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Salmuna ZN, Zulkefli AF, Nik Mohd Noor NZ, Ahmad Bakri NS. Phenotypic and Genotypic Identification of Four Cases of Plasmid-Mediated AmpC β-Lactamases-Producing Escherichia coli Admitted to a Tertiary Centre. Cureus 2024; 16:e64829. [PMID: 39156293 PMCID: PMC11330189 DOI: 10.7759/cureus.64829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/20/2024] Open
Abstract
We describe four patients with a positive culture of AmpC β-lactamases-producing Escherichia coli (E. coli), despite the fact that our understanding of plasmid-mediated AmpC β-lactamases (pAmpC) is currently limited. Three out of four cases of AmpC β-lactamases-producing Escherichia coli were isolated from a urine sample, and one was from a peritoneal fluid sample. All four isolates are resistant to cefoxitin disc and were subjected to a confirmatory AmpC phenotypic test (AmpC induction test) and monoplex polymerase chain reaction (PCR) for the determination of six pAmpC genotypes (blaDHA, blaEBC, blaMOX, blaFOX, blaACC, and blaCIT). All four E. coli isolates tested negative for the AmpC induction test, while monoplex PCR analysis was positive only for the blaDHA pAmpC genotype and negative for all five other genotypes (blaEBC, blaMOX, blaFOX, blaACC, and blaCIT). A common clinical characteristic across all patients was fever. One patient was treated for perforated sigmoid diverticulitis, while the other three patients were treated for acute pyelonephritis or urinary tract infections (UTIs). Each patient improved significantly and was successfully discharged.
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Affiliation(s)
- Zeti Norfidiyati Salmuna
- Medical Microbiology and Parasitology, Universiti Sains Malaysia School of Medical Sciences, Kota Bharu, MYS
| | - Alyaa Farhan Zulkefli
- Medical Microbiology and Parasitology, Universiti Sains Malaysia School of Medical Sciences, Kota Bharu, MYS
| | - Nik Zuraina Nik Mohd Noor
- Medical Microbiology and Parasitology, Universiti Sains Malaysia School of Medical Sciences, Kota Bharu, MYS
| | - Nur Saidah Ahmad Bakri
- Medical Microbiology and Parasitology, Universiti Sains Malaysia School of Medical Sciences, Kota Bharu, MYS
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2
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Bobbadi S, Bobby MN, Chinnam BK, Reddy PN, Kandhan S. Phenotypic and genetic screening of Klebsiella pneumoniae isolates from human UTI patients for beta-lactamases and their genetic diversity analysis by ERIC and REP PCRs. Braz J Microbiol 2023; 54:1723-1736. [PMID: 37198419 PMCID: PMC10484876 DOI: 10.1007/s42770-023-00984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/18/2023] [Indexed: 05/19/2023] Open
Abstract
Klebsiella pneumoniae is one of the major nosocomial pathogens responsible for pneumoniae, septicaemia, liver abscesses, and urinary tract infections. Coordinated efforts by antibiotic stewardship and clinicians are underway to curtail the emergence of antibiotic-resistant strains. The objective of the present study is to characterize K. pneumoniae strains through antibiotic resistance screening for production of beta-lactamases (β-lactamases) such as extended spectrum beta lactamases (ESBLs), AmpC β-lactamases, and carbapenemases by phenotypic and genotypic methods and genetic fingerprinting by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) and repetitive element palindromic PCR (REP-PCR). A total of 85 K. pneumoniae strains isolated from 504 human urinary tract infections (UTI) were used in this study. Only 76 isolates showed positive in phenotypic screening test (PST), while combination disc method (CDM) as phenotypic confirmatory test (PCT) confirmed 72 isolates as ESBL producers. One or more β-lactamase genes were detected by PCR in 66 isolates (91.66%, 66/72) with blaTEM gene being the most predominant (75.75%, 50/66). AmpC genes could be detected in 21 isolates (31.8%, 21/66) with FOX gene being the predominant (24.24%, 16/66), whereas NDM-I was detected in a single strain (1.51%, 1/66). Genetic fingerprinting using ERIC-PCR and REP-PCR revealed wide heterogeneity among β-lactamase producing isolates with discriminatory power of 0.9995 and 1, respectively.
