1887

Abstract

Drug-resistance due to AmpC β-lactamases represents a growing problem worldwide. In this study, a previously collected sample of 108 cefoxitin-resistant clinical isolates was assessed for AmpC β-lactamase production through routine phenotypic testing and double-disc cefoxitin/cloxcallin (DD-CC), cefoxitin/phenylboronic acid (CDT-PBA) and AmpC disc tests. The same isolates were characterized by a novel multiplex polymerase chain reaction molecular assay to detect the presence of blaACT , blaDHA , blaCIT , blaFOX , blaMIR and blaMOX. By phenotypic analysis, 56%, 55% and 48 % were detected as being AmpC β-lactamase producers by the CDT-PBA, DD-CC and AmpC disc tests, respectively. By molecular analysis, 57  % were determined to be AmpC β-lactamase producers, including 34 % blaFOX , 8 % blaCIT and 1.6 % blaDHA as mono-AmpC producers. The production of multiple AmpC molecular types was common, including 30 % with both blaCIT+FOX  and 1.6 % each of blaCIT+DHA , blaACT+MIR , blaACT+FOX , blaACT+DHA and blaMIR+FOX . Molecular characterization of AmpC would help detect the prevalence of AmpC β-lactamase producers, facilitate proper patient management and implement infection control practices.

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/content/journal/micro/10.1099/mic.0.000748
2018-12-13
2024-11-14
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References

  1. Soha AE, Lamiaa AA. Occurrence and detection of AmpC β-lactamases among Enterobacteriaceae isolates from patients at Ain Shams University Hospital. Egypt J Med Hum Genet 2015; 16:239–244
    [Google Scholar]
  2. Manoharan A, Sugumar M, Kumar A, Jose H, Mathai D et al. Phenotypic & molecular characterization of AmpC β-lactamases among Escherichia coli, Klebsiella spp. & Enterobacter spp. from five Indian Medical Centers. Indian J Med Res 2012; 135:359–364[PubMed]
    [Google Scholar]
  3. Tamma PD, Girdwood SC, Gopaul R, Tekle T, Roberts AA et al. The use of cefepime for treating AmpC β-lactamase-producing Enterobacteriaceae. Clin Infect Dis 2013; 57:781–788 [View Article][PubMed]
    [Google Scholar]
  4. Ingram PR, Vanzetti TR, Murray RJ, Inglis TJJ, Harnett GB et al. Comparison of methods for AmpC β-lactamase detection in Enterobacteriaceae. J Med Microbiol 2011; 60:715–721 [View Article]
    [Google Scholar]
  5. Pérez-Pérez FJ, Hanson ND. Detection of plasmid-mediated AmpC beta-lactamase genes in clinical isolates by using multiplex PCR. J Clin Microbiol 2002; 40:2153–2162 [View Article][PubMed]
    [Google Scholar]
  6. Barua T, Shariff M, Thukral SS. Detection and characterization of AmpC -lactamases in Indian Clinical Isolates of Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca. Univers J Microbiol Res 2013; 1:15–21
    [Google Scholar]
  7. Doi Y, Wachino J, Ishiguro M, Kurokawa H, Yamane K et al. Inhibitor-sensitive AmpC beta-lactamase variant produced by an Escherichia coli clinical isolate resistant to oxyiminocephalosporins and cephamycins. Antimicrob Agents Chemother 2004; 48:2652–2658 [View Article][PubMed]
    [Google Scholar]
  8. Wassef M, Behiry I, Younan M, El Guindy N, Mostafa S et al. Genotypic identification of AmpC β-lactamases production in Gram-negative bacilli isolates. Jundishapur J Microbiol 2014; 7:e8556 [View Article][PubMed]
    [Google Scholar]
  9. Black JA, Moland ES, Thomson KS. AmpC disk test for detection of plasmid-mediated AmpC beta-lactamases in Enterobacteriaceae lacking chromosomal AmpC beta-lactamases. J Clin Microbiol 2005; 43:3110–3113 [View Article][PubMed]
    [Google Scholar]
  10. CLSI Clinical Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Nineteenth Information Supplement, M100–S23. Wayne, PA: 2013
    [Google Scholar]
  11. Yong D, Park R, Yum JH, Lee K, Choi EC et al. Further modification of the Hodge test to screen AmpC beta-lactamase (CMY-1)-producing strains of Escherichia coli and Klebsiella pneumoniae. J Microbiol Methods 2002; 51:407–410 [View Article][PubMed]
    [Google Scholar]
  12. Gupta G, Tak V, Mathur P. Detection of ampc β lactamases in Gram-negative bacteria. J Lab Physicians 2014; 6:1-6 [View Article][PubMed]
    [Google Scholar]
  13. Japoni-Nejad A, Ghaznavi-Rad E, van Belkum A. Characterization of plasmid-mediated AmpC and carbapenemases among iranain nosocomial isolates of Klebsiella pneumoniae using phenotyping and genotyping methods. Osong Public Health Res Perspect 2014; 5:333–338 [View Article][PubMed]
    [Google Scholar]
  14. Upadhyay S, Sen MR, Bhattacharjee A. Diagnostic utility of boronic acid inhibition with different cephalosporins against Escherichia coli producing AmpC β-lactamases. J Med Microbiol 2011; 60:691–693 [View Article][PubMed]
    [Google Scholar]
  15. Joseph NM, Mathias S. Challenges in detection of AmpC β-lactamases among Enterobacteriaceae. Indian J Med Res 2013; 137:216–217[PubMed]
    [Google Scholar]
  16. Grover N, Sahni AK, Bhattacharya S. Therapeutic challenges of ESBLS and AmpC beta-lactamase producers in a tertiary care center. Med J Armed Forces India 2013; 69:4–10 [View Article][PubMed]
    [Google Scholar]
  17. Thakar V, Modak M. Comparison of various methods for detection of AmpC β-lactamase enzyme. J Acad Clin Microbio 2013; 15:45–48 [View Article]
    [Google Scholar]
  18. Arena F, Giani T, Becucci E, Conte V, Zanelli G et al. Large oligoclonal outbreak due to Klebsiella pneumoniae ST14 and ST26 producing the FOX-7 AmpC β-lactamase in a neonatal intensive care unit. J Clin Microbiol 2013; 51:4067–4072 [View Article][PubMed]
    [Google Scholar]
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