Association of Virulence with Antimicrobial Resistance among Isolated from Hospital Settings in Bangladesh.

INTRODUCTION

Infections caused by multidrug-resistant (MDR) hypervirulent are difficult to treat and associated with high mortality rates. Hence, this study was conducted to determine the antibiotic resistance pattern along with the distribution of virulence genes among isolated string test positive and negative strains.

MATERIALS AND METHODS

A total of 44 . strains were isolated following standard microbiological methods from 350 different clinical samples from patients admitted to Dhaka Medical College Hospital, Bangladesh. String test was done to detect the hypermucoid phenotype. Antimicrobial resistance (AMR) pattern was determined by dichlorodiphenyltrichloroethane (except colistin and fosfomycin) among all isolates. Polymerase chain reaction was done to detect the hypervirulence genes (, , , ).

RESULTS

In this study, 21/44 (47.73%) of the isolated . were string test positive and distribution of the virulence genes except was higher among them. A total of 15/44 (34.09%) of the isolated . were MDR, 10/44 (22.73%) were extensively drug resistant, 1/44 (2.27%) was pan drug resistant, and 14/44 (31.82%) were colistin resistant. Isolated organisms were highly resistant to third-generation cephalosporins and most sensitive to fosfomycin in this study. Although all the string test positive strains showed higher resistance rates than the string test negative ones toward most of the tested antibiotics, only the differences of resistance rates to amoxiclav and tigecycline among the two phenotypes were statistically significant.

CONCLUSION

Our findings highlight the importance of surveillance of the AMR pattern of hypervirulent . in clinical samples. Therefore, a response to check the global dissemination of this hypervirulent with resistance determinants is urgently needed.