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Affiliation(s)
- Suresh Bobbadi
- Department of Biotechnology, Vignan’s Foundation for Science, Technology and Research (Deemed to be University), Vadlamudi, Guntur district, Andhra Pradesh 522 213 India
| | - Md Nazneen Bobby
- Department of Biotechnology, Vignan’s Foundation for Science, Technology and Research (Deemed to be University), Vadlamudi, Guntur district, Andhra Pradesh 522 213 India
| | - Bindu Kiranmayi Chinnam
- Department of Veterinary Public Health and Epidemiology, NTR College of Veterinary Science, Gannavaram, Andhra Pradesh 521101 India
| | - Prakash Narayana Reddy
- Department of Microbiology, Dr. V.S. Krishna Government Degree and PG College (Autonomous), Maddilapalem, Visakhapatnam, Andhra Pradesh 530 013 India
| | - Srinivas Kandhan
- Division of Veterinary Public Health, ICAR – Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh 243 122 India
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3
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Prevalence of High-Risk β-Lactam Resistance Genes in Family Livestock Farms in Danjiangkou Reservoir Basin, Central China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106036. [PMID: 35627573 PMCID: PMC9140499 DOI: 10.3390/ijerph19106036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023]
Abstract
The propagation of antibiotic resistance genes (ARGs) from domestic livestock manure is an unnegligible important environmental problem. There is an increasing need to understand the role of domestic livestock manure in causing antibiotic resistance in the environment to minimize risks to human health. Here, we targeted β-lactam resistance genes (bla genes), primarily discovered in clinical settings, to compare the high-risk ARG profile and their main spreading vectors of 26 family livestock farms in China and analyze the effects of domestic livestock manure on their receiving farmland environments. Results showed that the high-risk bla genes and their spreading carriers were widely prevalent in livestock and poultry manure from family farms. The blaampC gene encoding extended-spectrum AmpC β-lactamases, as well as its corresponding spreading carrier (class-1 integron), had the highest occurrence level. The bla gene abundance in family chicken farms was higher than that in family swine and cattle farms, while the bla gene contamination in the feces of laying hens or beef cattle was worse than that in corresponding broiler chickens or dairy cattle. Notably, the application from domestic livestock manure led to substantial emission of bla genes, which significantly increased the abundance of high-risk resistance genes in farmland soil by 12–46 times. This study demonstrated the prevalence and severity of high-risk resistance genes in domestic livestock and poultry manure; meanwhile, the discharge of bla genes also highlighted the need to mitigate the persistence and spread of these elevated high-risk genes in agricultural systems.
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Fleifel M, Machmouchi A, Alameddine O, Hoyek K, Melki D, Hallab E, Masri K, Sidaoui HR, Stockman D, Daoud Z. The Spread of Plasmidic AmpC in a General Lebanese Hospital Over Nine Consecutive Years and the Relationship With Restricted Isolation Protocols. Front Med (Lausanne) 2021; 8:633783. [PMID: 34765610 PMCID: PMC8576109 DOI: 10.3389/fmed.2021.633783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The dreaded bacterial infection by extended-spectrum β-lactamases (ESBL)-producers has always troubled the medical field whether on the public, scientific, or clinical levels. One of the lesser known β-lactamases, which is capable of hydrolyzing broad and extended-spectrum cephalosporins—i.e., cephamycins plus oxyimino-β-lactams—are the AmpC β-lactamases. This group, which has also been termed occasionally—and incorrectly—as ESBL Class C, confers resistance to β-lactamase inhibitors. The prevalence of plasmidic AmpC (pAmpC) strains is possibly still a matter of debate considering the unevenly matched data between phenotypically-detected and molecularly-detected pAmpC. Aim: In the absence of any study in Lebanon addressing the AmpC, our intention was to determine the numbers and percentages of AmpC Enterobacteriaceae isolates, notably plasmid-mediated ones, across different wards at the Centre Hospitalier du Nord (CHN), Lebanon, and highlight the importance of infection control protocols. Materials and Methods: Carriage and infection with pAmpC Enterobacteriaceae were retrospectively investigated between 2011 and 2015 and prospectively between 2016 and 2019 at the Centre Hospitalier du Nord Hospital, North Lebanon. The rise or decline in the numbers of such strains, in concordance with the allegedly intensive isolation of the patients, were analyzed. Results: Intensive care unit (ICU) data shows an initial rise in infection isolates from 2012 to 2014 and in the carriage isolates from 2012 to 2013 with later notable overall decrease in the both isolates' numbers with the application of the isolation protocols at CHN from 2014 onwards. Floors 2, 3, and 4 seemed to house the bulk of the isolates as well. Conclusion: Preventive measures, such as on-going surveillance of the hospital wards by specialized healthcare personnel and strict implementation of infection control practices, should be a top priority in any medical center in order to isolate such strains and try to put a limit for the development and the dissemination of any possible multidrug resistant strains.
