Prevalence of AmpC beta-lactamase and extended spectrum beta-lactamase co-producer in Escherichia coli and Klebsiella species in a teaching hospital.

IF 0.6 4区医学 Q4 PATHOLOGY

Malaysian Journal of Pathology Pub Date : 2024-04-01

S M V Ting, Z Ismail, A Hanafiah

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引用次数: 0

Abstract

Introduction: Beta-lactamase producing bacterial infection has been on surge due to selection pressure and injudicious antibiotics usage. Organisms that co-produced more than one beta lactamase enzyme posed diagnostic challenges which may result in inadequate treatment. To date, there is no standardised guideline offering phenotypic detection of AmpC β-lactamase. The purpose of this study was to determine the prevalence of ESBLs, AmpC β-lactamase and co-producer organisms in a teaching hospital.

Materials and methods: Three hundred and four isolates of E. coli and Klebsiella sp. had been selected via convenient sampling. These isolates were identified using conventional laboratory methods and their antimicrobial susceptibilities were determined using disc diffusion method. Those isolates were then proceeded with ESBL confirmatory test, cloxacillin-containing Muller Hinton confirmatory test, modified double disk synergy test and AmpC disk test.

Results: Out of 304 isolates, 159 isolates were E. coli and 145 were Klebsiella sp. The prevalence of organisms which co-produced AmpC β-lactamase and ESBL enzymes were 3.0%. Besides that, 39 cefoxitin resistant and three cefoxitin susceptible isolates (13.8%) were proven to produce AmpC β-lactamase through AmpC disk test. Through the CLSI confirmatory test, 252 (82.9%) isolates were identified as ESBLs producers and the prevalence increased slightly when cloxacillin-containing Muller Hinton were used. Only three ESBLs positive organisms were positive for modified double disk synergy test.

Conclusion: Distinguishing between AmpC β-lactamase and ESBL-producing organisms has epidemiological significance as well as therapeutic importance. Moreover, AmpC β-lactamase and ESBLs co-producing organisms can lead to false negative ESBL confirmatory test. Therefore, knowing the local prevalence can guide the clinician in navigating the treatment.

本刊更多论文

一家教学医院的大肠埃希菌和克雷伯氏菌中安培C型β-内酰胺酶和广谱β-内酰胺酶共产菌的流行情况。

导言：由于选择压力和滥用抗生素，产生β-内酰胺酶的细菌感染呈上升趋势。同时产生一种以上β-内酰胺酶的细菌给诊断带来了挑战，可能导致治疗不当。迄今为止，还没有提供表型检测 AmpC β-内酰胺酶的标准化指南。本研究旨在确定一家教学医院中ESBLs、AmpC β-内酰胺酶和共产菌的流行情况：通过方便取样的方式，选取了三百零四例大肠埃希氏菌和克雷伯氏菌。采用传统的实验室方法对这些分离物进行鉴定，并采用盘扩散法测定其抗菌药敏感性。然后对这些分离物进行 ESBL 确认试验、含氯西林的 Muller Hinton 确认试验、改良双盘协同作用试验和 AmpC 盘试验：在 304 株分离菌中，159 株为大肠埃希菌，145 株为克雷伯氏菌，同时产生 AmpC β-内酰胺酶和 ESBL 酶的菌株比例为 3.0%。此外，39 个对头孢西丁耐药的分离菌株和 3 个对头孢西丁敏感的分离菌株（13.8%）经 AmpC 磁盘测试证实可产生 AmpC β-内酰胺酶。通过 CLSI 确认测试，252 个（82.9%）分离物被确定为 ESBLs 生产者，当使用含氯唑西林的 Muller Hinton 时，其流行率略有上升。只有 3 个 ESBLs 阳性菌在改良双盘协同试验中呈阳性：结论：区分 AmpC β-内酰胺酶和产 ESBLs 菌具有流行病学意义和治疗重要性。此外，AmpC β-内酰胺酶和ESBLs共产菌可导致ESBL确证试验出现假阴性。因此，了解当地的流行情况可为临床医生的治疗提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Malaysian Journal of Pathology PATHOLOGY-

CiteScore

3.60

自引率

5.60%

发文量

期刊介绍： The Malaysian Journal of Pathology is the official journal of the College of Pathologists, Academy of Medicine Malaysia. The primary purpose of The Journal is to publish the results of study and research in Pathology, especially those that have particular relevance to human disease occurring in Malaysia and other countries in this region. The term PATHOLOGY will be interpreted in its broadest sense to include Chemical Pathology, Cytology, Experimental Pathology, Forensic Pathology, Haematology, Histopathology, Immunology, Medical Microbiology and Parasitology. The Journal aims to bring under one cover publications of regional interest embracing the various sub-specialities of Pathology. It is expected that the articles published would be of value not only to pathologists, but also to medical practitioners in search of a scientific basis for the problems encountered in their practice, and to those with an interest in diseases which occur in the tropics.