Phenotypic Detection of ESBL, AmpC, MBL, and Their Co-occurrence among MDR Enterobacteriaceae Isolates.

Autor: Salvia T; Department of Microbiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India., Dolma KG; Department of Microbiology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India., Dhakal OP; Department of Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India., Khandelwal B; Department of Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Tadong, Gangtok, Sikkim, India., Singh LS; Department of Microbiology, Assam Down Town University, Guwahati 781026, Assam, India.; Microbial Resource Division, Institute of Bioresources and Sustainable Development (IBSD) Sikkim Centre, DBT, Tadong, Gangtok, Sikkim, India.
Jazyk: angličtina
Zdroj: Journal of laboratory physicians [J Lab Physicians] 2022 Apr 20; Vol. 14 (3), pp. 329-335. Date of Electronic Publication: 2022 Apr 20 (Print Publication: 2022).
DOI: 10.1055/s-0042-1744239
Abstrakt: Background  Emergence of extended-spectrum beta-lactamases (ESBLs), AmpC β-lactamases, and metallo-β lactamases (MBL), and their co-existence among members of Enterobacteriaceae pose newer diagnostic and therapeutic challenges. The present study examines the ESBL, AmpC, and MBL production by various phenotypic methods and their co-occurrence among the multidrug-resistant (MDR) Enterobacteriaceae clinical isolates. Materials and Methods  Four hundred non-repetitive Enterobacteriaceae clinical isolates were collected from the Central Referral Hospital, Sikkim. The isolates were used for identification and their antibiotic susceptibility tests were performed according to the Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL was detected by double-disc synergy test (DDST) and phenotypic confirmatory disc-diffusion test (PCDDT), AmpC detection by AmpC E-test, and boronic acid disc diffusion (BD) test. MBL was detected using the imipenem-imipenem/EDTA disc and carba-NP tests. Results  Around 76% were considered MDR. ESBL was seen in 58% and 50.4% based on DDST and phenotypic confirmation disc-diffusion test (PCDDT), respectively. AmpC was detected in 11.8% and 13.1% using a commercial E-test and boronic acid test, respectively. MBL were identified in 12.8% and 14.8% based on MBL imipenem-EDTA and carba-NP tests, respectively. Co-occurrence of ESBL and AmpC, ESBL and MBL, AmpC and MBL was seen in 5.2%, 11.5%, 1.3%, respectively, whereas a combination of these three β-lactamases was observed in only 0.3% of 304 MDR isolates. Conclusion  The findings highlight a high prevalence of β-lactamases and their co-production among the Enterobacteriaceae , mainly in Klebsiella pneumoniae and Escherichia coli isolates. The study further highlights the necessity to identify the MDR β-lactamases stains for effective therapy in severe as well as mild bacterial infections, thereby enabling to reduce the risk of MDR in hospital and community settings.
Competing Interests: Conflict of Interest None declared.
(The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
Databáze: MEDLINE
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