Medical and Clinical Microbiology

Biography

Biography: Mohamudha Parveen Rahamathulla

Abstract

Introduction:  Integrons are mobile genetic elements capable of gene capture and expression via site-specific recombination and the action of a promoter. Integrons play a major role in the dissemination of antibiotic resistance genes and are commonly associated with members of the family Enterobacteriaceae. 

Objectives:  To find out the incidence and the classes of integron associated with multidrug resistant ESBL producing Klebsiella pneumoniae isolated from blood stream infections.

Materials and Methods:  This study was carried out on 256 K.pneumoniae isolates over a period of two years. Antimicrobial susceptibility was tested for 14 antibiotics. ESBL detection was done as per CLSI guidelines followed by a multiplex PCR. Integrase gene PCR was done to detect class 1, class 2 integrons; similarly for class 3 and class 4 integron using specific primers. Sequencing was done for representative number of strains.

Results:  Out of the 256 isolates, 167 (65.2%) were ESBL producers. blaSHV (77.2%) and blaCTX-M (85.6%) were the most common. Of the 167 ESBL positive isolates, 121 (72.4%) carried class 1 integron; 51 (42.1%) isolates carried class 2 integron. Both class 1 and class 2 were found in 33 (27.2%) and none had class 3 or class 4 type. Sequencing and blasting results confirmed their identities. The drug resistant rates of integron positive isolates were 23% higher compared to integron negative strains.

Conclusions:  A higher percentage of class 2 integrons association with ESBL strains is being noted for the first time from our region, also the co-existence of both class 1 and class 2 types increases the higher risk of multidrug resistant gene transfer rates. These findings strongly suggest that integrons have a major role in the dissemination of ESBL mediated resistance among nosocomial isolates of K.pneumoniae.