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Affiliation(s)
- Mohamad Fleifel
- Department of Internal Medicine, The Lebanese American University Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
| | - Ahmad Machmouchi
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Omar Alameddine
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Kim Hoyek
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Dimitri Melki
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Elsa Hallab
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Khalil Masri
- Centre Hospitalier du Nord Hospital, Department of Infectious Diseases, Zgharta, Lebanon
| | - Hiam R Sidaoui
- Centre Hospitalier du Nord Hospital, Department of Infectious Diseases, Zgharta, Lebanon
| | - David Stockman
- Clinical Microbiology and Infection Prevention, Michigan Health Clinics, Saginaw, MI, United States
| | - Ziad Daoud
- Clinical Microbiology and Infection Prevention, Michigan Health Clinics and College of Medicine-Central Michigan University, Saginaw, MI, United States
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Mol P R, Bindayna KM, Shanthi G. Evaluation of Two Phenotypic Methods for the Detection of Plasmid-Mediated AmpC β-Lactamases among Enterobacteriaceae Isolates. J Lab Physicians 2021; 13:151-155. [PMID: 34483562 PMCID: PMC8409112 DOI: 10.1055/s-0041-1729472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives
AmpC β-lactamases are cephalosporinases that confer resistance to cephalothin, cefazolin, cefoxitin, penicillin, and β-lactamase inhibitor-β-lactam combinations. Even though the AmpC resistance is reported, but the accurate occurrence of AmpC β-lactamases in
Enterobacteriaceae
members is still unknown. Techniques to identify AmpC producers are still evolving but not yet optimized for the clinical laboratory. Here we aimed to compare the test performance of two different phenotypic methods, that is inhibitor-based assay using boronic acid and disk approximation test for AmpC detection in
Enterobacteriaceae
isolates from a tertiary hospital microbiology laboratory.
Materials and Methods
The study includes 137 nonrepeat
Enterobacteriaceae
strains. Bacterial isolates, that yielded a zone diameter of less than 18 mm for cefoxitin by disk diffusion method were considered potential AmpC producers and further confirmed by phenotype methods—inhibitor-based assay using boronic acid and disk approximation test. A multiplex polymerase chain reaction was used to detect the most common plasmid-mediated AmpC genes: ACC, FOX, MOX, DHA, CIT, and EBC.
Results
Of the 137 clinical isolates, 58 (42.33%) were cefoxitin resistant, while 53.4 and 18.9% of the cefoxitin-resistant isolates were positive by inhibitor-based assay and disk approximation test. Multiplex PCR detected 42 (30.6%) isolates with AmpC genes. Of the 42 isolates, the inhibitor-based assay detected 25 (59.5%) isolates, while the disk approximation test detected nine (21.4%) isolates.
Conclusion
Our findings suggest that inhibitor-based assay using boronic acid can be used for the detection of the isolates that harbor AmpC β-lactamases. This method is cost-effective, simple to perform, and easy to interpret. Thus AmpC detection as a routine in clinical laboratories can help in appropriate therapeutic intervention and improved infection control.
