{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:26:46Z","timestamp":1777922806224,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2017,7]]},"abstract":"\n The antibiotic, trimethoprim\u2013sulfamethoxazole (TMP-SMX), is generally used for prophylaxis in HIV individuals to protect them from\n Pneumocystis jiroveci<\/jats:italic>\n infection. Long-term use of TMP-SMX develops drug resistance among bacteria in HIV patients. The study was aimed to detect the TMP-SMX resistance genes among gram-negative bacteria from HIV patients. TMP-SMX-resistant isolates were detected by the Kirby-Bauer disc diffusion method. While TMP resistance genes such as\n dfrA1<\/jats:italic>\n ,\n dfrA5<\/jats:italic>\n ,\n dfrA7<\/jats:italic>\n , and\n dfrA17<\/jats:italic>\n and SMX resistance genes such as\n sul1<\/jats:italic>\n and\n sul2<\/jats:italic>\n were detected by multiplex PCR, class 1 and class 2 integrons were detected by standard monoplex PCR. Of the 151 TMP-SMX-resistant bacterial isolates, 3 were positive for\n sul1<\/jats:italic>\n alone, 48 for\n sul2<\/jats:italic>\n alone, 11 for\n dfrA7<\/jats:italic>\n alone, 21 for\n sul1<\/jats:italic>\n and\n sul2<\/jats:italic>\n , 1 for\n sul1<\/jats:italic>\n and\n dfrA7<\/jats:italic>\n , 23 for\n sul2<\/jats:italic>\n and\n dfrA7<\/jats:italic>\n , 2 for\n sul2<\/jats:italic>\n and\n dfrA5<\/jats:italic>\n , 41 for\n sul1<\/jats:italic>\n ,\n sul2<\/jats:italic>\n , and\n dfrA7<\/jats:italic>\n , and 1 for s\n ul2<\/jats:italic>\n ,\n dfrA5<\/jats:italic>\n , and\n dfrA7<\/jats:italic>\n . Of 60 TMP-SMX-resistant isolates positive for integrons, 44 had class 1 and 16 had class 2 integrons. It was found that the prevalence of\n sul<\/jats:italic>\n genes (\n n<\/jats:italic>\n \u2009=\u2009202;\n p<\/jats:italic>\n \u2009<\u20090.001) was higher compared with\n dfr<\/jats:italic>\n genes (\n n<\/jats:italic>\n \u2009=\u200980;\n p<\/jats:italic>\n \u2009<\u20090.001), and 87.4% (\n n<\/jats:italic>\n \u2009=\u2009132;\n p<\/jats:italic>\n \u2009<\u20090.001) of TMP-SMX-resistant isolates also were positive for \u03b2-lactamase production. This type of study is reported for the first time from HIV patients in India. Therefore, this study indicates that dissemination of TMP-SMX resistance genes and class 1 and class 2 integrons along with \u03b2-lactamase production among gram-negative bacteria in HIV patients will certainly make their treatment to bacterial infections more complicated in clinical settings.\n <\/jats:p>","DOI":"10.1089\/mdr.2016.0034","type":"journal-article","created":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T10:31:22Z","timestamp":1479378682000},"page":"602-608","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Dissemination of Trimethoprim\u2013Sulfamethoxazole Drug Resistance Genes Associated with Class 1 and Class 2 Integrons Among Gram-Negative Bacteria from HIV Patients in South India"],"prefix":"10.1177","volume":"23","author":[{"given":"Marimuthu Ragavan","family":"Ramesh Kumar","sequence":"first","affiliation":[{"name":"Presidency College (Autonomous)","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narasingam","family":"Arunagirinathan","sequence":"additional","affiliation":[{"name":"Presidency College (Autonomous)","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seetharaman","family":"Srivani","sequence":"additional","affiliation":[{"name":"University of Madras","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aridoss","family":"Dhanasezhian","sequence":"additional","affiliation":[{"name":"University of Madras","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nallusamy","family":"Vijaykanth","sequence":"additional","affiliation":[{"name":"Presidency College (Autonomous)","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natesan","family":"Manikandan","sequence":"additional","affiliation":[{"name":"Presidency College (Autonomous)","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sethuramalingam","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Presidency College (Autonomous)","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramachandran","family":"Vignesh","sequence":"additional","affiliation":[{"name":"Voluntary Health Services Hospital Campus","place":["India"]},{"name":"Universiti Kuala Lumpur Royal College of Medicine Perak (UniKL RCMP)","place":["Malaysia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pachamuthu","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Voluntary Health Services Hospital Campus","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suniti","family":"Solomon","sequence":"additional","affiliation":[{"name":"Voluntary Health Services Hospital Campus","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil S.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Voluntary Health Services Hospital Campus","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,7]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"1","article-title":"Surveillance for AIDS-defining opportunistic illnesses, 1992\u20131997","volume":"48","author":"Jones J.L.","year":"1999","unstructured":"Jones J.L., , Hanson D.L., , Dworkin M.S., , Aldeston D.L., , Fleming P.L., , Kaplan J.E., , and Ward J.. 1999. 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Med., 327:1842\u20131848.","journal-title":"N. Engl. J. Med."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17442-4"},{"key":"e_1_3_2_5_2","unstructured":"World Health Organization. 2000. Provisional WHO\/UNAIDS Secretariat Recommendations on the Use of Cotrimoxazole Prophylaxis in Adults and Children Living with HIV\/AIDS in Africa. WHO\/UNAIDS Geneva Switzerland."},{"key":"e_1_3_2_6_2","unstructured":"World Health Organization. 2006. Guidelines on Co-trimoxazole Prophylaxis for HIV Related Infections Among Children Adolescents and Adults: Recommendations for a Public Health Approach. WHO\/UNAIDS Geneva Switzerland."},{"key":"e_1_3_2_7_2","first-page":"1809","article-title":"Emergence of trimethoprim-sulfamethoxazole resistance in the AIDS era","volume":"180","author":"Martin J.N.","year":"1999","unstructured":"Martin J.N., , Rose D.A., , Hadley W.K., , Perdreau-Remington F., , Lam P.K., , and Gerberding J.L.. 1999. 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