Beta
252506

Assessment of Colistin Susceptibility among Carbapenem-Resistant Clinical Isolates

Article

Last updated: 28 Dec 2024

Subjects

-

Tags

Clinical microbiology

Abstract

Background: Colistin is the last treatment option for infections caused by carbapenem resistant Gram-negative bacilli (CRGNB). The increasing spread of chromosomally encoded and plasmid-mediated colistin resistance made colistin susceptibility assessment a necessity. Objectives: Assessment of colistin susceptibility in CRGNB by broth micro dilution method (BMD), as the standard method and colistin broth disk elution method (CBDE), as a substitute procedure. Genotypic determination of plasmid mediated colistin resistance (mcr) genes as also done. Methodology: CRGNB were collected and identified by conventional methods. Testing carbapenemase production by modified Carbapenem Inactivation Method (mCIM) and colistin susceptibility (by BMD and CBDE) were done and results were interpreted regarding CLSI (2022) guidelines followed by genotypic detection of mcr-1, -2, -3, -4, and -5 genes by multiplex PCR. Results: 155 out of 308 GNB (50.3%) were carbapenem resistant. Among them, 129 (83.2%) isolates were carbapenemase positive by mCIM. Colistin susceptibility testing by BMD revealed 43 out of 155 CRGNB isolates (27.7%) were colistin resistant. Sensitivity, Specificity, PPV, NPV and Accuracy of CBDE were 99.09%, 93.33%, 97.32% 97.67%, 97.42% respectively with almost perfect agreement with BMD. By PCR, only 3 CRGNB isolates (6.98%) carried mcr-1 while other mcr genes were not detected at all. Conclusion: Colistin resistance rate among CRGNB is concerning, causing serious and even deadly infections so prospective surveillance is essential. Broth disk elusion method is a simple, non-expensive reliable option to test colistin susceptibility.

DOI

10.21608/ejmm.2022.252506

Keywords

Colistin, CBDE, BMD, mcr, mCIM

Authors

First Name

Soma

Last Name

Ajlan

MiddleName

Elsayed

Affiliation

mostafa kamel street , elbtanoon, shebin elkom,menoufia Egypt

Email

dr.soma2007@yahoo.com

City

shebin elkom

Orcid

0000-0002-7791-2097

First Name

Esraa

Last Name

Elmahdy

MiddleName

E.

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, Menoufia University, Egypt

Email

-

City

-

Orcid

-

First Name

Asmaa

Last Name

Sleem

MiddleName

S.

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, Menoufia University, Egypt

Email

-

City

-

Orcid

-

Volume

31

Article Issue

3

Related Issue

35368

Issue Date

2022-07-01

Receive Date

2022-08-02

Publish Date

2022-07-01

Page Start

109

Page End

116

Print ISSN

1110-2179

Online ISSN

2537-0979

Link

https://ejmm.journals.ekb.eg/article_252506.html

Detail API

https://ejmm.journals.ekb.eg/service?article_code=252506

Order

252,506

Type

New and original researches in the field of Microbiology.

Type Code

2,038

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Microbiology

Publication Link

https://ejmm.journals.ekb.eg/

MainTitle

Assessment of Colistin Susceptibility among Carbapenem-Resistant Clinical Isolates

Details

Type

Article

Created At

23 Jan 2023