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Affiliation(s)
- Ronni Mol P
- Division of Microbiology (Medicine), Rajah Muthaiah Medical College, Annamalai University, Chidambaram, Tamil Nadu, India.,Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Khalid Mubarak Bindayna
- Department of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Ganesan Shanthi
- Division of Microbiology (Medicine), Rajah Muthaiah Medical College, Annamalai University, Chidambaram, Tamil Nadu, India
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Matloko K, Fri J, Ateba TP, Molale-Tom LG, Ateba CN. Evidence of potentially unrelated AmpC beta-lactamase producing Enterobacteriaceae from cattle, cattle products and hospital environments commonly harboring the blaACC resistance determinant. PLoS One 2021; 16:e0253647. [PMID: 34324493 PMCID: PMC8321102 DOI: 10.1371/journal.pone.0253647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/10/2021] [Indexed: 12/02/2022] Open
Abstract
The occurrence and genetic relatedness of AmpC beta-lactamase producing Enterobacteriaceae isolated from clinical environments, groundwater, beef, human and cattle faeces were investigated. One hundred seventy-seven (177) samples were collected and cultured on MacConkey agar. A total of 203 non-repetitive isolates were characterised using genus/species-specific PCRs and the identified isolates were subjected to antibiotic susceptibility testing. The production of AmpC beta-lactamases was evaluated using cefoxitin disc, confirmed by the D96C detection test and their encoding genes detected by PCR. The D64C extended-spectrum beta-lactamases (ESBL) test was also performed to appraise ESBLs/AmpC co-production. The genetic fingerprints of AmpC beta-lactamase producers were determined by ERIC-PCR. A total of 116 isolates were identified as E. coli (n = 65), Shigella spp. (n = 36) and Klebsiella pneumoniae (n = 15). Ciprofloxacin resistance (44.4-55.4%) was the most frequent and resistance against the Cephem antibiotics ranged from 15-43.1% for E. coli, 25-36.1% for Shigella spp., and 20-40% for K. pneumoniae. On the other hand, these bacteria strains were most sensitive to Amikacin (0%), Meropenem (2.8%) and Piperacillin-Tazobactam (6.7%) respectively. Nineteen (16.4%) isolates comprising 16 E. coli and 3 Shigella spp. were confirmed as AmpC beta-lactamase producers. However, only E. coli isolates possessed the corresponding resistance determinants: blaACC (73.7%, n = 14), blaCIT (26%, n = 5), blaDHA (11%, n = 2) and blaFOX (16%, n = 3). Thirty-four (27.3%) Enterobacteriaceae strains were confirmed as ESBL producers and a large proportion (79.4%, n = 27) harboured the blaTEM gene, however, only two were ESBLs/AmpC co-producers. Genetic fingerprinting of the AmpC beta-lactamase-producing E. coli isolates revealed low similarity between isolates. In conclusion, the findings indicate the presence of AmpC beta-lactamase-producing Enterobacteriaceae from cattle, beef products and hospital environments that commonly harbour the associated resistance determinants especially the blaACC gene, nonetheless, there is limited possible cross-contamination between these environments.
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Affiliation(s)
- Keduetswe Matloko
- Antimicrobial Resistance and Phage Biocontrol Research Group, Department of Microbiology, School of Biological Sciences, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa
| | - Justine Fri
- Antimicrobial Resistance and Phage Biocontrol Research Group, Department of Microbiology, School of Biological Sciences, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa
- Food Security and Safety Niche Area, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa
| | - Tshepiso Pleasure Ateba
- Centre for Animal Health Studies, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa
| | - Lesego G. Molale-Tom
- Unit for Environmental Sciences and Management - Microbiology, North-West University, Potchefstroom, South Africa
| | - Collins Njie Ateba
- Antimicrobial Resistance and Phage Biocontrol Research Group, Department of Microbiology, School of Biological Sciences, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa
- Food Security and Safety Niche Area, Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa
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Muriuki CW, Ogonda LA, Kyanya C, Matano D, Masakhwe C, Odoyo E, Musila L. Phenotypic and Genotypic Characteristics of Uropathogenic Escherichia coli Isolates from Kenya. Microb Drug Resist 2021; 28:31-38. [PMID: 34297634 PMCID: PMC8792489 DOI: 10.1089/mdr.2020.0432] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Uropathogenic Escherichia coli (UPECs) are a significant cause of urinary tract infections (UTIs). In Kenya, UTIs are typically treated with β-lactam antibiotics without antibiotic susceptibility testing, which could accelerate antibiotic resistance among UPEC strains. Aim: This study determined the occurrence of UPEC producing extended-spectrum β-lactamases (ESBLs), the genes conferring resistance to β-lactams, and the phylogenetic groups associated with ESBLs in Kenyan UPECs. Methodology: Ninety-five UPEC isolates from six Kenyan hospitals were tested for ESBL and plasmid-mediated AmpC β-lactamase (pAmpC) production by combined disk diffusion and disk approximation tests, respectively. Real-time and conventional polymerase chain reactions (PCRs) were used to detect three ESBL and six pAmpC genes, respectively, and phylogenetic groups were assigned by a quadruplex PCR method. Results: Twenty-four percent UPEC isolates were ESBL producers with blaCTX-M (95.6%), blaTEM (95.6%), and blaSHV (21.7%) genes detected. Sixteen isolates had blaCTX-M/TEM, whereas five had blaTEM/CTX-M/SHV. A total of 5/23 ESBLs were cefoxitin resistant, but no AmpC genes were detected. The UPECs belonged predominantly to phylogenetic groups B2 (31/95; 32.6%) and D (30/95; 31.6%), while groups B2 and A had the most ESBL producers. Conclusions: β-Lactam antibiotics have reduced utility for treating UTIs as a quarter of UPECs were ESBL producing. Single or multiple ESBL genes were present in UPECs, belonging primarily to phylogenetic groups B2 and A.
