Introduction: Lifesaving antibiotics pose an emerging risk in the health sector. Lactobacillus spp., a usual non-pathogenic bacteria is capable of causing infection in immunocompromised condition. In this study, Lactobacillus spp. been isolated from the faeces of infants with Hirschsprung disease (HD), which is a congenital aganglionosis of intestine, where surgical approach and antibiotics are frequently used as medical intervention. Antibiotic resistance pattern and the presence of resistance genes along with the behavioral changes of the isolated Lactobacillus spp. from HD infants with ileostomy has been assessed here.

Methodology: Six Lactobacillus spp. were isolated from faeces of six HD infants and confirmed using conventional and molecular methods. For antibiotic resistance pattern, disc diffusion method and investigation for the presence of antibiotic resistance genes (bla_TEM, bla_CTX-M, bla_OXA-2, bla_IMP, bla_VIM-2, bla_NDM-1 and mcr-1) was done. Furthermore, evaluation for the formation of stress-protein by SDS-PAGE under pH stress and the effect of isolates towards the growth of Escherichia coli and Vibrio cholerae were done using in vitro culture media and in vivo mouse model systems.

Results: The isolates showed high level of resistance towards cephalosporins, oxacillin, aztreonam, meropenem and polymyxin group. However, four of them showed the presence of bla_CTX-M gene after PCR amplification. Other results included, presence of 95KDa band in one isolate, 24KDa, 31KDa and 142KDa bands in another under pH stress (pH 8), and capability to inhibit E. coli and V. cholerae in co-culture under in vitro and in vivo experiment.

Conclusion: To current knowledge, this study is the first report on presence of antibiotic resistance gene bla_CTX-M in Lactobacillus spp. that can pose risk in treatment. This findings can shed new light on antibiotic resistance research in gut microflora. The study also indicates the gut condition can influence complications like entercolitis by causing dysbiosis of gut bacteria.

 

Key words: Hirschsprung; antibiotic resistance; Lactobacillus; bla_CTX-M.