Plasmid Derived AmpC Genotypes among the Multidrug Resistant Enterobacteriaceae Strains Isolated from Urine Samples in Southern India
Introduction: The most common pathogens causing Urinary Tract Infections (UTI) in community and hospital settings are Enterobacteriaceae. Antibiotic resistance is a major problem worldwide because of an increase in the use of antibiotics. Production of Extended Spectrum Beta-Lactamases (ESBLs)...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2021-06-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://www.jcdr.net/articles/PDF/14964/48194_CE[Ra]_F(Sh)_PF1(SC_SL)_PN(KM).pdf |
Summary: | Introduction: The most common pathogens causing Urinary
Tract Infections (UTI) in community and hospital settings are
Enterobacteriaceae. Antibiotic resistance is a major problem
worldwide because of an increase in the use of antibiotics.
Production of Extended Spectrum Beta-Lactamases (ESBLs)
and AmpC beta-lactamases is the most common cause of
resistance among Enterobacteriaceae (AmpC). Initially, AmpC
b-lactamases received less attention globally, but now it has
become a rising problem. Detection of AmpC β-lactamases
expressing microbes is a requirement for addressing
surveillance, for problems of hospital infection control, and for
choosing optimal antimicrobial therapy.
Aim: To study the genotype distribution of plasmid mediated
AmpC β-lactamase produced in Enterobacteriaceae strains
isolated from urine samples.
Materials and Methods: A cross-sectional study based on
clinical laboratory surveillance was conducted from July 2019
to February 2020. Sixty Enterobacteriaceae isolates were
identified by standard biochemical reactions. AmpC screening
were done by cefoxitin disk diffusion and confirmed by an
inhibitor-based assay using boronic acid. The presence of six
plasmid mediated AmpC genes was determined by multiplex
Polymerase Chain Reaction (PCR). Statistical Package for
the Social Science (SPSS) version 20.0 was used to obtain
descriptive data.
Results: Among 60 Enterobacteriaceae isolates, 23 (38.3%)
were cefoxitin-resistant isolates which contain Escherichia coli
strain (n=17) while the remaining samples consist of Klebsiella
pneumoniae (n=5) and Proteus mirabilis strains (n=1). AmpC
β-lactamase production was phenotypically confirmed in
12 (20%) isolates and genotypically confirmed by PCR analysis
in 16 (26.6%) of all the urine isolates. In the present study, 3
(13%), 2 (8.6%) of cefoxitin resistant isolates harboured the
DHA, EBC gene and 1 (4.3%) each harboured FOX and CIT
gene, and 9 (39.1%) harboured a combination of the genes.
Conclusion: The present study suggested the predominant
existence of plasmid mediated AmpC producers in multi-drug
resistant Escherichia coli and Klebsiella pneumoniae. We suggest
continuous surveillance is important to effectively control the
spread of these strains and for optimal clinical outcome. |
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ISSN: | 2249-782X 0973-709X |