Ajay Kumar P.1* and VinodKumar C.S.2
1Research Scholar in Microbiology, Bharathiar University, Coimbatore, India.
2Department of Microbiology, S. S. Institute of Medical Sciences and Research Centre,
Davangere – 577 005, Karnataka, India.
The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) in urinary tract infection among diabetic patients have become an increasing concern for management and treatment of the patients. The aim of this study was to investigate the genotypic features of CRE strains isolated from urinary tract infection among type 2 diabetes mellitus patients.A total of 1560 diabetic patients were screened for suspected urinary tract infection. 277 Gram negative bacteria were identified by Phoenix 100 system (Becton-Dickinson, USA). These isolates were screened for their ability to produce carbapenemases by a disc diﬀusion test. A total of 45 CRE isolates were recovered from these Gram negative bacteria. Carbapenamase producing isolates were screened for blaSPM, blaNDM, blaIMP, blaVIM, and blaGIMgenes.The PCR products were sequenced in an ABI 3500 DNA sequencer (Applied Biosystems, USA).blaIMP-1, blaIMP-8, blaNDM-1, blaNDM-2, and blaNDM-4 were the predominant genes seen among E.coli, Klebsiellapneumoniae, Citrobacterfreundii, Acinetobacterbaumanniiand Proteus mirabilis. Colistin and Amikacin were the drug of choice andColistin had the MIC value of ≤1mg/l and for Amikacin 62% of isolates had MIC value of ≤ 4mg/l.This rising trend of carbapenem resistanceamong Gram negative bacteria stresses the increasing importance of continuous surveillance system and stewardship of antibiotics as strategies in the overall management of diabetic patients with urinary tract infection.
Keywords: Carbapenem resistance encoding genes,Gram negative bacilli, Urinary tract infection, Type 2 diabetes mellitus.