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Affiliation(s)
- Catherine Wawira Muriuki
- Department of Biomedical Science and Technology, School of Biological and Physical Science, Maseno University, Maseno, Kenya.,Department of Emerging Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Lilian Adhiambo Ogonda
- Department of Biomedical Science and Technology, School of Biological and Physical Science, Maseno University, Maseno, Kenya
| | - Cecilia Kyanya
- Department of Emerging Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Daniel Matano
- Department of Emerging Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Clement Masakhwe
- Department of Emerging Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Erick Odoyo
- Department of Emerging Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya/Kenya Medical Research Institute, Nairobi, Kenya
| | - Lillian Musila
- Department of Emerging Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya/Kenya Medical Research Institute, Nairobi, Kenya
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El Shamy AA, Zakaria Z, Tolba MM, Salah Eldin N, Rabea AT, Tawfick MM, Nasser HA. AmpC β-Lactamase Variable Expression in Common Multidrug-Resistant Nosocomial Bacterial Pathogens from a Tertiary Hospital in Cairo, Egypt. Int J Microbiol 2021; 2021:6633888. [PMID: 33854549 PMCID: PMC8021464 DOI: 10.1155/2021/6633888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/18/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
The emergence of AmpC (pAmpC) β-lactamases conferring resistance to the third-generation cephalosporins has become a major clinical concern worldwide. In this study, we aimed to evaluate the expression of AmpC β-lactamase encoding gene among the pathogenic Gram-positive and Gram-negative resistant bacteria screened from clinical samples of Egyptian patients enrolled into El-Qasr El-Ainy Tertiary Hospital in Cairo, Egypt. A total of 153 bacterial isolates of the species Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus faecium were isolated from patients diagnosed with urinary tract infection (UTI), respiratory tract infection (RTI), and wound infections. The total number of E. faecium isolates was 53, comprising 29 urine isolates, 5 sputum isolates, and 19 wound swab isolates, whereas the total number of P. aeruginosa isolates was 49, comprising 27 urine isolates, 7 sputum isolates, and 15 wound swab isolates, and that of the K. pneumoniae isolates was 51, comprising 20 urine isolates, 25 sputum isolates, and 6 wound swab isolates. Our results indicated that there is no significant difference in the expression of AmpC β-lactamase gene among the tested bacterial species with respect to the type of infection and/or clinical specimen. However, the expression patterns of AmpC β-lactamase gene markedly differed according to the antibacterial resistance characteristics of the tested isolates.
