Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Multiple importations and transmission of colistin-resistant Klebsiella pneumoniae in a hospital in northern India
Infection Control and Hospital Epidemiology, Volume 40, No. 12, Year 2019
Notification
URL copied to clipboard!
Description
Objective: Resistance to colistin, a last resort antibiotic, has emerged in India. We investigated colistin-resistant Klebsiella pneumoniae(ColR-KP) in a hospital in India to describe infections, characterize resistance of isolates, compare concordance of detection methods, and identify transmission events.Design: Retrospective observational study.Methods: Case-patients were defined as individuals from whom ColR-KP was isolated from a clinical specimen between January 2016 and October 2017. Isolates resistant to colistin by Vitek 2 were confirmed by broth microdilution (BMD). Isolates underwent colistin susceptibility testing by disk diffusion and whole-genome sequencing. Medical records were reviewed.Results: Of 846 K. pneumoniae isolates, 34 (4%) were colistin resistant. In total, 22 case-patients were identified. Most (90%) were male; their median age was 33 years. Half were transferred from another hospital; 45% died. Case-patients were admitted for a median of 14 days before detection of ColR-KP. Also, 7 case-patients (32%) received colistin before detection of ColR-KP. All isolates were resistant to carbapenems and susceptible to tigecycline. Isolates resistant to colistin by Vitek 2 were also resistant by BMD; 2 ColR-KP isolates were resistant by disk diffusion. Moreover, 8 multilocus sequence types were identified. Isolates were negative for mobile colistin resistance (mcr) genes. Based on sequencing analysis, in-hospital transmission may have occurred with 8 case-patients (38%).Conclusions: Multiple infections caused by highly resistant, mcr-negative ColR-KP with substantial mortality were identified. Disk diffusion correlated poorly with Vitek 2 and BMD for detection of ColR-KP. Sequencing indicated multiple importation and in-hospital transmission events. Enhanced detection for ColR-KP may be warranted in India. © 2019 by The Society for Healthcare Epidemiology of America. All rights reserved.
Authors & Co-Authors
Balaji, Veeraraghavan
India, Vellore
Christian Medical College, Vellore
Neeravi, Ayyanraj
India, Vellore
Christian Medical College, Vellore
Venkatesan, Manigandan
India, Vellore
Christian Medical College, Vellore
Gupta, Amit Kumar
India, New Delhi
All India Institute of Medical Sciences, new Delhi
Soni, Kapil Dev
India, New Delhi
All India Institute of Medical Sciences, new Delhi
Malpiedi, Paul J.
United States, Atlanta
Centers for Disease Control and Prevention
Lutgring, Joseph D.
United States, Atlanta
Centers for Disease Control and Prevention
United States, Atlanta
Emory University
Laserson, Kayla F.
United States, Atlanta
Centers for Disease Control and Prevention
Gupta, Neil
United States, Atlanta
Centers for Disease Control and Prevention
Srikantiah, Padmini
United States, Atlanta
Centers for Disease Control and Prevention
Sharma, Aditya
United States, Atlanta
Centers for Disease Control and Prevention
Statistics
Citations: 6
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1017/ice.2019.252
ISSN:
0899823X
Research Areas
Health System And Policy
Study Design
Cohort Study
Participants Gender
Male