Prevalence of extensive drug resistance in bacterial isolates harboring blaNDM-1 in Quetta Pakistan

Drug resistance in bacterial isolates

  • Nazeer Ahmed Balochistan University of Information Technology, Engineering and Management Sciences, Quetta
  • Mohammad Din Bolan Medical College/Complex Hospital Quetta, Pakistan
  • Khan Muhammad Babar Bolan Medical College/Complex Hospital Quetta, Pakistan
  • Shabir Ahmed Bolan Medical College/Complex Hospital Quetta, Pakistan
  • Abdul Aleem Bolan Medical College/Complex Hospital Quetta, Pakistan
  • Dawood Shah Bolan Medical College/Complex Hospital Quetta, Pakistan
  • Daud Ghilzai Bolan Medical College/Complex Hospital Quetta, Pakistan
Keywords: Carbapenemase, Modified Hodge Test, New Delhi-Metallo-Beta-Lactamase, PDR, XDR, CRE

Abstract

Objective: Extensive drug resistant Gram-negative bacilli, harboring New Delhi metallo-β-lactamase-1 (blaNDM-1) having the ability to hydrolyze β-lactams, have become a vital global clinical threat. The present study was, therefore, designed to investigate the prevalence and epidemiology of NDM-1 producers in Quetta, Pakistan.

Methods: This study was carried out in Microbiology Laboratory, Bolan Medical Complex Hospital Quetta, Biotechnology laboratory, BUITEMS Quetta and Hi-tech laboratory, CASVAB, University of Balochistan, Quetta, from March to June 2018, during the hot season. Biochemical and molecular approaches were applied for the identification of bacterial isolates. Minimum Inhibitory Concentrations (MICs) were determined using E-test method. Carbapenemase activity was ascertained by Modified Hodge Test (MHT) and the presence of blaNDM-1 gene was recognized by Polymerase Chain Reaction (PCR).

Results: We isolated five blaNDM-1 harboring isolates of three different species namely Morganella morganii (n=2) Enterobacter cloacae (n=2) and Citrobacter freundii (n=1), from 300 pus samples. These isolates were found extensive drug resistant (XDR). Strikingly, two isolates of M. morganii were displaying resistance against 23 antibiotics of sulphonamides, aminoglycosides, polypeptide, monobactams, tetracyclines, quinolones, macrolides, cephalosporins, phosphonic acid and β-lactams groups, suggesting Pan Drug Resistance (PDR).

Conclusion: This is the first report on emergence of PDR strain of M. morganii producing NDM1 in the province of Balochistan, Pakistan. The presence of blaNDM-1 in different bacterial species and their extensive rather pan drug resistance pattern poses a momentous clinical threat.

doi: https://doi.org/10.12669/pjms.35.4.372

How to cite this:
Din M, Babar KM, Ahmed S, Aleem A, Shah D, Ghilzai D, et al. Prevalence of extensive drug resistance in bacterial isolates harboring blaNDM-1 in Quetta Pakistan. Pak J Med Sci. 2019;35(4):1155-1160. doi: https://doi.org/10.12669/pjms.35.4.372

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2019-07-10
Section
Original Articles