Prevalence of silver resistance determinants and extended-spectrum β-lactamases in bacterial species causing wound infection: First report from Bangladesh

Kazi Sarjana Safain; Mohammad Sazzadul Islam; Jumanah Amatullah; Mohammad Al Mahmud-Un-Nabi; Golam Sarower Bhuyan; Jakia Rahman; Suprovath Kumar Sarker; Md Tarikul Islam; Rosy Sultana; Firdausi Qadri; Kaiissar Mannoor

doi:10.1016/j.nmni.2023.101104

Prevalence of silver resistance determinants and extended-spectrum β-lactamases in bacterial species causing wound infection: First report from Bangladesh

New Microbes New Infect. 2023 Feb 23:52:101104. doi: 10.1016/j.nmni.2023.101104. eCollection 2023 Mar.

Authors

Kazi Sarjana Safain^{1

2}, Mohammad Sazzadul Islam^{3

4}, Jumanah Amatullah^{1

2}, Mohammad Al Mahmud-Un-Nabi¹, Golam Sarower Bhuyan¹, Jakia Rahman^{1

2}, Suprovath Kumar Sarker³, Md Tarikul Islam³, Rosy Sultana^{1

5}, Firdausi Qadri^{1

3

6}, Kaiissar Mannoor^{1

3}

Affiliations

¹ Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.
² Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh.
³ Genetics and Genomics Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.
⁴ Department of Biochemistry and Molecular Biology, Jagannath University, Dhaka, Bangladesh.
⁵ Department of Immunology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
⁶ Department of Enteric and Respiratory Infectious Diseases, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Abstract

Background: The use of silver is rapidly rising in wound care and silver-containing dressings are widely used along with other antibiotics, particularly β-lactams. Consequently, concerns are being raised regarding the emergence of silver-resistance and cross-resistance to β-lactams. Therefore, this study aimed to determine the phenotypic and genotypic profiles of silver-resistance and extended-spectrum β-lactamases in isolates from chronic wounds.

Methods: 317 wound swab specimens were collected from tertiary hospitals of Dhaka city and analysed for the microbial identification. The antibiotic resistance/susceptibility profiles were determined and phenotypes of silver resistant isolates were examined. The presence of silver-resistance (sil) genes (silE, silP, and silS) and extended-spectrum β-lactamases (ESBL) (CTX-M-1, NDM-1, KPC, OXA-48, and VIM-1) were explored in isolated microorganisms.

Results: A total of 501 strains were isolated with Staphylococcus aureus (24%) as the predominant organism. In 29% of the samples, polymicrobial infections were observed. A large proportion of Enterobacterales (59%) was resistant to carbapenems and a significantly high multiple antibiotic-resistance indexes (>0.2) were seen for 53% of organisms (P < 0.001). According to molecular analysis, the most prevalent types of ESBL and sil gene were CTX-M-1 (47%) and silE (42%), respectively. Furthermore, phenotypic silver-nitrate susceptibility testing showed significant minimum-inhibitory-concentration patterns between sil-negative and sil-positive isolates. We further observed co-occurrence of silver-resistance determinants and ESBLs (65%).

Conclusions: Notably, this is the first-time detection of silver-resistance along with its co-detection with ESBLs in Bangladesh. This research highlights the need for selecting appropriate treatment strategies and developing new alternative therapies to minimize microbial infection in wounds.

Keywords: Co-occurrence; Extended-spectrum β-lactamase; Low-income countries; Silver resistance; Wound infection.