Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients

Background and Objective: Production of beta-lactamase enzymes is the most common mechanism of bacterial resistance against beta-lactam antibiotics. The aim of this study was to determine the antibiotic resistance pattern and the frequency of AmpC genes in Escherichia coli (E.coli) isolated in outpa...

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Main Authors: Alisha Akya, Azam Elahi, Roya Chegene Lorestani, Yazdan Hamzavi
Format: Article
Language:fas
Published: Golestan University of Medical Sciences 2019-01-01
Series:مجله دانشگاه علوم پزشکی گرگان
Subjects:
Online Access:http://goums.ac.ir/journal/browse.php?a_code=A-10-1-1080&slc_lang=en&sid=1
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author Alisha Akya
Azam Elahi
Roya Chegene Lorestani
Yazdan Hamzavi
author_facet Alisha Akya
Azam Elahi
Roya Chegene Lorestani
Yazdan Hamzavi
author_sort Alisha Akya
collection DOAJ
description Background and Objective: Production of beta-lactamase enzymes is the most common mechanism of bacterial resistance against beta-lactam antibiotics. The aim of this study was to determine the antibiotic resistance pattern and the frequency of AmpC genes in Escherichia coli (E.coli) isolated in outpatients. Methods: In this descriptive-analytical study, 67 isolates of E.coli were investigated from urinary tract infection of outpatients of the largest medical center in Kermanshah, west of Iran. Their susceptibility to ceftriaxone, cefotaxime, ceftazidime, cefoxitin and imipenem antibiotics was determined using disk diffusion. AmpC phenotypic screening was performed using combination disk method (cefoxitin with and without boronic acid). After extraction the bacterial genome, the presence of MOX, CIT, DHA, ACC, EBC and FOX genes were tested by multiplex PCR. Results: The resistance of 67 E.coli isolated to ceftriaxone, cefotaxime, ceftazidime and cefoxitin was 49.2%, 49.2%, 37.3% and 25.3%, respectively. The 100% of the isolates were sensitive to imipenem. Seventeen (25.3%) and 9 isolates (13.4%) were phenotypically and genotypically positive for AmpC, respectively. The prevalence of CIT, MOX, FOX, DHA and EBC genes was 7.4%, 5.9%, 4.4%, 4.4% and 2.9%, respectively. However, the ACC gene was not found in isolates. Except for significant correlation between AmpC phenotype and MOX gene (P<0.05), no significant statistical relationship was found between phenotype and AmpC genotype. There was a significant correlation between AmpC phenotype and ceftazidime antibiotic (P<0.05). There was a significant correlation between CIT gene and EBC and FOX (P<0.05). Conclusion: AmpC-producing E.coli isolates cause significant resistance to cephalosporins. One of the current therapeutic options is using of carbapenems. However, the relatively high prevalence and synergistic genes of AmpC in outpatients are a big concern and unfortunately it reflects the fact that these isolates are prevalent in the society.
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spelling doaj.art-e1394fa89e3a45979e131221539884b82022-12-22T01:22:59ZfasGolestan University of Medical Sciencesمجله دانشگاه علوم پزشکی گرگان1562-47652008-40802019-01-01204108114Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from OutpatientsAlisha Akya0Azam Elahi1Roya Chegene Lorestani2Yazdan Hamzavi3 Associate Professor, Department of Microbiology, Nosocomial Infection Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran M.Sc of Medical Microbiology, Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran M.Sc of Medical Microbiology, Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Associate Professor, Department of Parasitology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Background and Objective: Production of beta-lactamase enzymes is the most common mechanism of bacterial resistance against beta-lactam antibiotics. The aim of this study was to determine the antibiotic resistance pattern and the frequency of AmpC genes in Escherichia coli (E.coli) isolated in outpatients. Methods: In this descriptive-analytical study, 67 isolates of E.coli were investigated from urinary tract infection of outpatients of the largest medical center in Kermanshah, west of Iran. Their susceptibility to ceftriaxone, cefotaxime, ceftazidime, cefoxitin and imipenem antibiotics was determined using disk diffusion. AmpC phenotypic screening was performed using combination disk method (cefoxitin with and without boronic acid). After extraction the bacterial genome, the presence of MOX, CIT, DHA, ACC, EBC and FOX genes were tested by multiplex PCR. Results: The resistance of 67 E.coli isolated to ceftriaxone, cefotaxime, ceftazidime and cefoxitin was 49.2%, 49.2%, 37.3% and 25.3%, respectively. The 100% of the isolates were sensitive to imipenem. Seventeen (25.3%) and 9 isolates (13.4%) were phenotypically and genotypically positive for AmpC, respectively. The prevalence of CIT, MOX, FOX, DHA and EBC genes was 7.4%, 5.9%, 4.4%, 4.4% and 2.9%, respectively. However, the ACC gene was not found in isolates. Except for significant correlation between AmpC phenotype and MOX gene (P<0.05), no significant statistical relationship was found between phenotype and AmpC genotype. There was a significant correlation between AmpC phenotype and ceftazidime antibiotic (P<0.05). There was a significant correlation between CIT gene and EBC and FOX (P<0.05). Conclusion: AmpC-producing E.coli isolates cause significant resistance to cephalosporins. One of the current therapeutic options is using of carbapenems. However, the relatively high prevalence and synergistic genes of AmpC in outpatients are a big concern and unfortunately it reflects the fact that these isolates are prevalent in the society.http://goums.ac.ir/journal/browse.php?a_code=A-10-1-1080&slc_lang=en&sid=1Escherichia coliUrinary tract infectionAmpC
spellingShingle Alisha Akya
Azam Elahi
Roya Chegene Lorestani
Yazdan Hamzavi
Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients
مجله دانشگاه علوم پزشکی گرگان
Escherichia coli
Urinary tract infection
AmpC
title Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients
title_full Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients
title_fullStr Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients
title_full_unstemmed Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients
title_short Antibiotic resistance and phenotypically and genotypically AmpC beta-lactamases among Escherichia coli isolates from Outpatients
title_sort antibiotic resistance and phenotypically and genotypically ampc beta lactamases among escherichia coli isolates from outpatients
topic Escherichia coli
Urinary tract infection
AmpC
url http://goums.ac.ir/journal/browse.php?a_code=A-10-1-1080&slc_lang=en&sid=1
work_keys_str_mv AT alishaakya antibioticresistanceandphenotypicallyandgenotypicallyampcbetalactamasesamongescherichiacoliisolatesfromoutpatients
AT azamelahi antibioticresistanceandphenotypicallyandgenotypicallyampcbetalactamasesamongescherichiacoliisolatesfromoutpatients
AT royachegenelorestani antibioticresistanceandphenotypicallyandgenotypicallyampcbetalactamasesamongescherichiacoliisolatesfromoutpatients
AT yazdanhamzavi antibioticresistanceandphenotypicallyandgenotypicallyampcbetalactamasesamongescherichiacoliisolatesfromoutpatients