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. 2021 Jul;26(7):720-729.
doi: 10.1111/tmi.13584. Epub 2021 May 2.

Genotypic and phenotypic profiles of antibiotic-resistant bacteria isolated from hospitalised patients in Bangladesh

Kazi Sarjana Safain  1   2 , Golam Sarower Bhuyan  1 , Saad Hassan Hasib  1 , Mohammad Sazzadul Islam  3   4 , Mohammad Al Mahmud-Un-Nabi  1 , Rosy Sultana  1   5 , Sadia Tasnim  1   2 , Farjana Akther Noor  3   6 , Suprovath Kumar Sarker  3 , Md Tarikul Islam  3 , Asifuzzaman Rahat  1 , Daniel T Leung  7 , Daryl Domman  8 , Farhana Manzoor  2 , Sajid Anwar  3 , Md Abdul Majid Bhuiyan  9 , Emran Kabir Chowdhury  6 , Syed Saleheen Qadri  1   3 , Firdausi Qadri  1   3   10 , Kaiissar Mannoor  1   3
Affiliations
Free article

Genotypic and phenotypic profiles of antibiotic-resistant bacteria isolated from hospitalised patients in Bangladesh

Kazi Sarjana Safain et al. Trop Med Int Health. 2021 Jul.
Free article

Abstract

Objectives: Characterisation of resistance phenotype and genotype is crucial to understanding the burden and transmission of antimicrobial resistance (AMR). This study aims to determine the spectrum of AMR and associated genes encoding aminoglycoside, macrolide and β-lactam classes of antimicrobials in bacteria isolated from hospitalised patients in Bangladesh.

Methods: 430 bacterial isolates from patients with respiratory, intestinal, wound infections and typhoid fever, presenting to clinical care from 2015 to 2019, were examined. They included Escherichia coli (n = 85); Staphylococcus aureus (n = 84); Salmonella typhi (n = 82); Klebsiella pneumoniae (n = 42); Streptococcus pneumoniae (n = 36); coagulase-negative staphylococci (n = 28); Enterococcus faecalis (n = 27); Pseudomonas aeruginosa (n = 26); and Acinetobacter baumannii (n = 20). Reconfirmation of these clinical isolates and antimicrobial susceptibility tests was performed. PCR amplification using resistance gene-specific primers was done, and the amplified products were confirmed by Sanger sequencing.

Results: 53% of isolates were multidrug-resistant (MDR), including 97% of Escherichia coli. There was a year-wise gradual increase in MDR isolates from 2015 to 2018, and there was an almost twofold increase in the number of MDR strains isolated in 2019 (P = 0.00058). Among the 5 extended-spectrum β-lactamases investigated, CTX-M-1 was the most prevalent (63%) followed by NDM-1 (22%); Escherichia coli was the major reservoir of these genes. The ermB (55%) and aac(6')-Ib (35%) genes were the most frequently detected macrolide and aminoglycoside resistance genes, respectively.

Conclusion: MDR pathogens are highly prevalent in hospital settings of Bangladesh.

Keywords: acute respiratory infections; aminoglycoside; antimicrobial resistance; diarrhoea; extended-spectrum β-lactamase; macrolide; multidrug resistance; typhoid fever; wound infections.

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