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Affiliation(s)
- Aliaa Ali El Shamy
- Microbiology and Immunology Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Zainab Zakaria
- Biomedical Research Lab, Research and Development Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Mahmoud M. Tolba
- Pharmaceutical Division, Ministry of Health and Population, Faiyum, Egypt
| | - Nermeen Salah Eldin
- Microbiology and Immunology Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Al-Taher Rabea
- Biomedical Research Lab, Research and Development Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Mahmoud M. Tawfick
- Microbiology and Immunology Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
- Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Hebatallah A. Nasser
- Microbiology and Immunology Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
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10
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Onanuga A, Mahindroo J, Singh S, Taneja N. Phenotypic and molecular characterization of antimicrobial resistant Escherichia coli from urinary tract infections in Port-Harcourt, Nigeria. Pan Afr Med J 2019; 34:144. [PMID: 32010423 PMCID: PMC6969895 DOI: 10.11604/pamj.2019.34.144.18182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 11/01/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction Multidrug resistance among Escherichia coli causing Urinary Tract Infections (UTIs) is a major public health problem, threatening the effective treatment of UTIs. This study investigated the phenotypic and molecular characteristics of E. coli associated with UTIs in Port-Harcourt, Nigeria. Methods Twenty-five non-duplicate isolates of E. coli from UTIs patients at the University of Port-Harcourt Teaching Hospital, Nigeria were identified using Matrix-Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry. The antimicrobial susceptibility patterns were determined using Kirby-Bauer disc diffusion technique. Phenotypic expression of Extended Spectrum Beta Lactamases (ESBLs) and AmpC beta-lactamase were determined using standard laboratory methods and polymerase chain reaction (PCR) was used to detect ESBLs, AmpC, Quinolones and Aminoglycosides resistance genes. Results The isolates exhibited high rates of resistance to co-trimoxazole (76%), nalidixic acid (68%), ciprofloxacin (60%), gentamicin (44%) and low resistance to cefotaxime (20%) but were fully susceptible to cefoperazone/sulbactam, amikacin, nitrofurantoin, colistin and carbapenems. Phenotypic expression of ESBLs was recorded in 6(24%) isolates while genotypic detection revealed the highest prevalence of blaTEM 22(88%), followed by blaCTX-M-15 16(64%), blaSHV 7(28%) and blaOXA-1 6(24%) while AmpC (blaCMY-2) gene was detected in 8(32%) isolates. Amongst the quinolone resistant isolates, qnr variants (qnrB, qnrD and qnrS) and aac(6')-Ib genes were detected in 7(28%) and 3(12%) isolates respectively while all gentamicin resistant isolates possessed the aacC2 gene. The co-expression of blaCTX-M-15 with quinolones and aminoglycoside genes were 20% and 40% respectively. The prevalence of multiple drug resistance was 52%. Conclusion A high proportion of the studied E. coli isolates co-expressed ESBLs, quinolones and aminoglycosides resistance genes which call for prompt antibiotic stewardship and preventive strategies to limit the spread of these genes.
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Affiliation(s)
- Adebola Onanuga
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.,Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaspreet Mahindroo
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shreya Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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11
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Kazi M, Ajbani K, Tornheim JA, Shetty A, Rodrigues C. Multiplex PCR to detect pAmpC β-lactamases among enterobacteriaceae at a tertiary care laboratory in Mumbai, India. MICROBIOLOGY (READING, ENGLAND) 2019; 165:246-250. [PMID: 30543509 PMCID: PMC7003648 DOI: 10.1099/mic.0.000748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/02/2018] [Indexed: 12/18/2022]
Abstract
Drug-resistance due to AmpC β-lactamases represents a growing problem worldwide. In this study, a previously collected sample of 108 cefoxitin-resistant clinical isolates was assessed for AmpC β-lactamase production through routine phenotypic testing and double-disc cefoxitin/cloxcallin (DD-CC), cefoxitin/phenylboronic acid (CDT-PBA) and AmpC disc tests. The same isolates were characterized by a novel multiplex polymerase chain reaction molecular assay to detect the presence of blaACT, blaDHA, blaCIT, blaFOX, blaMIR and blaMOX. By phenotypic analysis, 56%, 55% and 48 % were detected as being AmpC β-lactamase producers by the CDT-PBA, DD-CC and AmpC disc tests, respectively. By molecular analysis, 57 % were determined to be AmpC β-lactamase producers, including 34 % blaFOX, 8 % blaCIT and 1.6 % blaDHAas mono-AmpC producers. The production of multiple AmpC molecular types was common, including 30 % with both blaCIT+FOX and 1.6 % each of blaCIT+DHA, blaACT+MIR, blaACT+FOX, blaACT+DHA and blaMIR+FOX. Molecular characterization of AmpC would help detect the prevalence of AmpC β-lactamase producers, facilitate proper patient management and implement infection control practices.
