PDF herunterladen
CC BY-NC-ND 4.0 · J Lab Physicians 2013; 5(02): 090-093
DOI: 10.4103/0974-2727.119849
Original Article

Determination of Extended-Spectrum β-Lactamases and AmpC Production in Uropathogenic Isolates of Escherichia coli and Susceptibility to Fosfomycin

Varsha Gupta
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
,
Hena Rani
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
,
Nidhi Singla
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
,
Neelam Kaistha
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
,
Jagdish Chander
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
› Institutsangaben Source of Support: Nil.
› Weitere Informationen
Auch verfügbar auf
  als PDF herunterladen Lizenzen und Reprints

ABSTRACT

Background: Urinary tract infection due to Escherichia coli is one of the common problem in clinical practice. Various drug resistance mechanisms are making the bacteria resistant to higher group of drugs making the treatment options very limited. This study was undertaken to detect ESBLs and AmpC production in uropathogenic Escherichia coli isolates and to determine their antimicrobial susceptibility pattern with special reference to fosfomycin.

Materials and Methods: A total number of 150 E. coli isolates were studied. ESBL detection was done by double disc synergy and CLSI method. AmpC screening was done using cefoxitin disc and confirmation was done using cefoxitin/cefoxitin-boronic acid discs. In AmpC positive isolates, ESBLs was detected by modifying CLSI method using boronic acid. Antimicrobial susceptibility pattern was determined following CLSI guidelines. Fosfomycin susceptibility was determined by disc diffusion and E-test methods.

Results: ESBLs production was seen in 52.6% of isolates and AmpC production was seen in 8% of isolates. All AmpC producers were also found to be ESBLs positive. ESBLs positive isolates were found to be more drug resistant than ESBLs negative isolates. All the strains were found to be fosfomycin sensitive.

Conclusions: ESBLs and AmpC producing isolates are becoming prevalent in E. coli isolates from community setting also. Amongst the oral drugs, no in-vitro resistance has been seen for fosfomycin making it a newer choice of drug (although not new) in future. An integrated approach to contain antimicrobial resistance should be actually the goal of present times.

Keywords

AmpC - E. coli - extended-spectrum β-lactamases - fosfomycin - urinary tract infection


Publikationsverlauf

Artikel online veröffentlicht:
07. April 2020

© 2013.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • REFERENCES

  • 1 Auer S, Wojna A, Hell M. Oral treatment options for ambulatory patients with urinary tract infections caused by extended- spectrum-beta-lactamase-producing Escherichia coli. Antimicrob Agents Chemother 2010;54:4006-8.
  • 2 Payne DJ, Cramp R, Winstanley DJ, Knowles DJ. Comparative activities of clavulanic acid, sulbactam, and tazobactam against clinically important beta-lactamases. Antimicrob Agents Chemother 1994;38:767-72.
  • 3 Yagi T, Wachino J, Kurokawa H, Suzuki S, Yamane K, Doi Y, et al. Practical methods using boronic acid compounds for identification of class C beta-lactamase producing Klebsiella pneumoniae and Escherichia coli. J Clin Microbiol 2005;43:2551-8.
  • 4 Coudron PE. Inhibitor-based methods for detection of plasmid-mediated AmpC beta-lactamases in Klebsiella spp., Escherichia coli, and Proteus mirabilis. J Clin Microbiol 2005;43:4163-7.
  • 5 Paterson DL, Bonomo RA. Extended-spectrum β-lactamases: A clinical update. Clin Microbiol Rev 2005;18:657-86.
  • 6 Karlowsky JA, Thornsberry C, Jones ME, Sahm DF. Susceptibility of antimicrobial-resistant urinary Escherichia coli isolates to fluoroquinolones and nitrofurantoin. Clin Infect Dis 2003;36:183-7.
  • 7 Gupta V, Singla N, Chander J. Detection of ESBLs using third and fourth generation cephalosporins in double disc synergy test. Indian J Med Res 2007;126:486-7.
  • 8 Song W, Bae IK, Lee YN, Lee CH, Lee SH, Jeong SH. Detection of extended-spectrum beta-lactamases by using boronic acid as an AmpC beta-lactamase inhibitor in clinical isolates of Klebsiella spp. and Escherichia coli. J Clin Microbiol 2007;45:1180-4.
  • 9 Lee W, Jung B, Hong SG, Song W, Jeong SH, Lee K, et al. Comparison of 3 phenotypic-detection methods for identifying plasmid-mediated AmpC beta-lactamase-producing Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis strains. Korean J Lab Med 2009;29:448-54.
  • 10 Taneja N, Rao P, Arora J, Dogra A. Occurrence of ESBL and Amp-C â-lactamases and susceptibility to newer antimicrobial agents in complicated UTI. Indian J Med Res 2008;127:85-8.
  • 11 Kothari A, Sagar V. Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: A multicenter study. J Infect Dev Ctries 2008;2:354-8.
  • 12 Chislett RJ, White G, Hills T, Turner DP. Fosfomycin susceptibility among extended-spectrum beta-lactamase producing Escherichia coli in Nottingham, UK. J Antimicrob Chemother 2010;65:1076-7.
  • 13 Maraki S, Samonis G, Rafailidis PI, Vouloumanou EK, Mavromanolakis E, Falagas ME. Susceptibility of urinary tract bacteria to fosfomycin. Antimicrob Agents Chemother 2009;53:4508-10.
  • 14 Falagas ME, Giannopoulou KP, Kokolakis GN, Rafailidis PI. Fosfomycin: Use beyond urinary tract and gastrointestinal infections. Clin Infect Dis 2008;46:1069-77.
  • 15 Suárez JE, Mendoza MC. Plasmid-encoded fosfomycin resistance. Antimicrob Agents Chemother 1991;35:791-5.