DETECTION OF AMPC BETA LACTAMASES IN CEFOXITIN-RESISTANT GRAM-NEGATIVE CLINICAL ISOLATES USING PHENYLBORONIC ACID
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 3
Abstract
BACKGROUND AmpC β-lactamases are Ambler class C enzymes that confer resistance to extended spectrum cephalosporins and are not inhibited by β-lactamase inhibitors. These enzyme-producing organisms produce infections that are associated with significant morbidity and mortality. Resistance to third-generation cephalosporins develop in these organisms after exposure to these agents. This complicates treatment options and carbapenems are considered optimal. MATERIALS AND METHODS In this cross-sectional study, AmpC β-lactamase production was determined in Gram-negative clinical isolates from various clinical samples. Isolates resistant to cefoxitin and third generation cephalosporin (3GC) antibiotics were tested for the production of AmpC β-lactamases by using an inhibitor-based method (IBM) with phenylboronic acid. RESULTS It was observed that, among the 100 Gram-negative isolates, 48 (48%) were resistant to cefoxitin. Using IBM, the occurrence of AmpC β-lactamases was found in 24 (24%) of these 48 isolates. ESBL/AmpC co-carriage was found in 13 (13%) of these isolates by E-Test. Among the 24 AmpC positive isolates, 10 (41.6%) were E. coli, 5 (20.8%) were Enterobacter cloacae, 5 (20.8%) were Klebsiella pneumoniae, 2 (8.3%) were Acinetobacter baumannii and 2 (8.3%) were Pseudomonas aeruginosa. CONCLUSION AmpC production can be determined in routine clinical microbiology laboratory using IBM as it is a simple, rapid and technically easy procedure. Thus, their accurate detection and characterisation plays an important role in their epidemiological survey, infection control and treatment.
Authors and Affiliations
Mohammed Hisham Poilil Puthanpura, Shabina Methele Pangat Balakrishnan, Rema Devi Santhakumari, Beena Philomina Jose, Anitha Puduvail Moorkoth
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