Pub Date : 2025-11-19DOI: 10.1016/j.ijmmb.2025.101025
Gayatree Nayak , Naveen Kumar Devanga Ragupathi , Bijayini Behera
Cefiderocol (FDC) is regarded as a reserved therapeutic option for serious CRE infections. In an earlier study, we had reported a 9.9 % FDC resistance in CRE isolates. In the present study, we are reporting the whole genome sequencing analysis findings of two FDC-resistant CRE (One E. coli and one K. pneumoniae). PBP3 insertions and mutations in the siderophore receptor cirA were the primary drivers of FDC resistance in E. coli. In K. pneumoniae, there was intact porin and a single copy of blaNDM-5, and a combination of β-lactamase and carbapenem resistance genes, including blaTEM- 1B, blaCTX-M-15,blaNDM-5 and blaOXA-181.
{"title":"Whole-genome sequence analysis of cefiderocol-resistant E. coli and Klebsiella pneumoniae isolates from cefiderocol treatment-naïve patients","authors":"Gayatree Nayak , Naveen Kumar Devanga Ragupathi , Bijayini Behera","doi":"10.1016/j.ijmmb.2025.101025","DOIUrl":"10.1016/j.ijmmb.2025.101025","url":null,"abstract":"<div><div>Cefiderocol (FDC) is regarded as a reserved therapeutic option for serious CRE infections. In an earlier study, we had reported a 9.9 % FDC resistance in CRE isolates. In the present study, we are reporting the whole genome sequencing analysis findings of two FDC-resistant CRE (One <em>E. coli</em> and one <em>K. pneumoniae</em>). PBP3 insertions and mutations in the siderophore receptor <em>cirA</em> were the primary drivers of FDC resistance in <em>E. coli</em>. In <em>K. pneumoniae</em>, there was intact porin and a single copy of <em>bla</em><sub>NDM-5</sub>, and a combination of β-lactamase and carbapenem resistance genes, including <em>bla</em><sub>TEM- 1B</sub>, <em>bla</em><sub>CTX-M-15,</sub> <em>bla</em><sub>NDM-5</sub> and <em>bla</em><sub>OXA-181</sub>.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101025"},"PeriodicalIF":1.3,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.ijmmb.2025.101023
Alisha Mahajan , Varsha Gupta , Suksham Jain
Background
Neonatal sepsis is a major cause of mortality and morbidity, representing a critical emergency that demands swift diagnosis and intervention. Recent trend shows increasing resistance to commonly used antibiotics.
Aims and objectives
To study the antimicrobial resistance pattern in blood culture positive neonatal sepsis in outborn and inborn neonates and to compare the clinical profile in neonates with proven sepsis.
Methods
Bacterial cultures of the blood samples received from neonates with suspected sepsis was performed and antimicrobial susceptibility testing of blood culture positive neonates was done. Antibiotic sensitivity tests were done as per Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines.
Results
Of the 100 participants, 34 were early onset neonatal sepsis and 66 were late onset neonatal sepsis. 35 % of the delivery were vaginal whereas 65 % of the deliveries were by Caesarean section. 17 % of the total neonates delivered had to undergo neonatal resuscitation and 36 % of the neonates had birth asphyxia. The most commonly isolated organisms were Coagulase-negative Staphylococcus species (CoNS) (30 %) followed by Klebsiella pneumoniae (21 %) and Acinetobacter baumannii complex (20 %). 45.1 % were Extended Spectrum beta lactamase (ESBL) producers and 58 % were AmpC beta lactamases producers.
Case fatality rate was highest with Klebsiella pneumoniae i.e. 34.6 % followed by Acinetobacter baumannii complex i.e. 23.07 %.
Conclusion
Increase in antibiotic resistance organisms can lead to an increase in the neonatal case fatality rate (CFR), so regular surveillance is needed. Comparison between the resistance profile between inborn and outborn neonates provides an insight into the difference in the variety of organisms isolated and also the difference in resistance shown by community acquired and hospital acquired organisms.
