Drug Resistance and Molecular Epidemiology of Aerobic Bacteria Isolated from Puerperal Infections in Bangladesh

• Published in: Microbial drug resistance (Larchmont, N.Y.) Vol. 21; no. 3; pp. 297 - 306
• Main Authors: Ahmed, Salma, Kawaguchiya, Mitsuyo, Ghosh, Souvik, Paul, Shyamal Kumar, Urushibara, Noriko, Mahmud, Chand, Nahar, Kamrun, Hossain, Mohammad Akram, Kobayashi, Nobumichi
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc 01.06.2015
• Subjects: Acinetobacter baumannii; Adult; Aerobic bacteria; Anti-Bacterial Agents - pharmacology; Antimicrobial agents; Bacteria; Bacterial infections; Bangladesh - epidemiology; Base Sequence; beta-Lactamases - genetics; beta-Lactamases - metabolism; Cephalosporins - pharmacology; Developing countries; Drug resistance; Drug Resistance, Multiple, Bacterial - genetics; E coli; Enterobacter cloacae; Enterobacteriacae; Enterobacteriaceae - classification; Enterobacteriaceae - drug effects; Enterobacteriaceae - genetics; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Enterococcus faecalis; Epidemiology; Escherichia coli; Female; Gene Expression Regulation, Bacterial; Humans; Klebsiella pneumoniae; LDCs; Microbial Sensitivity Tests; Molecular Epidemiology; Molecular Sequence Data; Multilocus Sequence Typing; Phylogenetics; Phylogeny; Plasmids - chemistry; Plasmids - metabolism; Proteus mirabilis; Puerperal Infection - drug therapy; Puerperal Infection - epidemiology; Puerperal Infection - microbiology; Sequence Analysis, DNA; Staphylococcal Infections - drug therapy; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcus aureus; Staphylococcus aureus - classification; Staphylococcus aureus - drug effects; Staphylococcus aureus - genetics; Staphylococcus aureus - isolation & purification; Staphylococcus haemolyticus; Staphylococcus haemolyticus - classification; Staphylococcus haemolyticus - drug effects; Staphylococcus haemolyticus - genetics; Staphylococcus haemolyticus - isolation & purification; Bangladesh
• ISSN: 1076-6294; 1931-8448
• DOI: 10.1089/mdr.2014.0219

Puerperal infection is a common complication during postnatal period in developing countries. Bacterial species, drug resistance, and genetic characteristics were investigated for a total of 470 isolates from puerperal infections in Bangladesh for a 2-year period (2010–2012). The most common species was Escherichia coli ( n =98), followed by Enterococcus faecalis ( n =54), Staphylococcus haemolyticus ( n =33), Proteus mirabilis ( n =32), Staphylococcus aureus ( n =27), Klebsiella pneumoniae ( n =22), and Enterobacter cloacae ( n =21). S. aureus and Acinetobacter baumannii were isolated at a higher frequency from wound infections after cesarean section, while E. coli , E. cloacae , and K. pneumoniae were isolated from community-acquired endometritis and urinary tract infections. Resistance to third-generation cephalosporins was frequent for Enterobacteriacae , and was mainly mediated by bla CTX-M-1 group beta-lactamases. The CTX-M gene in E. coli from the four phylogroups was identified as bla CTX-M-15 , and phylogroup B2 isolates with bla CTX-M-15 were classified into ST131 with O25b allele, harboring aac(6′)-Ib-cr and various virulence factors. Carbapenemase genes bla NDM-1 and bla NDM-7 were identified in one isolate each of phylogroup A E. coli . Methicillin-resistant S. aureus isolates had type IV or V SCC mec , including isolates of ST361 (CC672), which is related to an emerging ST672 clone in the Indian subcontinent. This study revealed the recent epidemiological status of aerobic bacteria causing puerperal infections in Bangladesh, providing useful information to improve clinical practice and infection control.