Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;149(2):276-280.
doi: 10.4103/ijmr.IJMR_207_18.

Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community

Madhu Gupta  1 , Gunjan Didwal  2 , Shruti Bansal  3 , Kanica Kaushal  1 , Nitya Batra  4 , Vikas Gautam  4 , Pallab Ray  4
Affiliations

Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community

Madhu Gupta et al. Indian J Med Res. 2019 Feb.

Abstract

Background & objectives: Rampant use of β-lactam antibiotics in both community and hospitals has transformed the human healthy intestinal gut flora into a reservoir of antibiotic-resistant organisms. This study was conducted to find the faecal presence of antibiotic-resistant Enterobacteriaceae in faecal samples in the community in north India.

Methods: In this prospective study, 207 stool samples were collected from apparently healthy individuals residing in a semiurban community in Chandigarh, India, from August to October, 2015. Isolates belonging to family Enterobacteriaceae were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and antibiotic susceptibility was determined using Clinical Laboratory Standard Institute disc diffusion method. Detection of extended spectrum β-lactamases (TEM, SHV, OXA-1, CTXM 1, CTXM 2, CTXM 9 and CTXM 8/25), carbapenemases (IMP, VIM and KPC) and New Delhi metallo-β-lactamase was done by multiplex PCR.

Results: Of the population studied, 55.5 per cent were females and 60 per cent were illiterate or had only primary education; 43.4 per cent individuals were aged <20 yr. Overall, 70.5 per cent of stool samples had antibiotic-resistant isolates. Maximum resistance was seen for cephalosporins (60.4%) followed by fluoroquinolones (41.5%). The multidrug-resistant (MDR) isolates were 2.4 per cent. The most commonly detected genes were TEM, SHV, OXA-1, CTXM-1, CTXM-2, CTXM-9 and CTXM-8/25 β-lactamases. Escherichia coli was the most common resistant isolate, and TEM was the most common gene detected.

Interpretation & conclusions: Overall, 70.5 per cent members of Enterobacteriaceae had antibiotic resistance in the community and 2.4 per cent were MDR. Higher resistance rates were observed for most commonly used drugs such as cephalosporins and fluoroquinolones. High rate of antibiotic-resistant Enterobacteriaceae in gut of healthy individuals points towards the need for active screening and prevention of dissemination.

Keywords: Antimicrobial resistance; Enterobacteriaceae; community health; extended-spectrum β; gut resistome; lactamases; multidrug-resistant organisms.

PubMed Disclaimer

Conflict of interest statement

None

References

    1. van Schaik W. The human gut resistome. Philos Trans R Soc Lond B Biol Sci. 2015;370:20140087. - PMC - PubMed
    1. Shaikh S, Fatima J, Shakil S, Rizvi SMD, Kamal MA. Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment. Saudi J Biol Sci. 2015;22:90–101. - PMC - PubMed
    1. Jacoby GA. AmpC beta-lactamases. Clin Microbiol Rev. 2009;22:161–82. - PMC - PubMed
    1. van Duin D, Paterson DL. Multidrug-resistant bacteria in the community: Trends and lessons learned. Infect Dis Clin North Am. 2016;30:377–90. - PMC - PubMed
    1. Tamhankar AJ, Karnik SS, Stålsby Lundborg C. Determinants of antibiotic consumption - development of a model using partial least squares regression based on data from India. Sci Rep. 2018;8:6421. - PMC - PubMed

MeSH terms