The emergence of clonally diverse carbapenem-resistant Enterobacter cloacae complex in West Bengal, India: a dockyard of β-lactamases periling nosocomial infections

• Published in: International microbiology 2024-08, Vol.27 (4), p.1023-1033
• Main Authors: Das, Surojit, Mallick, Abhi, Barik, Mili, Sarkar, Soma, Saha, Puranjoy
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - pharmacology; Applied Microbiology; Bacterial Proteins - genetics; Bacterial Proteins - metabolism; beta-Lactamases - genetics; Biomedical and Life Sciences; Carbapenem-Resistant Enterobacteriaceae - classification; Carbapenem-Resistant Enterobacteriaceae - drug effects; Carbapenem-Resistant Enterobacteriaceae - genetics; Carbapenem-Resistant Enterobacteriaceae - isolation & purification; Carbapenems - pharmacology; Child; Child, Preschool; Cross Infection - epidemiology; Cross Infection - microbiology; Drug Resistance, Multiple, Bacterial - genetics; Enterobacter cloacae - drug effects; Enterobacter cloacae - enzymology; Enterobacter cloacae - genetics; Enterobacter cloacae - isolation & purification; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Eukaryotic Microbiology; Female; Humans; India - epidemiology; Infant; Life Sciences; Male; Medical Microbiology; Microbial Ecology; Microbial Sensitivity Tests; Microbiology; Middle Aged; Molecular Epidemiology; Plasmids - genetics; Young Adult
• ISSN: 1618-1905; 1618-1905
• DOI: 10.1007/s10123-023-00451-0

Carbapenem-resistant Enterobacter cloacae complex (CRECC) constitutes a global public health threat challenging clinical treatment and infection control, especially in low- and middle-income countries such as India. We analyzed the antimicrobial susceptibility, major β-lactamase genes, plasmid profiles, and genetic relatedness to understand the molecular epidemiology of CRECC clinical isolates (n = 44) in West Bengal, India, during 2021–2022. The majority (> 55%) of the isolates were resistant to fluoroquinolones, aminoglycosides, and co-trimoxazole, even > 20% for tigecycline and > 35% were extensively drug-resistant. Co-β-lactamase production was categorized into twenty-seven types, importantly NDM (84%), OXA-48 (40%), TEM (61%), CTX-M (46%), OXA-1 (55%), and MIR (27%). The NDM-1 and OXA-181 were major variants with the first observations of NDM-24 and -29 variants in India. Wide-range of plasmids (2 to > 212 kb) were harbored by the β-lactamase-producing isolates: small (91%), medium (27%), large (9%), and mega (71%). IncX3, ColE1, and HI2 were noted in about 30% of isolates, while IncF and R were carried by