Genotypic and phenotypic profiles of antibiotic-resistant bacteria isolated from hospitalised patients in Bangladesh.
OBJECTIVES
Characterisation of resistance phenotype and genotype is crucial to understanding the burden and transmission of antimicrobial resistance (AMR). This study aims to determine the spectrum of AMR and associated genes encoding aminoglycoside, macrolide and β-lactam classes of antimicrobials in bacteria isolated from hospitalised patients in Bangladesh.


METHODS
430 bacterial isolates from patients with respiratory, intestinal, wound infections and typhoid fever, presenting to clinical care from 2015 to 2019, were examined. They included Escherichia coli (n = 85); Staphylococcus aureus (n = 84); Salmonella typhi (n = 82); Klebsiella pneumoniae (n = 42); Streptococcus pneumoniae (n = 36); coagulase-negative staphylococci (n = 28); Enterococcus faecalis (n = 27); Pseudomonas aeruginosa (n = 26); and Acinetobacter baumannii (n = 20). Reconfirmation of these clinical isolates and antimicrobial susceptibility tests was performed. PCR amplification using resistance gene-specific primers was done, and the amplified products were confirmed by Sanger sequencing.


RESULTS
53% of isolates were multidrug-resistant (MDR), including 97% of Escherichia coli. There was a year-wise gradual increase in MDR isolates from 2015 to 2018, and there was an almost twofold increase in the number of MDR strains isolated in 2019 (P = 0.00058). Among the 5 extended-spectrum β-lactamases investigated, CTX-M-1 was the most prevalent (63%) followed by NDM-1 (22%); Escherichia coli was the major reservoir of these genes. The ermB (55%) and aac(6')-Ib (35%) genes were the most frequently detected macrolide and aminoglycoside resistance genes, respectively.


CONCLUSION
MDR pathogens are highly prevalent in hospital settings of Bangladesh.
['Sarjana Safain|Kazi|K|', 'Bhuyan|Golam Sarower|GS|', 'Hassan Hasib|Saad|S|', 'Islam|Mohammad Sazzadul|MS|', 'Mahmud-Un-Nabi|Mohammad Al|MA|', 'Sultana|Rosy|R|', 'Tasnim|Sadia|S|', 'Noor|Farjana Akther|FA|', 'Sarker|Suprovath Kumar|SK|', 'Islam|Md Tarikul|MT|', 'Rahat|Asifuzzaman|A|', 'Leung|Daniel T|DT|', 'Domman|Daryl|D|', 'Manzoor|Farhana|F|', 'Anwar|Sajid|S|', 'Majid Bhuiyan|Md Abdul|MA|', 'Chowdhury|Emran Kabir|EK|', 'Qadri|Syed Saleheen|SS|', 'Qadri|Firdausi|F|', 'Mannoor|Kaiissar|K|']
D040981:Acinetobacter baumannii D001459:Bangladesh D024901:Drug Resistance, Multiple, Bacterial D013293:Enterococcus faecalis D004926:Escherichia coli D005838:Genotype D006801:Humans D007297:Inpatients D007711:Klebsiella pneumoniae D010641:Phenotype D011550:Pseudomonas aeruginosa D012485:Salmonella typhi D013211:Staphylococcus aureus
antimicrobial resistance aminoglycoside macrolide wound infections typhoid fever extended-spectrum β-lactamase acute respiratory infections diarrhoea multidrug resistance