Therapeutic options for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases producing Escherichia coli and Klebsiella sp. isolated from various clinical samples

https://doi.org/10.19106/JMedSci005403202205

Vimal Kumar(1), Narinder Kaur(2*), Shubham Chauhan(3), Rosy Bala(4), Jyoti Chauhan(5), Harit Kumar(6), Shivani Devi(7)

(1) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(2) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(3) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(4) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(5) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(6) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(7) Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
(*) Corresponding Author

Abstract


Escherichia coli and Klebsiella sp. are the predominant species isolated from clinical samples. Recent and proper understanding of the antibiotic susceptibility pattern of extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases (AmpC) producing E. coli and Klebsiella sp. will prevent the distribution and future incidence of ESBL and AmpC. We designed this study to understand antibiotic susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. isolated from a tertiary care hospital in North India. A cross-sectional study was conducted from March 2021 to February 2022. Guring this period, various clinical samples were collected and further tested for ESBL producing E. coli and Klebsiella sp. by using the Double disc Synergy test, whereas AmpC was detected by the Boronic acid disk potentiation method. Their antibiotic susceptibility patterns were noted. Various clinical specimens were collected, in which 37.95% were shown growth of bacteria. Among them, 46.67% of E. coli and 25.21% of Klebsiella sp. were identified by standard laboratory protocol. ESBL producing isolates were 44.37% and 34.20% in E. coli and Klebsiella sp., respectively. Whereas AmpC production was detected in 18.27% of E. coli and 29.36% of Klebsiella sp. ESBL and AmpC producing E. coli and Klebsiella sp. isolated from pus, blood, and sputum samples showed the highest sensitivity towards colistin, tigecycline, and imipenem while in urine samples imipenem, meropenem showed the highest sensitivity. Susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. from various clinical specimens enhance hospital infection management and help clinicians to prescribe the appropriate antibiotics. The carbapenem, nitrofurantoin, colistin and tigecycline were showed highest susceptible against ESBL and AmpC producing E. coli and Klebsiella sp.


Keywords


ESBL; AmpC; β-lactamase; producer; bacterial resistance; E. coli; Klebsiella sp.

Full Text:

