Prevalence of faecal carriage of Carbapenemase Producing Enterobacteriaceae in healthy Indian subjects from the community |
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| Authors: | Nasheed Arum Abdul Ghafur Mubin Kazi Ratna Rao Camilla Rodrigues MS Ratnamani Prathiba J Sreeveni Alaparthi Palani Gnanasoundari Krishna Prabha Premachandran MA Thirunarayanan |
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| Institution: | 1. Department of Microbiology, P D Hinduja Hospital, Mumbai, 400016, India;2. Apollo Cancer Institute, 320 Anna Salai, Chennai 600035, India;3. Department of Microbiology, Apollo Hospital, Hyderabad, Telangana, 500033, India;1. L & T Microbiology Research Centre, Medical Research Foundation, Sankara Nethralaya, Chennai, India;2. Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India;1. Medical Entomology, Arbovirology and Rickettsial Disease Division, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre (RMRC), Northeast Region, Dibrugarh, 786010, Assam, India;2. Naga Hospital Authority, Kohima, Nagaland, India;3. Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India;1. Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan;2. Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan;3. Department of Microbiology, Faculty of Pharmacy, Meijo University, Aichi, Japan;4. Department of Diabetology, Endocrinology and Metabolism, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan;1. Department of Biotechnology, Mizoram University, Aizawl 796004, Mizoram, India;2. Department of Microbiology, Synod Hospital, Durtlang, Aizawl 796025, Mizoram, India;3. Department of Health and Family Welfare, Directorate of Health Services, Aizawl 796009, Mizoram, India;4. Directorate of Health Services, National Health Mission, Aizawl 796009, Mizoram, India;5. CMO, Health & Family Welfare Department, Mamit 796441, Mizoram, India;6. Department of Microbiology, Zoram Medical College, Falkawn 796005, Mizoram, India;7. Cellular Immunology Group, International Centre for Genetic Engineering & Biotechnology, Aruna Asaf Ali Marg, New Delhi 110067, India;1. Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey;2. Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey |
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| Abstract: | PurposeFaecal carriage of carbapenemase-producing Enterobacterales (CPE) has been extensively investigated in hospitalized patients, but limited data is available on the carriage rate in healthy individuals in India.MethodsA total of 1000 stool samples were screened for CPE from healthy individuals in Chennai (n ?= ?50), Hyderabad (n ?= ?184) and Mumbai (n ?= ?766). Diluted stool samples were cultured on chromID CARBA SMART plates. Growing colonies were screened for CPE by RAPIDEC® CARBA NP Test and minimum inhibitory concentration (MIC) of imipenem by E-Test. PCR was performed for confirmation of CPE genes.ResultsOut of the 1000 stool samples tested, 6.1% were positive for CPE. A total of 64 carbapenem resistant isolates (56 ?E.coli, 4 Klebsiella pneumoniae, 3 Enterobacter cloacae and 1 Citrobacter freundii) were recovered from ChromID CARBA SMART biplate. Carbapenemase production was identified in 57/64 isolates by RAPIDEC® CARBA NP test. PCR analysis showed 28 blaNDM-1 and 33 blaOXA48. Three remaining isolates (2 ?E.coli, 1 ?K.pneumoniae) were negative for the tested carbapenemase genes. Interestingly, out of these 61 PCR positive isolates, 49.1% displayed imipenem MIC within the susceptibility range on the basis of CLSI interpretative criteria.ConclusionsFaecal carriage of CPE among healthy individuals was 6.1%. Comprehensive measures to improve the sanitation scenario and implementation of National AMR action plan are needed to prevent further generation and dissemination of carbapenem resistant Enterobacterales (CRE). |
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| Keywords: | Faecal carriage Carbapenem resistance |
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