Extended-spectrum β-lactamase and AmpC β-lactamase Production among Gram-negative Bacilli Isolates Obtained from Urinary Tract Infections and Wound Infections.
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Date
2014-04
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Abstract
Extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases continue to be a major problem in healthcare settings.
Due to the scarcity of information regarding the antibiotic susceptibility patterns particularly from urinary tract infections (UTIs)
and wound infections, the current study was carried out to assist the clinicians to prescribe appropriate antibiotics against
gram-negative clinical isolates. In the current study, urine (n = 620) and pus (n = 228) samples were collected from different sites
(at various clinical departments) and subjected to direct microscopic examination, culture and antibiotic susceptibility testing
(AST). In the AST testings, the isolates that exhibited reduced zone of inhibition to one or more of the antibiotics such as
cefotaxime (≤27 mm), ceftriaxone (≤25 mm), ceftazidime (≤22 mm), cefpodoxime (≤17 mm) and aztreonam (≤27 mm) were
considered as potential ESBL producers and the ESBL production was confirmed using phenotypic screening test (doubledisk
synergy test) and phenotypic confirmatory test (combined-disk test). However, isolates showing resistance or decreased
sensitivity to cefoxitin, cefotaxime, ceftriaxone, ceftazidime, cefpodoxime or aztreonam
and sensitive to cefepime were
considered as a screen positive AmpC producer and subjected to AmpC disk tests. The current study concluded that 72.41%
and 21.76% of ESBL and AmpC producers
were detected, respectively in our hospital. It was also observed that the double-disk
synergy and combined-disk tests were equally effective for ESBL detection. Further, AmpC disk test is simple, easy to perform
and interpret, requiring less expertise for the rapid detection of AmpC isolates.
Description
Keywords
Extended-spectrum β-lactamases, AmpC β-lactamases, gram-negative isolates, antibiotic susceptibility testing
Citation
Shinu Pottahil, Bareja Rajesh, Goyal Manoj, Singh Varsha A, Mehrishi Priya, Bansal Monika, Narang Vinod Kumar, Grover Prem Singh, Singh Virendra, Yadav Shailesh, Nabeel Ahmed. Extended-spectrum β-lactamase and AmpC β-lactamase Production among Gram-negative Bacilli Isolates Obtained from Urinary Tract Infections and Wound Infections. Indian Journal of Clinical Practice. 2014 Apr; 24(11): 1019-1026.