Limited efficacy of plazomicin against carbapenem resistant Enterobacterales in a tertiary care centre in Eastern India.

Abstract

The global escalation of carbapenem resistant Enterobacterales (CRE) represents a critical threat to public health, necessitating the investigation of alternative therapeutic agents. Plazomicin, a newer aminoglycoside, was engineered to evade common aminoglycoside-modifying enzymes. This study evaluated the susceptibility of plazomicin among 100 CRE isolates. The findings reveal a strikingly low plazomicin susceptibility rate of only 15/100 (15%). Whole-genome sequencing identified a high prevalence of 16S rRNA methyltransferase (RMTase) genes, such as armA and rmtB1, which confer high-level resistance to plazomicin. These results suggest that plazomicin may have limited utility against CRE in regions where RMTase-mediated resistance is prevalent.