PDF


References

Rochford C, Sridhar D, Woods N, Saleh Z, Hartenstein L, Ahlawat H, et al. Global governance of antimicrobial resistance. Lancet 2018; 391(10134):1976-1978.
https://doi.org/10.1016/S0140-6736(18)31117-6
2.Daulaire N, Bang A, Tomson G, Kalyango J, Cars O. Universal access to effective antibiotics is essential for tackling antibiotic resistance. J Law Med Ethics 2015; 43(Suppl 3):17-21.
https://doi.org/10.1111/jlme.12269
3.Bush K, Jacoby GA, Medeiros AA. A functional classification scheme for beta-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 1995; 39(6):1211-33.
https://doi.org/10.1128/AAC.39.6.1211
4.Raut S, Rijal KR, Khatiwada S, Karna S, Khanal R, Adhikari J, et al. Trend and characteristics of Acinetobacterbaumannii infections in patients Attending universal College of Medical Sciences, Bhairahawa, Western Nepal: a longitudinal study of 2018. Infect Drug Resist 2020; 13:1631-41.
https://doi.org/10.2147/IDR.S257851
5.Drieux L, Brossier F, Sougakoff W, Jarlier V. Phenotypic detection of extended-spectrum β-lactamase production in Enterobacteriaceae: review and bench guide. Clin Microbiol Infect 2008; 14(suppl 1):90-103.
https://doi.org/10.1111/j.1469-0691.2007.01846.x
6.Clinical Laboratory and Standard Institute. Performance standard for antimicrobial susceptibility testing; twenty fourth information supplement. M100-s24. Wayne, PA: Clinical laboratory and standard institute 2021.
7.Fam N, Gamal D, Said M, Fadl LA, Dabei EE, Attar SE, et al. Detection of plasmid-mediated AmpC β-lactamases in clinically significant bacterial isolates in a Research Institute Hospital in Egypt. Life Sci J 2013; 10(2):2294-304.
8.Yilmaz NO, Agus N, Bozcal E, Oner O, Uzel A. Detection of plasmid-mediated AmpC β-lactamase in Escherichia coli and Klebsiella pneumoniae. Indian J Med Microbiol 2013; 31(1):53-9.
https://doi.org/10.4103/0255-0857.108723
9.Young AL, Nicol MP, Moodley C, Bamford CM. The accuracy of extended-spectrum beta-lactamase detection in Escherichia coli and Klebsiella pneumoniae in South African laboratories using the Vitek 2 Gram-negative susceptibility card AST-N255. S Afr J Infect Dis 2019; 34(1):114.
https://doi.org/10.4102/sajid.v34i1.114
10.Hassan A, Usman J, Kaleem F, Gill MM, Khalid A, Iqbal M, et al. Evaluation of different phenotypic methods for detection of Amp C β-lactamase producing bacteria in clinical isolates. J Coll Physicians Surg Pak 2013; 23(9):629-32.
11.Coudron PE. Inhibitor-based methods for detection of plasmid-mediated AmpC β-lactamases in Klebsiella spp., Escherichia coli, and Proteus mirabilis. J Clin Microbiol 2005; 43(8):4163-7.
https://doi.org/10.1128/JCM.43.8.4163-4167.2005
12.Taneja N, Singh G, Singh M, Madhup S, Pahil S, Sharma M. High occurrence of blaCMY-1 AmpC lactamase producing Escherichia coli in cases of complicated urinary tract infection (UTI) from a tertiary health care centre in north India. Indian J Med Res 2012; 136(2):289-91.
13.Sah RSP, Dhungel B, Yadav BK, Adhikari N, Shrestha UT, Lekhak B, et al. Detection of TEM and CTX-M Genes in Escherichia coli isolated from clinical specimens at Tertiary Care Heart Hospital, Kathmandu, Nepal. Diseases 2021; 9(1):15.
https://doi.org/10.3390/diseases9010015
14.Nepal K, Pant ND, Neupane B, Belbase A, Baidhya R, Shrestha RK, et al. Extended spectrum β-lactamase and metallo β-lactamase production among Escherichia coli and Klebsiella pneumoniae isolated from different clinical samples in a tertiary care hospital in Kathmandu, Nepal. Ann Clin Microbiol Antimicrob 2017; 16(1):62.
https://doi.org/10.1186/s12941-017-0236-7
15.Shivanna V, Achut R. Detection of co-existence of β-lactamases in Gram negative bacteria using disc potentiation tests. Indian J Microbiol Res 2017; 64-7.
https://doi.org/10. 18231/2394-5478 .2017.0013
16.Nasir K, Preeti S, Singh N. Prevalence of ESBL and AmpC β-lactamase in gram negative bacilli in various clinical samples at tertiary care hospital. Int Res J Medical Sci 2015; 3(8):1-6.
17.Yusuf I, Haruna M, Yahaya H. Prevalence and antibiotic susceptibility of AmpC and ESBLs producing clinical isolates at a tertiary health care center in Kano, north-west Nigeria. African J Clin Exp Microbiol 2013; 14(2):109-19.
https://doi.org/10.4314/ajcem.v14i2.12
18.Saffar H, Niaraki NA, Tali AG, Baseri Z, Abdollahi A, Yalfani R. Prevalence of AmpC β-lactamase in clinical isolates of Escherichia coli, Klebsiella spp., and Proteus mirabilis in a Tertiary Hospital in Tehran, Iran. Jundishapur J Microbiol 2016; 9(12):e39121.
https://doi.org/10.5812/jjm.39121
19.Somily AM, Habib HA, Absar MM, Arshad MZ, Manneh K, Al Subaie SS, et al. ESBL-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care hospital in Saudi Arabia. J Infect Dev Ctries 2014; 8(09):1129-36.
https://doi.org/10.3855/jidc.4292
20.Sasirekha B, Shivakumar S. Occurrence of plasmid-mediated AmpC β-lactamases among Escherichia coli and Klebsiella pneumoniae clinical isolates in a Tertiary Care Hospital in Bangalore. Indian J Microbiol 2012; 52(2):174-9.
https://doi.org/10.1007/s12088-011-0214-2
21.Cho YH, Jung SI, Chung HS, Yu HS, Hwang EC, Kim SO, et al. Antimicrobial susceptibilities of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in health care-associated urinary tract infection: focus on susceptibility to fosfomycin. Int Urol Nephrol 2015; 47(7):1059-66.
https://doi.org/10.1007/s11255-015-1018-9
22.Halabi MK, Lahlou FA, Diawara I, El Adouzi Y, Marnaoui R, Benmessaoud R, et al. Antibiotic resistance pattern of extended spectrum β-lactamase producing Escherichia coli isolated from patients with urinary tract infection in Morocco. Front Cell Infect Microbiol 2021; 11:720701.
https://doi.org/10.3389/fcimb.2021.720701
23.Hedaoo J, Rathod V, Paramne A. Bacteriology of surgical site infections and antibiotic susceptibility pattern in isolates of postoperative wound infections. AJS 2019; 5(1-2):16-20.
24.Saikumar C, Nishanthy M. A study on extended spectrum beta lactamase producing gram negative bacilli among blood culture isolates and their antibiotic susceptibility pattern from intensive care units in a tertiary care hospital. World J Pharm Res 2020 9;12:1408-1414.
25.Malik N, Bisht D, Faujdar SS. Extended spectrum β-lactamases and metallo-β-lactamases production in Klebsiella pneumoniae isolates causing pneumonia in rural population of Uttar Pradesh, India. Int J Curr Microbiol App Sci 2019; 8(6):1732-8.
https://doi.org/10.20546/ijcmas.2019.806.207
26.Tekele SG, Teklu DS, Tullu KD, Birru SK, Legese MH. Extended-spectrum β-lactamase and AmpC beta-lactamases producing Gram negative bacilli isolated from clinical specimens at International Clinical Laboratories, Addis Ababa, Ethiopia. PLoS One 2020; 15(11):e0241984.
https://doi.org/10.1371/journal.pone.0241984



DOI: https://doi.org/10.19106/JMedSci005403202205

Article Metrics

Abstract views : 797 | views : 1286




Copyright (c) 2022 Shubham Chauhan

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.