{"title":"Antimicrobial resistance in blood culture proven sepsis in outborn and inborn neonates","authors":"Alisha Mahajan , Varsha Gupta , Suksham Jain","doi":"10.1016/j.ijmmb.2025.101023","DOIUrl":"10.1016/j.ijmmb.2025.101023","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal sepsis is a major cause of mortality and morbidity, representing a critical emergency that demands swift diagnosis and intervention. Recent trend shows increasing resistance to commonly used antibiotics.</div></div><div><h3>Aims and objectives</h3><div>To study the antimicrobial resistance pattern in blood culture positive neonatal sepsis in outborn and inborn neonates and to compare the clinical profile in neonates with proven sepsis.</div></div><div><h3>Methods</h3><div>Bacterial cultures of the blood samples received from neonates with suspected sepsis was performed and antimicrobial susceptibility testing of blood culture positive neonates was done. Antibiotic sensitivity tests were done as per Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines.</div></div><div><h3>Results</h3><div>Of the 100 participants, 34 were early onset neonatal sepsis and 66 were late onset neonatal sepsis. 35 % of the delivery were vaginal whereas 65 % of the deliveries were by Caesarean section. 17 % of the total neonates delivered had to undergo neonatal resuscitation and 36 % of the neonates had birth asphyxia. The most commonly isolated organisms were Coagulase-negative Staphylococcus species (CoNS) (30 %) followed by <em>Klebsiella pneumoniae</em> (21 %) and <em>Acinetobacter baumannii complex</em> (20 %). 45.1 % were Extended Spectrum beta lactamase (ESBL) producers and 58 % were AmpC beta lactamases producers.</div><div>Case fatality rate was highest with <em>Klebsiella pneumoniae</em> i.e. 34.6 % followed by <em>Acinetobacter baumannii complex</em> i.e. 23.07 %.</div></div><div><h3>Conclusion</h3><div>Increase in antibiotic resistance organisms can lead to an increase in the neonatal case fatality rate (CFR), so regular surveillance is needed. Comparison between the resistance profile between inborn and outborn neonates provides an insight into the difference in the variety of organisms isolated and also the difference in resistance shown by community acquired and hospital acquired organisms.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101023"},"PeriodicalIF":1.3,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdominal tuberculosis (TB) poses diagnostic difficulties due to its vague symptoms and low bacterial load. Culture, the gold standard, is limited by a prolonged turnaround time of up to eight weeks. Xpert MTB/RIF Ultra (Xpert Ultra), a rapid, automated molecular test, can detect Mycobacterium tuberculosis and rifampicin resistance in under two hours. This study evaluated the diagnostic accuracy of Xpert Ultra for abdominal TB using both culture and a composite reference standard (CRS), and assessed its agreement in rifampicin resistance detection with phenotypic and genotypic drug susceptibility testing (DST).
Methods
A prospective observational study was conducted from September 2019 to March 2021 at a tertiary care centre in North India. Adults with clinical and radiological features of abdominal TB were enrolled. Relevant abdominal samples were collected and tested using smear, culture (BACTEC MGIT 960), Xpert Ultra, histopathology, and clinical response. Rifampicin resistance was confirmed using MGIT 960 and GenoType MTBDRplus.
Results
Of 176 eligible patients, 144 were enrolled, yielding 152 abdominal samples: lymph node aspirates (52%), biopsies (42.8%), pus/aspirates (3.3%), and ascitic/omental fluids (2%). Xpert Ultra showed 84% diagnostic accuracy against CRS and 75% against culture. Rifampicin resistance detection showed 100% concordance with both phenotypic and genotypic DST.
Conclusion
Xpert Ultra offers high diagnostic accuracy and excellent concordance in rifampicin resistance detection for abdominal TB. Its speed and reliability make it a valuable diagnostic tool in high-burden settings.
