{"title":"在印度三级医院产生β-内酰胺酶的变形杆菌的表型检测和抗生素谱。","authors":"N Pal, S Hooja, R Sharma, R K Maheshwari","doi":"10.4103/amhsr.amhsr_413_15","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><i>Proteus</i> species cause a variety of community- and hospital-acquired illnesses. Synthesis of β-lactamases is the predominant mechanism for resistance to β-lactam antibiotics. Among the β-lactamases, extended spectrum β-lactamases (ESBLs) and AmpC β-lactamases are the most common.</p><p><strong>Aim: </strong>The objective of this study was to determine the occurrence of ESBL and AmpC β-lactamases in <i>Proteus</i> species among various clinical isolates at a tertiary care hospital, India.</p><p><strong>Materials and methods: </strong>This study was done to identify various species of <i>Proteus</i> from clinical samples (<i>n</i> = 3922). Antimicrobial susceptibility was performed by Kirby-Bauer disc diffusion method. ESBL production was detected by modified double-disc synergy test and indirect modified three-dimensional tests and AmpC β-lactamase production by AmpC disc test and modified Hodge test.</p><p><strong>Results: </strong><i>Proteus</i> species were isolated in 5.4% (101/1876) specimens. Three <i>Proteus</i> species isolated were <i>Proteus mirabilis</i> 62.4% (63/101), <i>Proteus vulgaris</i> 29.7% (30/101), and <i>Proteus penneri</i> 7.9% (8/101). ESBL producers confirmed by both tests were of 88.1% (89/101). Only AmpC β-lactamase was produced by four isolates. Coproduction of ESBL and AmpC β-lactamase was observed in 58.4% (52/89) of isolates. Twelve isolates were non-β-lactamase producers. Multidrug resistance (MDR) was found in 95.1% (96/101) of isolates, 50.5% (51/101) were possibly extensively drug resistant and none were pan drug resistant. None of the isolates were resistant to piperacillin-tazobactam. <i>P. penneri</i> isolates exhibited high resistance to most of the antibiotics.</p><p><strong>Conclusions: </strong>A high prevalence of ESBL and AmpC β-lactamases was found that concurrently showed MDR. Phenotypic methods for the detection of β-lactamases are easy and simple and can be implemented in routine diagnostic laboratories along with susceptibility testing. These data will assist the clinicians in the management and control of infections.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"267-273"},"PeriodicalIF":0.0000,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/ed/AMHSR-6-267.PMC5414437.pdf","citationCount":"15","resultStr":"{\"title\":\"Phenotypic Detection and Antibiogram of β-lactamase-producing <i>Proteus</i> Species in a Tertiary Care Hospital, India.\",\"authors\":\"N Pal, S Hooja, R Sharma, R K Maheshwari\",\"doi\":\"10.4103/amhsr.amhsr_413_15\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong><i>Proteus</i> species cause a variety of community- and hospital-acquired illnesses. Synthesis of β-lactamases is the predominant mechanism for resistance to β-lactam antibiotics. Among the β-lactamases, extended spectrum β-lactamases (ESBLs) and AmpC β-lactamases are the most common.</p><p><strong>Aim: </strong>The objective of this study was to determine the occurrence of ESBL and AmpC β-lactamases in <i>Proteus</i> species among various clinical isolates at a tertiary care hospital, India.</p><p><strong>Materials and methods: </strong>This study was done to identify various species of <i>Proteus</i> from clinical samples (<i>n</i> = 3922). Antimicrobial susceptibility was performed by Kirby-Bauer disc diffusion method. ESBL production was detected by modified double-disc synergy test and indirect modified three-dimensional tests and AmpC β-lactamase production by AmpC disc test and modified Hodge test.</p><p><strong>Results: </strong><i>Proteus</i> species were isolated in 5.4% (101/1876) specimens. Three <i>Proteus</i> species isolated were <i>Proteus mirabilis</i> 62.4% (63/101), <i>Proteus vulgaris</i> 29.7% (30/101), and <i>Proteus penneri</i> 7.9% (8/101). ESBL producers confirmed by both tests were of 88.1% (89/101). Only AmpC β-lactamase was produced by four isolates. Coproduction of ESBL and AmpC β-lactamase was observed in 58.4% (52/89) of isolates. Twelve isolates were non-β-lactamase producers. Multidrug resistance (MDR) was found in 95.1% (96/101) of isolates, 50.5% (51/101) were possibly extensively drug resistant and none were pan drug resistant. None of the isolates were resistant to piperacillin-tazobactam. <i>P. penneri</i> isolates exhibited high resistance to most of the antibiotics.</p><p><strong>Conclusions: </strong>A high prevalence of ESBL and AmpC β-lactamases was found that concurrently showed MDR. Phenotypic methods for the detection of β-lactamases are easy and simple and can be implemented in routine diagnostic laboratories along with susceptibility testing. These data will assist the clinicians in the management and control of infections.</p>\",\"PeriodicalId\":8186,\"journal\":{\"name\":\"Annals of Medical and Health Sciences Research\",\"volume\":\"6 5\",\"pages\":\"267-273\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/ed/AMHSR-6-267.PMC5414437.pdf\",\"citationCount\":\"15\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Medical and Health Sciences Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/amhsr.amhsr_413_15\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Medical and Health Sciences Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/amhsr.amhsr_413_15","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Phenotypic Detection and Antibiogram of β-lactamase-producing Proteus Species in a Tertiary Care Hospital, India.
Background: Proteus species cause a variety of community- and hospital-acquired illnesses. Synthesis of β-lactamases is the predominant mechanism for resistance to β-lactam antibiotics. Among the β-lactamases, extended spectrum β-lactamases (ESBLs) and AmpC β-lactamases are the most common.
Aim: The objective of this study was to determine the occurrence of ESBL and AmpC β-lactamases in Proteus species among various clinical isolates at a tertiary care hospital, India.
Materials and methods: This study was done to identify various species of Proteus from clinical samples (n = 3922). Antimicrobial susceptibility was performed by Kirby-Bauer disc diffusion method. ESBL production was detected by modified double-disc synergy test and indirect modified three-dimensional tests and AmpC β-lactamase production by AmpC disc test and modified Hodge test.
Results: Proteus species were isolated in 5.4% (101/1876) specimens. Three Proteus species isolated were Proteus mirabilis 62.4% (63/101), Proteus vulgaris 29.7% (30/101), and Proteus penneri 7.9% (8/101). ESBL producers confirmed by both tests were of 88.1% (89/101). Only AmpC β-lactamase was produced by four isolates. Coproduction of ESBL and AmpC β-lactamase was observed in 58.4% (52/89) of isolates. Twelve isolates were non-β-lactamase producers. Multidrug resistance (MDR) was found in 95.1% (96/101) of isolates, 50.5% (51/101) were possibly extensively drug resistant and none were pan drug resistant. None of the isolates were resistant to piperacillin-tazobactam. P. penneri isolates exhibited high resistance to most of the antibiotics.
Conclusions: A high prevalence of ESBL and AmpC β-lactamases was found that concurrently showed MDR. Phenotypic methods for the detection of β-lactamases are easy and simple and can be implemented in routine diagnostic laboratories along with susceptibility testing. These data will assist the clinicians in the management and control of infections.
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