, University Park, Pennsylvania, United States) revealed that 8 blaNDM-1 (KU695556) gene sequences had fallen into blaNDM-1 clad. One blaNDM-1 fell into blaNDM-5 (KU695557) clad due to two amino acid substitutions such as valine instead of leucine (Leu) in the 88th position and methionine instead of Leu in the 154th position. blaNDM positive isolates also exhibited co-positivity to other drug-resistant genes [Table 1].
Table 1: Positivity of blaNDM-1 and blaNDM-5 along with other drug-resistant genes among Gram-negative bacteria isolated from HIV patients

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Vignesh et al. in 2008 reported that IPM is the drug of choice against MDR bacteria and also that only 28% of GNB from HIV patients were resistant to IPM.[4] We found that 45% of GNB were resistant to IPM which indicates that IPM resistance rate has been increasing among HIV population. Another study demonstrated clonal similarity between blaNDM-1 strains and difference in antibiotic resistance profiles based on 1–5 amino acid substitutions.[1] In our study, blaNDM isolates were found clonally different by random amplified polymorphic DNA analysis. In a study from Ecuador, blaNDM-positive K. pneumoniae from HIV patients exhibited co-positivity to blaCTX-M and blaSHV genes.[5] Our study reports first time the positivity of blaNDM-1 and its variant blaNDM-5 among GNB from HIV patients in South India. Continuous monitoring of blaNDM genes among GNB is needed due to XDR and MDR profiles which could help in the timely treatment of bacterial infections in HIV patients.

Acknowledgments

This study was approved by the Institutional Review Board of YR Gaitonde Centre for AIDS Research and Education (approval number: YRG 209A), Voluntary Health Services Hospital Campus, Chennai, India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Liu Z, Wang Y, Walsh TR, Liu D, Shen Z, Zhang R, et al. Plasmid-mediated novel blaNDM-17 gene encoding a carbapenemase with enhanced activity in a sequence type 48 Escherichia coli strain. Antimicrob Agents Chemother 2017;61. pii: e02233-16.  Back to cited text no. 1
    
2.
Clinical and Laboratory Standards Institute. M100-S23 Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third Informational Supplement. Wayne, PA, USA: Clinical Laboratory Standards Institute; 2013.  Back to cited text no. 2
    
3.
Teo J, Ngan G, Balm M, Jureen R, Krishnan P, Lin R, et al. Molecular characterization of NDM-1 producing Enterobacteriaceae isolates in Singapore hospitals. Western Pac Surveill Response J 2012;3:19-24.  Back to cited text no. 3
    
4.
Vignesh R, Shankar EM, Murugavel KG, Kumarasamy N, Sekar R, Irene P, et al. Urinary infections due to multi-drug-resistant Escherichia coli among persons with HIV disease at a tertiary AIDS care centre in South India. Nephron Clin Pract 2008;110:c55-7.  Back to cited text no. 4
    
5.
Romero-Alvarez D, Reyes J, Quezada V, Satán C, Cevallos N, Barrera S, et al. First case of New Delhi metallo-β-lactamase in Klebsiella pneumoniae from Ecuador: An update for South America. Int J Infect Dis 2017;65:119-21.  Back to cited text no. 5
    



 
 
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