{"title":"Diagnostic accuracy of Xpert MTB/RIF Ultra for abdominal tuberculosis in a tertiary care setting in North India","authors":"Anuj Pathak , Reena Raveendran , Jaswinder Kaur Oberoi , Chand Wattal , Anil Arora , Vikas Singla","doi":"10.1016/j.ijmmb.2025.101008","DOIUrl":"10.1016/j.ijmmb.2025.101008","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal tuberculosis (TB) poses diagnostic difficulties due to its vague symptoms and low bacterial load. Culture, the gold standard, is limited by a prolonged turnaround time of up to eight weeks. Xpert MTB/RIF Ultra (Xpert Ultra), a rapid, automated molecular test, can detect Mycobacterium tuberculosis and rifampicin resistance in under two hours. This study evaluated the diagnostic accuracy of Xpert Ultra for abdominal TB using both culture and a composite reference standard (CRS), and assessed its agreement in rifampicin resistance detection with phenotypic and genotypic drug susceptibility testing (DST).</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted from September 2019 to March 2021 at a tertiary care centre in North India. Adults with clinical and radiological features of abdominal TB were enrolled. Relevant abdominal samples were collected and tested using smear, culture (BACTEC MGIT 960), Xpert Ultra, histopathology, and clinical response. Rifampicin resistance was confirmed using MGIT 960 and GenoType MTBDRplus.</div></div><div><h3>Results</h3><div>Of 176 eligible patients, 144 were enrolled, yielding 152 abdominal samples: lymph node aspirates (52%), biopsies (42.8%), pus/aspirates (3.3%), and ascitic/omental fluids (2%). Xpert Ultra showed 84% diagnostic accuracy against CRS and 75% against culture. Rifampicin resistance detection showed 100% concordance with both phenotypic and genotypic DST.</div></div><div><h3>Conclusion</h3><div>Xpert Ultra offers high diagnostic accuracy and excellent concordance in rifampicin resistance detection for abdominal TB. Its speed and reliability make it a valuable diagnostic tool in high-burden settings.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101008"},"PeriodicalIF":1.3,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1016/j.ijmmb.2025.101009
Shikhir Malhotra, Vibhor Tak
{"title":"Recurrent MALDI-TOF MS identification failure for Sphingomonas paucimobilis from blood cultures: A single-center observation","authors":"Shikhir Malhotra, Vibhor Tak","doi":"10.1016/j.ijmmb.2025.101009","DOIUrl":"10.1016/j.ijmmb.2025.101009","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101009"},"PeriodicalIF":1.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Measles virus (MeV) transmission pathways can be traced via molecular surveillance based on the N-450 region of the Nucleocapsid gene of the virus. Genetic characterization of MeV can identify the circulating genotypes in a given area and provide insights into vaccine efficacy on them.
Objective
India is a vast country where molecular surveillance data on circulating MeV from all states can help gauge vaccination coverage in the elimination settings of measles. The aim of the study was genetic characterization of circulating MeV in Jharkhand and evaluate the effectiveness of vaccination drives.
Study design
Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was employed to detect MeV RNA in samples used for molecular testing. The positive RT-PCR products were sequenced, phylogenetic analysis performed, and submitted in the MeaNS2 (Measles Nucleotide Surveillance2) database.
Results
113 of the 788 molecular samples from 788 cases tested positive by RT-PCR, and sequencing was carried out on these samples. 82 samples yielded good sequences on which phylogenetic analysis was done. All sequences clustered around MANCHES.UNK94 of D8 genotype. 13 Distinct Sequence Identifier (DSId) within D8 genotype identified. The maximum cases were less than 5 years of age. No vaccine strains were identified.
Conclusions
Molecular surveillance data based on virus detection and genotyping helped to identify the circulating genotype of MeV, which is the D8 genotype in Jharkhand. Many DSIds indicate lineages of the current D8 genotype, which can be controlled with existing vaccines. Immunity gaps need to be addressed by stringent vaccination coverage.
{"title":"Genetic characterization of measles virus circulating in Jharkhand","authors":"Aparna Aparajita , Ashok Kumar Sharma , Nikesh Sinha , Kumari Seema , Abhay Kumar , Manju Boipai , Manoj Kumar","doi":"10.1016/j.ijmmb.2025.101006","DOIUrl":"10.1016/j.ijmmb.2025.101006","url":null,"abstract":"<div><h3>Background</h3><div>Measles virus (MeV) transmission pathways can be traced via molecular surveillance based on the N-450 region of the Nucleocapsid gene of the virus. Genetic characterization of MeV can identify the circulating genotypes in a given area and provide insights into vaccine efficacy on them.</div></div><div><h3>Objective</h3><div>India is a vast country where molecular surveillance data on circulating MeV from all states can help gauge vaccination coverage in the elimination settings of measles. The aim of the study was genetic characterization of circulating MeV in Jharkhand and evaluate the effectiveness of vaccination drives.</div></div><div><h3>Study design</h3><div>Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was employed to detect MeV RNA in samples used for molecular testing. The positive RT-PCR products were sequenced, phylogenetic analysis performed, and submitted in the MeaNS2 (Measles Nucleotide Surveillance2) database.</div></div><div><h3>Results</h3><div>113 of the 788 molecular samples from 788 cases tested positive by RT-PCR, and sequencing was carried out on these samples. 82 samples yielded good sequences on which phylogenetic analysis was done. All sequences clustered around MANCHES.UNK94 of D8 genotype. 13 Distinct Sequence Identifier (DSId) within D8 genotype identified. The maximum cases were less than 5 years of age. No vaccine strains were identified.</div></div><div><h3>Conclusions</h3><div>Molecular surveillance data based on virus detection and genotyping helped to identify the circulating genotype of MeV, which is the D8 genotype in Jharkhand. Many DSIds indicate lineages of the current D8 genotype, which can be controlled with existing vaccines. Immunity gaps need to be addressed by stringent vaccination coverage.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 101006"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lacrimal canaliculitis is an infection of the lacrimal canaliculus, often caused by bacteria, including species of Actinomyces. This report presents a unique instance of lacrimal canaliculitis instigated by the rare periodontal pathogen, Fusobacterium periodonticum, in a 49-year-old female homemaker. To the best of our knowledge, this is the first documented culture-confirmed case report of lacrimal canaliculitis associated with F. periodonticum.