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Affiliation(s)
- Mubin Kazi
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Centre, Veer Sarvarkar Marg, Mahim, Mumbai, India
| | - Kanchan Ajbani
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Centre, Veer Sarvarkar Marg, Mahim, Mumbai, India
| | - Jeffrey A. Tornheim
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anjali Shetty
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Centre, Veer Sarvarkar Marg, Mahim, Mumbai, India
| | - Camilla Rodrigues
- Department of Microbiology, P. D. Hinduja Hospital and Medical Research Centre, Veer Sarvarkar Marg, Mahim, Mumbai, India
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Coertze RD, Bezuidenhout CC. The prevalence and diversity of AmpC β-lactamase genes in plasmids from aquatic systems. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2018; 2017:603-611. [PMID: 29851413 DOI: 10.2166/wst.2018.188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study aimed to investigate the presence and diversity of AmpC β-lactamase and integrase genes among DNA (genomic and plasmid) from bacterial populations in selected aquatic systems. Following an enrichment step, DNA was isolated and subjected to polymerase chain reaction (PCR) and digital droplet PCR. The intI1 gene and AmpC β-lactamase genes were present in genomic and plasmid DNA from all sites in the Mooi, Crocodile and Marico Rivers, with the exception of intI1 in the Marico River. Digital droplet PCR demonstrated that copy numbers varied considerably (0.0 to 29.38 copies per picogram of DNA). Some samples in which ampC was not detected, intI1 was present. Amplicons of ampC genes were subjected to restriction digest using HindIII. Samples where the restriction markers were absent were purified by cloning followed by plasmid extraction, PCR amplification, and sequencing of individual AmpC gene fragments. Phylogenetic analysis identified all positive AmpC genes as Class C β-lactamases, comprising of ampC, CMY- and ACT-families. Detecting AmpC and intl1 genes on plasmids suggests a high risk of horizontal gene transfer and potential dissemination of these and other antibiotic resistance genes surrounding immediate aquatic environments. Consequences of β-lactamase diversity in aquatic ecosystems are relatively unexplored in South African aquatic ecosystems.
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Affiliation(s)
- Roelof Dirk Coertze
- Unit for Environmental Science and Management: Microbiology, North-West University: Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, South Africa E-mail:
| | - Cornelius Carlos Bezuidenhout
- Unit for Environmental Science and Management: Microbiology, North-West University: Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, South Africa E-mail:
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13
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Zorgani A, Daw H, Sufya N, Bashein A, Elahmer O, Chouchani C. Co-Occurrence of Plasmid-Mediated AmpC β-Lactamase Activity Among Klebsiella pneumoniae and Escherichia Coli. Open Microbiol J 2017; 11:195-202. [PMID: 29151996 PMCID: PMC5678236 DOI: 10.2174/1874285801711010195] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/17/2017] [Accepted: 08/13/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction: Extended-spectrum β-lactamases (ESBLs), including the AmpC type, are important mechanisms of resistance among Klebsiella pneumoniae and Escherichia coli isolates. Objective: The aim of the study was to investigate the occurrence of AmpC-type β-lactamase producers isolated from two hospitals in Tripoli, Libya. Methods: All clinical isolates (76 K. pneumoniae and 75 E. coli) collected over two years (2013-2014) were evaluated for susceptibility to a panel of antimicrobials and were analyzed phenotypically for the ESBL and AmpC phenotype using E-test and ESBL and AmpC screen disc test. Both ESBL and AmpC-positive isolates were then screened for the presence of genes encoding plasmid-mediated AmpC β-lactamases by polymerase chain reaction (PCR). Results: Of the K. pneumoniae and E. coli tested, 75% and 16% were resistant to gentamicin, 74% and 1.3% to imipenem, 71% and 12% to cefoxitin, 80% and 12% to cefepime, 69% and 22.6% to ciprofloxacin, respectively. None of the E. coli isolates were multidrug resistant compared with K. pneumoniae (65.8%). K. pneumoniae ESBL producers were significantly higher (85.5%) compared with (17.3%) E. coli isolates (P <0.0001, OR=4.93). Plasmid-mediated AmpC genes were detected in 7.9% of K. pneumoniae, and 4% E. coli isolates. There was low agreement between phenotypic and genotypic methods, phenotypic testing underestimated detection of AmpC enzyme and did not correlate well with molecular results. The gene encoding CMY enzyme was the most prevalent (66.6%) of AmpC positive isolates followed by MOX, DHA and EBC. Only one AmpC gene was detected in 5/9 isolates, i.e, blaCMY (n=3), blaMOX (n=1), blaDHA (n=1). However, co-occurrence of AmpC genes were evident in 3/9 isolates with the following distribution:
blaCMY and blaEBC (n=1), and blaCMY and blaMOX (n=2). Neither blaFOX nor blaACC was detected in all tested isolates. All AmpC positive strains were resistant to cefoxitin and isolated from patients admitted to intensive care units. Conclusion: Further studies are needed for detection of other AmpC variant enzyme production among such isolates. Continued surveillance and judicious antibiotic usage together with the implementation of efficient infection control measures are absolutely required.
