10.Frequency of AmpC β-Lactamases in Multi-Drug Resistant Isolates of Escherichia Coli at Tertiary Care Hospital
Whied ul Hussan Shahzad1, Ali Abuzar Raza2, Mehvish Javeed1, Sajida Zafar2, Muhammad Ibrahim3 and Ahsanullah M Mirbahar1
ABSTRACT
Objective: To determine the frequency of plasmid mediated AmpC beta-lactamases (PABLs) in multi-drug resistant isolates of E.coli.
Study Design: Cross sectional study
Place and Duration of Study: This study was conducted in a 450- bed Tertiary Care Hospital of Lahore, (Ittefaq Hospital, Lahore), Pakistan from January 2014 to December 2014.
Materials and Methods: Total 2610 clinical specimens were obtained from different wards and outdoor patient department (OPD) of hospital. Out of 2610 cultured samples only 1200 specimen showed significant growth of pathogens. These isolates were further proceeded for identification through colonial characters, gram staining and biochemical reactions. Standards protocols were used for inoculation, identification and isolation of E.coli. Cefoxitin resistance was used as a primary screening protocol for AmpC enzyme production. AmpC disk test (EDTA disk) was used as a confirmatory test for AmpC enzyme production.
Results: Out of 2610 culture samples only 1200 specimen showed significant growth of pathogens. Out of 1200 positive cultures, 421 (35.08%) isolates were identified as E.coli. Male patients 230 (54.63%) and 191 (45.37 %) female patients having mean ages 44.23 + 10.89 years. AmpC producing strains were more prevalent in surgical specimens than others. Out of 421 E.coli isolates, only 19.95% (n=84) E.coli were selected as plasmid mediated AmpC b-lactamase (PABLs) producers. After the confirmatory AmpC disk test only 8.07% (n=34) E.coli were isolated as PABLs producers and 47.05% (n=16) as ESBL producers. Total 20% (n=84) cefoxitin resistant was detected and 40.48% (n=34) of E.coli were isolated as PABLs producers from cefoxitin resistant. Out of (n=34) the percentage of PABLS and ESBLs co-producers was 26.47 % (n=9).
Conclusion: The isolates that involved in coproduction of PABLs and ESBL showed increased MICs against the applied cephalosporin drugs. This study noted high frequency of PABLs producing bacteria from hospital that may contribute to serious therapeutic problems.
Key Words: Hospital acquired infection (HAI), E.coli, Antimicrobial sensitivity testing, PABLs, ESBLs
Citation of article: Shahzad WH, Raza AA, Javeed M, Zafar S, Ibrahim M, Mirbahar AM. Frequency of AmpC β-Lactamases in Multi-Drug Resistant Isolates of Escherichia Coli at Tertiary Care Hospital. Med Forum 2021;32(10):45-49.