{"title":"Lacrimal canaliculitis caused by Fusobacterium periodonticum: A rare clinical encounter","authors":"Ishleen Pahwa , Padmaja Ananth Shenoy , Neetha I.R. Kuzhuppilly , Shashidhar Vishwanath","doi":"10.1016/j.ijmmb.2025.101003","DOIUrl":"10.1016/j.ijmmb.2025.101003","url":null,"abstract":"<div><div>Lacrimal canaliculitis is an infection of the lacrimal canaliculus, often caused by bacteria, including species of <em>Actinomyces</em>. This report presents a unique instance of lacrimal canaliculitis instigated by the rare periodontal pathogen, <em>Fusobacterium periodonticum,</em> in a 49-year-old female homemaker. To the best of our knowledge, this is the first documented culture-confirmed case report of lacrimal canaliculitis associated with <em>F. periodonticum</em>.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 101003"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ijmmb.2025.100946
Kamran Zaman , Jyothi Bhat , Subarna Roy
{"title":"Enhancing the diagnostic and surveillance framework for acute encephalitis syndrome in resource-limited settings","authors":"Kamran Zaman , Jyothi Bhat , Subarna Roy","doi":"10.1016/j.ijmmb.2025.100946","DOIUrl":"10.1016/j.ijmmb.2025.100946","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 100946"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ijmmb.2025.101007
Rajalakshmi Preethi G , G. Vithiya , Vanishree Balaji , P. Shunmuga Sundaram , T. Rajendran , V. Mangayarkarasi
Spleen and liver are the most commonly affected extrapulmonary visceral organs in melioidosis. We present the clinical features and outcome of nineteen cases of hepatosplenic abscess due to Burkholderia pseudomallei reported between 2015 and 2023. Isolated liver abscess, isolated splenic involvement and concurrent liver and spleen abscess were seen in 5 (26 %), 7 (37 %) and 7 (37 %) patients correspondingly. Honeycomb sign was seen in 10 (83 %) patients with liver abscess. Splenic involvement in the form multiple microabscesses was seen in 4 (29 %) patients and multiple larger discrete and coalescent abscesses in 10 (71 %) patients. Seventeen patients recovered with treatment.
{"title":"Hepatosplenic abscess due to Burkholderia pseudomallei-a retrospective review of nineteen cases from a tertiary care centre in South India","authors":"Rajalakshmi Preethi G , G. Vithiya , Vanishree Balaji , P. Shunmuga Sundaram , T. Rajendran , V. Mangayarkarasi","doi":"10.1016/j.ijmmb.2025.101007","DOIUrl":"10.1016/j.ijmmb.2025.101007","url":null,"abstract":"<div><div>Spleen and liver are the most commonly affected extrapulmonary visceral organs in melioidosis. We present the clinical features and outcome of nineteen cases of hepatosplenic abscess due to <em>Burkholderia pseudomallei</em> reported between 2015 and 2023. Isolated liver abscess, isolated splenic involvement and concurrent liver and spleen abscess were seen in 5 (26 %), 7 (37 %) and 7 (37 %) patients correspondingly. Honeycomb sign was seen in 10 (83 %) patients with liver abscess. Splenic involvement in the form multiple microabscesses was seen in 4 (29 %) patients and multiple larger discrete and coalescent abscesses in 10 (71 %) patients. Seventeen patients recovered with treatment.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 101007"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/S0255-0857(25)00227-0
{"title":"Aims and Scope","authors":"","doi":"10.1016/S0255-0857(25)00227-0","DOIUrl":"10.1016/S0255-0857(25)00227-0","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 101014"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urinary tract infections (UTIs) are prevalent in pregnancy and may contribute to problems including pyelonephritis, premature labour, and low birth weight. Rising antimicrobial resistance has impacted the efficiency of conventional oral antibiotics, emphasising the significance of alternatives, such as fosfomycin. To determine the frequency of fosfomycin resistance in uropathogens isolated from pregnant women, evaluate their antimicrobial susceptibility, and identify fosA and fosA3 resistance genes.