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Affiliation(s)
- Abdulaziz Zorgani
- Medical Microbiology and Immunology Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya.,National Centre for Disease Control, Tripoli, Libya
| | - Hiyam Daw
- Medical Microbiology and Immunology Department, Faculty of Pharmacy, University of Tripoli, Tripoli, Libya
| | - Najib Sufya
- Medical Microbiology and Immunology Department, Faculty of Pharmacy, University of Tripoli, Tripoli, Libya
| | - Abdullah Bashein
- Biochemistry Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya.,National Centre for Disease Control, Tripoli, Libya
| | - Omar Elahmer
- National Centre for Disease Control, Tripoli, Libya.,Faculty of Medical Technology, University of Tripoli, Tripoli, Libya
| | - Chedly Chouchani
- Laboratoire de Microorganismes et Biomolécules Actives Faculté des Sciences de Tunis, Université de Tunis El-Manar, 2098 El-Manar II, Tunisie.,Laboratoire de Recherche Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Technopôle de Borj-Cedria, BP-1003, Hammam-Lif 2050, Tunisie
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14
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Ye Q, Wu Q, Zhang S, Zhang J, Yang G, Wang H, Huang J, Chen M, Xue L, Wang J. Antibiotic-Resistant Extended Spectrum ß-Lactamase- and Plasmid-Mediated AmpC-Producing Enterobacteriaceae Isolated from Retail Food Products and the Pearl River in Guangzhou, China. Front Microbiol 2017; 8:96. [PMID: 28217112 PMCID: PMC5289952 DOI: 10.3389/fmicb.2017.00096] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/13/2017] [Indexed: 12/18/2022] Open
Abstract
We conducted a survey in 2015 to evaluate the presence of extended spectrum β-lactamase (ESBL)- and plasmid-mediated AmpC-producing Enterobacteriaceae in retail food and water of the Pearl River in Guangzhou, China, as well as their antibiotic resistance profiles. Samples (88 fresh food samples and 43 water samples) from eight different districts were analyzed by direct plating and after enrichment. Multidrug-resistant strains were found in 41.7 and 43.4% of food and water samples, respectively. ESBLs were found in 3.4 and 11.6% of food and water samples, respectively, and AmpC producers were found in 13.6 and 16.3% of food and water samples, respectively. Molecular characterization revealed the domination of blaCTX−Mgenes; plasmidic AmpC was of the type DHA-1 both in food and water samples. Thirteen of Fifty one β-lactamase-producing positive isolates were detected to be transconjugants, which readily received the β-lactamase genes conferring resistance to β-lactam antibiotics as well as some non-β-lactam antibiotics. These findings provide evidence that retail food and the river water may be considered as reservoirs for the dissemination of β-lactam antibiotics, and these resistance genes could readily be transmitted to humans through the food chain and water.
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Affiliation(s)
- Qinghua Ye
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China; School of Bioscience and Bioengineering, South China University of TechnologyGuangzhou, China
| | - Qingping Wu
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Shuhong Zhang
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Jumei Zhang
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Guangzhu Yang
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Huixian Wang
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Jiahui Huang
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Mongtong Chen
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Liang Xue
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China
| | - Juan Wang
- Guangdong Institute of Microbiology, State Key Laboratory of Applied Microbiology Southern ChinaGuangzhou, China; Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied MicrobiologyGuangzhou, China; College of Food Science, South China Agricultural UniversityGuangzhou, China
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