Dissemination of Trimethoprim-Sulfamethoxazole Drug Resistance Genes Associated with Class 1 and Class 2 Integrons among Gram-Negative Bacteria from HIV Patients in South India

Marimuthu Ragavan Ramesh Kumar, Narasingam Arunagirinathan, Seetharaman Srivani, Aridoss Dhanasezhian, Nallusamy Vijaykanth, Natesan Manikandan, Sethuramalingam Balakrishnan, Ramachandran Vignesh, Pachamuthu Balakrishnan, Suniti Solomon, Sunil Solomon

Research output: Contribution to journalArticle

Abstract

The antibiotic, trimethoprim-sulfamethoxazole (TMP-SMX), is generally used for prophylaxis in HIV individuals to protect them from Pneumocystis jiroveci infection. Long-term use of TMP-SMX develops drug resistance among bacteria in HIV patients. The study was aimed to detect the TMP-SMX resistance genes among gram-negative bacteria from HIV patients. TMP-SMX-resistant isolates were detected by the Kirby-Bauer disc diffusion method. While TMP resistance genes such as dfrA1, dfrA5, dfrA7, and dfrA17 and SMX resistance genes such as sul1 and sul2 were detected by multiplex PCR, class 1 and class 2 integrons were detected by standard monoplex PCR. Of the 151 TMP-SMX-resistant bacterial isolates, 3 were positive for sul1 alone, 48 for sul2 alone, 11 for dfrA7 alone, 21 for sul1 and sul2, 1 for sul1 and dfrA7, 23 for sul2 and dfrA7, 2 for sul2 and dfrA5, 41 for sul1, sul2, and dfrA7, and 1 for sul2, dfrA5, and dfrA7. Of 60 TMP-SMX-resistant isolates positive for integrons, 44 had class 1 and 16 had class 2 integrons. It was found that the prevalence of sul genes (n = 202; p < 0.001) was higher compared with dfr genes (n = 80; p < 0.001), and 87.4% (n = 132; p < 0.001) of TMP-SMX-resistant isolates also were positive for β-lactamase production. This type of study is reported for the first time from HIV patients in India. Therefore, this study indicates that dissemination of TMP-SMX resistance genes and class 1 and class 2 integrons along with β-lactamase production among gram-negative bacteria in HIV patients will certainly make their treatment to bacterial infections more complicated in clinical settings.

Original languageEnglish (US)
Pages (from-to)602-608
Number of pages7
JournalMicrobial Drug Resistance
Volume23
Issue number5
DOIs
StatePublished - Jul 1 2017
Externally publishedYes

Keywords

  • AmpC
  • dfrA7
  • ESBLs
  • HIV
  • integrons
  • MBL
  • sul1
  • TMP-SMX
  • trimethoprim-sulfamethoxazole

ASJC Scopus subject areas

  • Microbiology
  • Immunology
  • Pharmacology
  • Microbiology (medical)

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    Ramesh Kumar, M. R., Arunagirinathan, N., Srivani, S., Dhanasezhian, A., Vijaykanth, N., Manikandan, N., Balakrishnan, S., Vignesh, R., Balakrishnan, P., Solomon, S., & Solomon, S. (2017). Dissemination of Trimethoprim-Sulfamethoxazole Drug Resistance Genes Associated with Class 1 and Class 2 Integrons among Gram-Negative Bacteria from HIV Patients in South India. Microbial Drug Resistance, 23(5), 602-608. https://doi.org/10.1089/mdr.2016.0034