Methods
A prospective, hospital-based investigation was conducted that included midstream urine samples from 250 pregnant women were processed using conventional microbiological methods. Antimicrobial susceptibility was determined using the Kirby-Bauer disc diffusion technique. Agar dilution was used to estimate fosfomycin minimum inhibitory concentrations (MICs). PCR was used to identify the fosA and fosA3 genes in phenotypically resistant isolates.
Results
Out of 250 samples, 118 (47.2 %) showed significant bacteriuria. Escherichia coli (35.9 %) was the most common isolate, followed by Klebsiella pneumoniae (24.4 %) and Enterococcus faecalis (19.2 %). Resistance to ampicillin and amoxicillin-clavulanate was found to be high. Fosfomycin showed 96.2 % susceptibility by disc diffusion. MIC analysis indicated that the majority of E. coli and Enterococcus isolates had low MICs. No fosA or fosA3 genes were found in resistant isolates, suggesting that resistance is due to non-plasmid processes.
Conclusions
Fosfomycin remains effective against uropathogens in pregnant women, with no plasmid-mediated resistance found in this North Indian cohort. Its single-dose administration provides a compliance benefit, particularly in low-resource prenatal care settings. Continued regional surveillance and antimicrobial management are required to maintain its effectiveness and guide empirical treatment throughout pregnancy.
{"title":"Phenotypic and genotypic profiling of fosfomycin susceptibility in urinary pathogens isolated from pregnant women in North India","authors":"Nandini Mishra , Sheetal Verma , Vimala Venkatesh , R.K. Kalyan , Rashmi , Upma Singh , Anjoo Agarwaj","doi":"10.1016/j.ijmmb.2025.101005","DOIUrl":"10.1016/j.ijmmb.2025.101005","url":null,"abstract":"<div><h3>Purpose</h3><div>Urinary tract infections (UTIs) are prevalent in pregnancy and may contribute to problems including pyelonephritis, premature labour, and low birth weight. Rising antimicrobial resistance has impacted the efficiency of conventional oral antibiotics, emphasising the significance of alternatives, such as fosfomycin. To determine the frequency of fosfomycin resistance in uropathogens isolated from pregnant women, evaluate their antimicrobial susceptibility, and identify <em>fosA</em> and <em>fosA3</em> resistance genes.</div></div><div><h3>Methods</h3><div>A prospective, hospital-based investigation was conducted that included midstream urine samples from 250 pregnant women were processed using conventional microbiological methods. Antimicrobial susceptibility was determined using the Kirby-Bauer disc diffusion technique. Agar dilution was used to estimate fosfomycin minimum inhibitory concentrations (MICs). PCR was used to identify the <em>fosA</em> and <em>fosA3</em> genes in phenotypically resistant isolates.</div></div><div><h3>Results</h3><div>Out of 250 samples, 118 (47.2 %) showed significant bacteriuria. <em>Escherichia coli</em> (35.9 %) was the most common isolate, followed by <em>Klebsiella pneumoniae</em> (24.4 %) and <em>Enterococcus faecalis</em> (19.2 %). Resistance to ampicillin and amoxicillin-clavulanate was found to be high. Fosfomycin showed 96.2 % susceptibility by disc diffusion. MIC analysis indicated that the majority of E. coli and Enterococcus isolates had low MICs. No <em>fosA</em> or <em>fosA3</em> genes were found in resistant isolates, suggesting that resistance is due to non-plasmid processes.</div></div><div><h3>Conclusions</h3><div>Fosfomycin remains effective against uropathogens in pregnant women, with no plasmid-mediated resistance found in this North Indian cohort. Its single-dose administration provides a compliance benefit, particularly in low-resource prenatal care settings. Continued regional surveillance and antimicrobial management are required to maintain its effectiveness and guide empirical treatment throughout pregnancy.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"58 ","pages":"Article 101005"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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