Journal of Laboratory Physicians
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LETTER TO EDITOR
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 64-65  

Emergence of aeromonas spp. harboring multiple carbapenemase-encoding genes from hospital sewage


Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Date of Web Publication26-Aug-2016

Correspondence Address:
Dr. Tuhina Banerjee
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2727.187924

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How to cite this article:
Banerjee T, Pal S, Das A. Emergence of aeromonas spp. harboring multiple carbapenemase-encoding genes from hospital sewage. J Lab Physicians 2017;9:64-5

How to cite this URL:
Banerjee T, Pal S, Das A. Emergence of aeromonas spp. harboring multiple carbapenemase-encoding genes from hospital sewage. J Lab Physicians [serial online] 2017 [cited 2019 Sep 20];9:64-5. Available from: http://www.jlponline.org/text.asp?2017/9/1/64/187924

Sir,

In January 2016 issue of the journal, an excellent review on Aeromonas spp.[1] as an emerging pathogen has been published emphasizing the importance of this enteric pathogen. We have also recently experienced the increasing prevalence of this organism in our hospital environment. A study was carried out to determine the prevalence of various enteric pathogens in hospital sewage of a tertiary care center in Varanasi, North India. Samples from 22 different sites were collected as previously described,[2] and sewage samples were processed by membrane filtration method. Colonies of Aeromonas spp. were isolated on MacConkey agar and isolates were biochemically identified [2] and type species were confirmed by 16sRNA-based polymerase chain reaction (PCR) and sequencing. Antimicrobial susceptibility testing was performed as per the Clinical and Laboratory Standards Institute [3] and isolates were screened for the presence of carbapenemase genes by PCR (blaGES, blaIMI/NMC-A, blaSME, blaKPC, blaIMP, blaVIM, blaOXA-48, blaNDM).[4]

A total of seven Aeromonas isolates were identified from seven different sites comprising four isolates of Aeromonas caviae and three isolates of Aeromonas hydrophila. The antimicrobial resistance profile of the isolates was 28.57% resistance to cefuroxime, 28.57% to ceftriaxone, 28.57% to cefepime, and 42.85% to levofloxacin. All except one (No.A) isolate were susceptible to carbapenems, namely, imipenem and meropenem by disc diffusion method. However, this isolate No.A harbored the blaNDM-1 and blaOXA-48 along with blaGES carbapenemase genes [Figure 1].
Figure 1: Polymerase chain reaction amplification of carbapenemase-encoding genes

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It has been stated that the carriage rate of Aeromonas in human gut varies from 0% to 4%.[1] However, their increased isolation in hospital effluents which provides an excellent media for genetic exchange, being enriched with selective antibiotic pressure, is a threat to their emergence as virulent enteric pathogens. A few reports of blaKPC-positive Aeromonas carriage in stool have been recently reported.[5],[6] In this case, isolate-harboring multiple carbapenemase-encoding genes simply accelerate the evolution of antimicrobial resistance in these pathogens.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Batra P, Mathur P, Misra MC. Aeromonas spp.: An emerging nosocomial pathogen. J Lab Physicians 2016;8:1-4.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Monfort P, Baleux B. Distribution and survival of motile Aeromonas spp. in brackish water receiving sewage treatment effluent. Appl Environ Microbiol 1991;57:2459-67.  Back to cited text no. 2
    
3.
Clinical and Laboratory Standards Institute (CLSI). Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria; Approved Guideline. M45-A2. 2nd ed. Clinical and Laboratory Standards Institute; Wayne, PA: 2010.  Back to cited text no. 3
    
4.
Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis 2011;70:119-23.  Back to cited text no. 4
    
5.
Picão RC, Cardoso JP, Campana EH, Nicoletti AG, Petrolini FV, Assis DM, et al. The route of antimicrobial resistance from the hospital effluent to the environment: Focus on the occurrence of KPC-producing Aeromonas spp. and Enterobacteriaceae in sewage. Diagn Microbiol Infect Dis 2013;76:80-5.  Back to cited text no. 5
    
6.
Hughes HY, Michelin AV, Lau AF, Dekker J, Frank K, Conlan S, et al. Detection of carbapenemase-producing Aeromonas hydrophila on perirectal surveillance culture. Open Forum Infect Dis 2014;1 Suppl 1:S134.  Back to cited text no. 6
    


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