Journal of The Academy of Clinical Microbiologists

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 18  |  Issue : 2  |  Page : 80--85

Occurrence of extended-spectrum beta-lactamase, AmpC and MBLase producers among multidrug-resistant Enterobacteriaceae causing urinary tract infection in a tertiary health-care teaching hospital


Anitha Madhavan, V Jayalakshmi 
 Department of Microbiology, Government T. D. Medical College, Alappuzha, Kerala, India

Correspondence Address:
Anitha Madhavan
Department of Microbiology, Government T. D. Medical College, Alappuzha, Kerala
India

Introduction: Emerging multidrug resistance continues to be a major concern in healthcare settings. The aim of the study was to determine the resistance pattern of multidrug-resistant (MDR) Enterobacteriaceae causing urinary tract infections in our hospital and to report the occurrence of extended-spectrum beta-lactamase (ESBL), AmpC and metallo-beta-lactamase (MBL) production in them. Materials and Methods: Out of 280 MDR strains collected over a period of one year, 130 strains of Escherichia coli (96), Klebsiella spp. (31) and Enterobacter spp. (3) resistant to the second- and third-generation Cephalosporins were selected for further testing. Cefotaxime, Cefotaxime-Clavulanic acid, Ceftazidime, Ceftazidime-Clavulanic acid and Cefepime, Cefepime-Clavulanic acid Etest strips, Cefoxitin and Cefotetan with Boronic acid and Imipenem/Imipenem-EDTA Etest strips were used to detect ESBLs, AmpC and MBLs. Multiplex polymerase chain reaction (PCR) was done to detect plasmid-mediated AmpC genes. Results: Among 130 Cefoxitin-resistant strains, Cefoxitin-Boronic acid inhibitor method detected AmpC phenotype in 116 (89.2%) isolates. The overall occurrence of AmpC (n = 280) was 116 (41.42%). 92 (32.8%) isolates were found to be ESBL producers by the Clinical and Laboratory Standards Institute confirmatory method. ESBL production was detected in 107 (38.2%) more isolates by Cefepime/Cefepime-Clavulanic acid Etest. MBL producers were relatively low in our study 5 (1.8%). PCR detected CIT genotype (CMY-2) in 13 isolates (4.6%). Conclusion: This study reveals high prevalence of AmpC and ESBL co-carriage suggesting plasmid-mediated spread, indicates the need for surveillance of resistance mechanisms and takes necessary measures to control the emergence of MDR organisms.


How to cite this article:
Madhavan A, Jayalakshmi V. Occurrence of extended-spectrum beta-lactamase, AmpC and MBLase producers among multidrug-resistant Enterobacteriaceae causing urinary tract infection in a tertiary health-care teaching hospital.J Acad Clin Microbiol 2016;18:80-85


How to cite this URL:
Madhavan A, Jayalakshmi V. Occurrence of extended-spectrum beta-lactamase, AmpC and MBLase producers among multidrug-resistant Enterobacteriaceae causing urinary tract infection in a tertiary health-care teaching hospital. J Acad Clin Microbiol [serial online] 2016 [cited 2017 Mar 29 ];18:80-85
Available from: http://www.jacmjournal.org/article.asp?issn=0972-1282;year=2016;volume=18;issue=2;spage=80;epage=85;aulast=Madhavan;type=0