Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India
INTRODUCTION: Acinetobacter baumannii has now emerged as a significant nosocomial pathogen in health-care setting ESP in intensive care units. Rapidly growing resistance among clinical isolates suggests a need to detect resistance mechanisms in this organism. The present study was designed to compar...
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| Format: | Article |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2019-04-01
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| Series: | Journal of Laboratory Physicians |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/JLP.JLP_139_18 |
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| author | Priyam Batra Surbhi Khurana Aishwarya Govindaswamy Anjana Aravinda Vijeta Bajpai Muruganantham Ayyanar Purva Mathur Rajesh Malhotra |
| author_facet | Priyam Batra Surbhi Khurana Aishwarya Govindaswamy Anjana Aravinda Vijeta Bajpai Muruganantham Ayyanar Purva Mathur Rajesh Malhotra |
| author_sort | Priyam Batra |
| collection | DOAJ |
| description | INTRODUCTION: Acinetobacter baumannii has now emerged as a significant nosocomial pathogen in health-care setting ESP in intensive care units. Rapidly growing resistance among clinical isolates suggests a need to detect resistance mechanisms in this organism. The present study was designed to compare the various phenotypic tests available with the gold standard of genotype.
METHODOLOGY: The present study was conducted to include all isolates of Acinetobacter spp. isolated over 3 years. Their resistance to various antibiotics was determined and extended spectrum beta-lactamases (ESBL) and AmpC production in the isolates showing resistance to ceftazidime/ceftriaxone/cefotaxime (CAZ/CTR/CTX) was determined. ESBL and AmpC production was confirmed using polymerase chain reaction (PCR).
RESULTS: A total of 154 strains were isolated, and all the strains were tested for ESBL and AmpC detection. Of the strains tested, 15 (9.7%), 17 (11%), 24 (15.6%), 27 (17.5%), 54 (35%), 67 (43.5%), and 72 (46.7%) strains showed ESBL production using CTX/CTX-clavulanate double-disc synergy test (DDST), CTX/CTX-clavulanate E-test, CAZ/CAZ-clavulanate DDST, CAZ/CAZ-clavulanate E-test, Piperacillin/Piperacillin-tazobactam (TZ) DDST, CTR/CTR-Sulbactum DDST, and Piperacillin/Piperacillin-TZ E-test, respectively. 20 (12.9%) and 19 (12.3%) of strains were positive for AmpC production using AmpC disc test and Boronic acid inhibition test, respectively. Genotype analysis using PCR for TEM, SHV, CTXM, PER, and VEB genes was done and 69 (51.5%) strains were positive for TEM gene.
DISCUSSION: ESBL detection in Acinetobacter spp. is difficult as standard guidelines for the same are not available unlike in enterobacteriaceae, and there are no zone diameter breakpoints for aztreonam and cefpodoxime. In comparison, piperacillin/piperacillin-TZ E-test had the best sensitivity and specificity for ESBL detection.
CONCLUSION: Standard guidelines for ESBL detection in nil fermeners like Acinetobacter spp. must be laid down for ease of detection. Use of piperacillin/piperacillin-tazobactam E-test could be used as one of the standard methods. |
| first_indexed | 2024-12-22T04:32:15Z |
| format | Article |
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| issn | 0974-2727 0974-7826 |
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| publishDate | 2019-04-01 |
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| series | Journal of Laboratory Physicians |
| spelling | doaj.art-235071aa3269457485d4375bfd5970122022-12-21T18:39:00ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Laboratory Physicians0974-27270974-78262019-04-01110212813210.4103/JLP.JLP_139_18Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from IndiaPriyam Batra0Surbhi Khurana1Aishwarya Govindaswamy2Anjana Aravinda3Vijeta Bajpai4Muruganantham Ayyanar5Purva Mathur6Rajesh Malhotra7Department of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Lab Medicine and JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Orthopaedics JPNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, IndiaINTRODUCTION: Acinetobacter baumannii has now emerged as a significant nosocomial pathogen in health-care setting ESP in intensive care units. Rapidly growing resistance among clinical isolates suggests a need to detect resistance mechanisms in this organism. The present study was designed to compare the various phenotypic tests available with the gold standard of genotype. METHODOLOGY: The present study was conducted to include all isolates of Acinetobacter spp. isolated over 3 years. Their resistance to various antibiotics was determined and extended spectrum beta-lactamases (ESBL) and AmpC production in the isolates showing resistance to ceftazidime/ceftriaxone/cefotaxime (CAZ/CTR/CTX) was determined. ESBL and AmpC production was confirmed using polymerase chain reaction (PCR). RESULTS: A total of 154 strains were isolated, and all the strains were tested for ESBL and AmpC detection. Of the strains tested, 15 (9.7%), 17 (11%), 24 (15.6%), 27 (17.5%), 54 (35%), 67 (43.5%), and 72 (46.7%) strains showed ESBL production using CTX/CTX-clavulanate double-disc synergy test (DDST), CTX/CTX-clavulanate E-test, CAZ/CAZ-clavulanate DDST, CAZ/CAZ-clavulanate E-test, Piperacillin/Piperacillin-tazobactam (TZ) DDST, CTR/CTR-Sulbactum DDST, and Piperacillin/Piperacillin-TZ E-test, respectively. 20 (12.9%) and 19 (12.3%) of strains were positive for AmpC production using AmpC disc test and Boronic acid inhibition test, respectively. Genotype analysis using PCR for TEM, SHV, CTXM, PER, and VEB genes was done and 69 (51.5%) strains were positive for TEM gene. DISCUSSION: ESBL detection in Acinetobacter spp. is difficult as standard guidelines for the same are not available unlike in enterobacteriaceae, and there are no zone diameter breakpoints for aztreonam and cefpodoxime. In comparison, piperacillin/piperacillin-TZ E-test had the best sensitivity and specificity for ESBL detection. CONCLUSION: Standard guidelines for ESBL detection in nil fermeners like Acinetobacter spp. must be laid down for ease of detection. Use of piperacillin/piperacillin-tazobactam E-test could be used as one of the standard methods.http://www.thieme-connect.de/DOI/DOI?10.4103/JLP.JLP_139_18 acinetobacter spp.ampcantibiotic resistanceextended spectrum beta-lactamases |
| spellingShingle | Priyam Batra Surbhi Khurana Aishwarya Govindaswamy Anjana Aravinda Vijeta Bajpai Muruganantham Ayyanar Purva Mathur Rajesh Malhotra Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India Journal of Laboratory Physicians acinetobacter spp. ampc antibiotic resistance extended spectrum beta-lactamases |
| title | Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India |
| title_full | Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India |
| title_fullStr | Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India |
| title_full_unstemmed | Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India |
| title_short | Antibiotic resistance profile and co-production of extended spectrum beta lactamases and AmpC in Acinetobacter spp. in a level 1 trauma center from India |
| title_sort | antibiotic resistance profile and co production of extended spectrum beta lactamases and ampc in acinetobacter spp in a level 1 trauma center from india |
| topic | acinetobacter spp. ampc antibiotic resistance extended spectrum beta-lactamases |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/JLP.JLP_139_18 |
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