Background: Multi-drug resistance mechanisms are varied and highly complex. The emergence of MDR organisms and their increasing spread remains a significant challenge, due to limited options of antimicrobial therapy and the technical challenges associated with common bacteriologic approaches and its interpretation.
Methods: The Taqman assay panel was designed to screen for twenty-six MDRG that encode for resistances to four major classes of antibiotics: aminoglycosides, β-lactams, fluoroquinolones, and macrolides. Stool samples were obtained from patients admitted to a tertiary medical center. Data included demographics and discharge diagnosis.
Results: This study enrolled 155 patients, mean age of 59 and 57% female. 104 patients had recently received antibiotics and 99 had GI symptoms with the most common presentation being diarrhea (88). Among the 155 patients, the following genes were detected: qnrS (1), SHV (22), TEM (139), OXA-1 (3), ACT/MIR (22), CTX-M (9), blaCMY (6), blaDHA (7), ermC (58), ermA (33), and ermB (117). We found a higher detection of TEM (97%) and ermB (87%) in the 71-90 age group, while detection of SHV (29%), qnrs (3%) and ermC (45%) was prevalent in 51-70 age group. The 20-50 age group had increased detection of ACT/MIR (16%) and CTX-M group 1,2, and 9 (12%). Females had higher detection of TEM, ACT/MIR, ermC and B while males had higher detection of OXA-1 and CTX-M. Those who recently received antibiotics had higher detections of ermC, ermA and OXA-1 while those who did not receive antibiotics had higher a detection of SHV, ACT/MIR, and ermB. Symptomatic patients had a higher rate of detection for TEM (91%) and ermC (40%), while asymptomatic patients had increase of SHV (24%) and ermB (80%) detection. Patients with Clostridium difficile infection had a lower rate of MDRG detection as compared to those with gastroenteritis associated with Escherichia coli and Campylobacter jejuni.
Conclusion: Large spectrum of MGRG was identified in stool samples of hospitalized patients. Although detection of a resistance gene does not necessarily imply on protein expression, further studies are urgently needed to incorporate these evolving rapid molecular tests for early detection of MDR organisms to improve infection control and prevention in hospitals.
E. Asis, None
D. Stalons, Diatherix Lab: Investigator , Salary
S. Brzezinski, Diatherix lab: Employee , Salary
P. Brozka, Thermo fisher: Employee , Salary
K. Varma, Thermo fisher: Employee , Salary
N. Fantin, Thermo fisher: Employee , Salary
J. Trotta, Thermo fisher: Employee , Salary
E. Grigorenko, Diatherix lab: Investigator , Salary