Molecular Epidemiology of AmpC-Producing Klebsiella Pneumoniae Isolated from Perioperative Patients in a Tertiary Hospital
Journal of Cellular & Molecular Anesthesia,
Vol. 6 No. 3 (2021),
7 September 2021
,
Page 216-221
https://doi.org/10.22037/jcma.v6i3.35261
Abstract
Background: Extended-spectrum cephalosporin-resistant organisms are the sources of AmpC- type β-lactamase isolates. AmpC-producing Klebsiella pneumoniae isolates are a major challenge in clinics due to their high rate of antibiotic resistance. This study aimed to detect AmpC β-lactamases in K. pneumoniae isolated from hospitalized patients with a surgical history.
Materials and Methods: This cross-sectional study was performed on 120 urine catheter samples. After antibiotic susceptibility testing, plasmid-mediated AmpC was detected by double-disc plus combined disc test (DCDT) and three-dimensional extract test (TDET). The genotypic detection of plasmid-mediated AmpC was carried out using multiplex-polymerase chain reaction (PCR).
Results: Of 120 samples, 60 (50%) instances of K. pneumoniae were isolated. The highest and lowest resistance rates were related to cefotaxime (CTX) (50%) and ciprofloxacin (CIP) (23.3%), respectively. 18.3% (n: 11) K. pneumoniae showed an AmpC phenotype in DCDT and TDET tests. AmpC genotyping showed that the prevalence of CIT, DHA, EBC, and ACC genotypes were 47.1%, 35.3%, 29.5%, and 23.6%, respectively. MOX and FOX genotypes were not identified in the isolates of interest.
Conclusion: AmpC β-lactamase identification tests should be considered a routine microbiology workup for gram-negative microorganisms. Multiplex-PCR can identify the plasmid AmpC genotypes.
- AmpC, Klebsiella pneumoniae, double-disc plus combined test, three-dimensional extract test.
How to Cite
References
Morris, S.; Cerceo, E. Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting. Antibiotics 2020, 9, 196. 2020; 62(9):196-203.
Fadare FT, Okoh AI. Distribution and molecular characterization of ESBL, pAmpC β-lactamases, and non-β-lactam encoding genes in Enterobacteriaceae isolated from hospital wastewater in Eastern Cape Province, South Africa. PLoS One. 2021;16(7):e0254753.
Werner RM, Bradlow ET. Relationship between Medicare’s Hospital Compare performance measures and mortality rates. JAMA. 2006;296(22): 2694-702.
Jha AK, Orav EJ, Li Z, Epstein AM. The inverse relationship between mortality rates and performance in the Hospital Quality Alliance measures. Health Aff (Millwood). 2007;26(4):1104-10.
Bina, M., Pournajaf, A., Mirkalantari, S., Talebi, M., Irajian, G. Detection of the Klebsiella pneumoniae carbapenemase (KPC) in K. pneumoniae Isolated from the Clinical Samples by the Phenotypic and Genotypic Methods. Iran J Pathol. 2020; 10(3): 199-201.
Dirar M, Bilal N, Ibrahim ME, Hamid M. Resistance Patterns and Phenotypic Detection of β-lactamase Enzymes among Enterobacteriaceae Isolates from Referral Hospitals in Khartoum State, Sudan. Cureus. 2020;12(3) 87-95.
Ibrahim, M.E.; Abbas, M.; Al-Shahrai, A.M.; Elamin, B.K. Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia. Can. J. Infect. Dis. Med. Microbiol. Med. 2019;23(4):605-14
Foxman, B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002; 113(1): 5-13.
Ghafourian, S., bin Sekawi, Z., Sadeghifard, N., Laran J. The prevalence of ESBLs producing Klebsiella pneumoniae isolates in some major hospitals, Iran. Open Microbiol J. 2011; 108 (5):91-95.
Hanson, N.D. AmpC β-lactamases: what do we need to know for the future? J Antimicrob Chemother. 2010; 52(1): 2-4.
Japoni-Nejad, A., Fardmusavi, N., Safari. Prevalence of Plasmid-Mediated AmpC ß-Lactamase Genes in Clinical Isolates of Klebsiella Pneumoniae in Arak City, Iran. J Isfn Med Sc, 2013. 31(49): 69-73.
Liu, X.Q., and Liu, Y.R. Detection and genotype analysis of AmpC β lactamase in Klebsiella pneumoniae from tertiary hospitals. Exp Ther Med. 2009; 12(1): 480-4.
Mardaneh, J., Anvarinejad, M., Abbasian, A., Abbasi P., Rafatpour N., Dehyadegari M., et al. Emergence of Multi-drug Resistant ESBL Producing Strains among Enterobacteriaceae Members Isolated from Patients Blood Samples in South of Iran. Ir Sou Med J. 2005; 18(5): 970-81.
Kim, K.g.; Jeong, J.; Kim, M.j.; Park, D.w.; Shin, J.h.; Park, H. et al. Prevalence and molecular epidemiology of ESBLs, plasmid-determined AmpC-type β-lactamases and carbapenemases among diarrhoeagenic Escherichia coli isolates from children in Gwangju, Korea: J. Antimicrob. Chemother. 2019; 16 (8). 2181–7.
Pourali Sheshblouki, G., and Mardaneh, J. Characterization of blaCTX gene and Cross-resistance in Klebsiella pneumoniae Isolated from Hospitalized Patients. J Birj Uni Med Sci. 2019; 23 (2). 23-38.
Rostam Zad, A., Yar Padervand, A. Evaluation of Bla-CTX-M-15 and Bla-AMPC(FOX) Beta Lactamase Genes in Klebsiella Pneumoniae Isolates Isolated from Patients in Isfahan City Hospitals. Jundisha Sci Med J, 2007; 15(6), 733-44.
Shibl, A., Al-Agamy, M., Memish, Z., Senok, A., Khader, S.A., Assiri, A. The emergence of OXA-48-and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis. 2013; 17(12): e1130-3.
Tamma, P.D., Doi, Y., Bonomo, R.A., Johnson JK., Simner PJ., A Primer on AmpC β-Lactamases: Necessary Knowledge for an Increasingly Multidrug-resistant World. Clin Infect Dis. 2019; 69(8): 1446-55.
Tan, T.Y., Ng, L.S.Y., He, J., Koh, T.H., Hsu, L.Y. Evaluation of screening methods to detect plasmid-mediated AmpC in Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis. Antimicrob Agents Chemother. 2009; 53(1): 146-9.
Yilmaz, N., Agus, N., Bozcal, E., Oner, O., Uzel, A. Detection of plasmid-mediated AmpC β-lactamase in Escherichia coli and Klebsiella pneumoniae. Indian J Med Microbiol. 2013; 31(1): 53-7.
- Abstract Viewed: 137 times
- PDF Downloaded: 162 times