Characterization of plasmid mediated AmpC producing Escherichia coli clinical isolates from a tertiary care hospital in South India

Chakraborty, Arindam and Adhikari, Prabha and Shenoy, Shalini and Saralaya, Vishwas (2014) Characterization of plasmid mediated AmpC producing Escherichia coli clinical isolates from a tertiary care hospital in South India. Indian Journal of Pathology & Microbiology, 57 (2). pp. 255-258. ISSN 0377-4929

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Abstract

Context: Plasmid mediated AmpC (pAmpC) β-lactamase producing Escherichia coli are an emerging problem worldwide as they are now exhibiting resistance to multiple classes of antibiotics and are a major cause of therapeutic failure. Aims: The aim of this study was to characterize pAmpC β-lactamase producing extraintestinal E. coli, their phylogenetic distribution, resistance pattern, treatment options, and impact on patient’s clinical outcome. Settings and Design: This descriptive study was carried out in a multi-specialty tertiary care hospital. Materials and Methods: A total of 300 clinically signifi cant, non-repeat isolates were studied. AmpC disk test was used for phenotypic AmpC-β- lactamase detection. Molecular types of pAmpC were determined by a multiplex polymerase chain reaction (PCR). Phylogenetic analysis was performed by triplex PCR methods. Metallo-beta-lactamase (MBL) detection was done by E test. Antibiogram, treatment, and clinical outcome were collected in a structured proforma. Results: Although 95 isolates (32%) were phenotypically positive for AmpC, PCR detected CIT type of AmpC gene in only 37 isolates. Majority of strains were from phylogroup A (85%) and B1 (58%) which are considered as commensal groups. Co-production of ESBL’s was observed in 33 strains and 5 strains were found to be MBL producers. Most widely prescribed antibiotics were 3rd generation cephalosporins (30%), carbapenems (19%) and aminoglycosides (16%). Conclusions: Plasmid mediated AmpC producing isolates were found to exhibit a high degree of drug resistance, and they mainly belonged to commensal strains possibly due to misuse of antibiotics. Proper antibiotic policy is required to limit the spread of pAmpC producers or else it will lead to a therapeutic dead end in the near future.

Item Type: Article
Uncontrolled Keywords: Clinical outcome, multidrug-resistance, multiplex polymerase chain reaction, phylogenetic group, plasmid mediated AmpC -lactamases
Subjects: Medicine > KMC Mangalore > Microbiology
Medicine > KMC Mangalore > Medicine
Depositing User: KMCMLR User
Date Deposited: 28 Nov 2015 12:40
Last Modified: 28 Nov 2015 12:40
URI: http://eprints.manipal.edu/id/eprint/144625

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