质粒介导的AmpC β-内酰胺酶活性在肺炎克雷伯菌和大肠杆菌中共现

Q3 Immunology and Microbiology Open Microbiology Journal Pub Date : 2017-09-26 eCollection Date: 2017-01-01 DOI:10.2174/1874285801711010195
Abdulaziz Zorgani, Hiyam Daw, Najib Sufya, Abdullah Bashein, Omar Elahmer, Chedly Chouchani
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引用次数: 21

摘要

广谱β-内酰胺酶(ESBLs),包括AmpC型,是肺炎克雷伯菌和大肠杆菌分离株耐药的重要机制。目的:调查利比亚的黎波里两家医院分离的ampc型β-内酰胺酶产生菌的发生情况。方法:对2013-2014年两年内收集的所有临床分离株(76株肺炎克雷伯菌和75株大肠杆菌)进行抗菌药物敏感性评估,并采用E-test和ESBL和AmpC筛片试验分析ESBL和AmpC表型。然后用聚合酶链反应(PCR)筛选ESBL和AmpC阳性分离株是否存在编码质粒介导的AmpC β-内酰胺酶的基因。结果:检出的肺炎克雷伯菌和大肠杆菌对庆大霉素耐药率分别为75%和16%,对亚胺培南耐药率分别为74%和1.3%,对头孢西丁耐药率分别为71%和12%,对头孢吡肟耐药率分别为80%和12%,对环丙沙星耐药率分别为69%和22.6%。与肺炎克雷伯菌(65.8%)相比,所有大肠杆菌分离株均无多重耐药。肺炎克雷伯菌ESBL产生菌(85.5%)显著高于大肠杆菌(17.3%)和大肠杆菌(4%)。表型检测方法与基因检测方法的一致性较低,表型检测低估了AmpC酶的检测,与分子检测结果的相关性不强。AmpC阳性菌株中编码CMY酶的基因最多(66.6%),其次是MOX、DHA和EBC。5/9株分离株中仅检测到1个AmpC基因,分别为blaCMY (n=3)、blaMOX (n=1)、blaDHA (n=1)。而AmpC基因在3/9的菌株中明显共现,分布如下:blaCMY和blaEBC (n=1), blaCMY和blaMOX (n=2)。所有分离株均未检出blaFOX和blaACC。所有AmpC阳性菌株均对头孢西丁耐药,并从重症监护病房住院患者中分离出来。结论:需要进一步的研究来检测这些分离株中其他AmpC变异酶的产生。绝对需要继续监测和明智地使用抗生素,同时实施有效的感染控制措施。
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Co-Occurrence of Plasmid-Mediated AmpC β-Lactamase Activity Among Klebsiella pneumoniae and Escherichia Coli.

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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来源期刊
Open Microbiology Journal
Open Microbiology Journal Immunology and Microbiology-Immunology and Microbiology (all)
CiteScore
1.80
自引率
0.00%
发文量
24
期刊介绍: The Open Microbiology Journal is a peer-reviewed open access journal which publishes research articles, reviews/mini-reviews, case studies, guest edited thematic issues and short communications/letters covering theoretical and practical aspects of Microbial systematics, evolutionary microbiology, immunology, virology, parasitology , bacteriology, mycology, phycology, protozoology, microbial ecology, molecular biology, microbial physiology, biochemistry, microbial pathogenesis, host-microbe interaction, systems microbiology, synthetic microbiology, bioinformatics. The Open Microbiology Journal , a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and freely available to researchers worldwide.
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