Indian journal of medical microbiology · 2025
Evaluation of the present scenario of last resort antimicrobial resistance with special emphasis on colistin at a tertiary care hospital in India.
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Pal Nupur, Ray Raja, Sur Suhita, Roy Ujjaini, Mallick Wasim, Saha Shreya
Аннотация
INTRODUCTION: Recently, Multi-Drug-Resistant (MDR) bacteria have become a major threat worldwide. Due to the frequent use of last-resort antimicrobials, the emergence of carbapenem and tigecycline-resistant strains has become more common in the hospital environment. This has impelled to the inclusion of colistin against MDR bacteria. This study evaluates the resistance pattern to last resort antibiotics such as carbapenems, tigecycline, and colistin, as well as compares the VITEK-2 MIC result of colistin with the broth microdilution method (BMD).
METHODOLOGY: Among the total 250 MDR-GNB strains selected from 1789 isolates, resistance to carbapenem, tigecycline, and colistin was reevaluated by the VITEK2 automated system. After excluding intrinsic resistance colistin bacteria, 158 isolates were further tested by the broth microdilution method for colistin and compared statistically with VITEK-2AST results.
RESULT: In this study, resistance to carbapenem was the highest (Imipenem 65.5 %, Meropenem 62.7 %), followed by Tigecycline 31.1 % and Colistin 11.1 %. The comparison of BMD with the VITEK-2 AST showed comparable results in terms of resistant and intermediate strains. In this study, Essential Agreement (EA), Categorical Agreement (CA), Very Major Error (VME), and Major Error (ME) were 88.60 %, 98.10 %, 1.26 %, and 0.63 % respectively. The CA, VME, and ME were within the accepted range as per CLSI, except for the EA. Here, the Essential disagreement was basically MIC value differences, which were mostly within interpretative ranges.
CONCLUSION: Colistin-resistant strains are on the rise in India. In resource-limited countries and in life-threatening conditions, VITEK-2 may be employed as a viable substitute for colistin AST.
METHODOLOGY: Among the total 250 MDR-GNB strains selected from 1789 isolates, resistance to carbapenem, tigecycline, and colistin was reevaluated by the VITEK2 automated system. After excluding intrinsic resistance colistin bacteria, 158 isolates were further tested by the broth microdilution method for colistin and compared statistically with VITEK-2AST results.
RESULT: In this study, resistance to carbapenem was the highest (Imipenem 65.5 %, Meropenem 62.7 %), followed by Tigecycline 31.1 % and Colistin 11.1 %. The comparison of BMD with the VITEK-2 AST showed comparable results in terms of resistant and intermediate strains. In this study, Essential Agreement (EA), Categorical Agreement (CA), Very Major Error (VME), and Major Error (ME) were 88.60 %, 98.10 %, 1.26 %, and 0.63 % respectively. The CA, VME, and ME were within the accepted range as per CLSI, except for the EA. Here, the Essential disagreement was basically MIC value differences, which were mostly within interpretative ranges.
CONCLUSION: Colistin-resistant strains are on the rise in India. In resource-limited countries and in life-threatening conditions, VITEK-2 may be employed as a viable substitute for colistin AST.