Molecular Epidemiology of AmpC-Producing Klebsiella Pneumoniae Isolated from Perioperative Patients in a Tertiary Hospital

How to Cite:Roghayeh Gholizadeh Doran MahallehNadia Kazemi PourFarokh Rokhbakhsh-ZaminMolecular Epidemiology of AmpC-Producing Klebsiella Pneumoniae Isolated from Perioperative Patients in a Tertiary Hospital.J Cell Mol Anesth.6(3):e150191.https://doi.org/10.22037/jcma.v6i3.35261.

Abstract

Background: Extended-spectrum cephalosporin-resistant organisms are the sources of AmpC- type ?-lactamase isolates. AmpC-producing Klebsiella pneumoniae isolates are a major challenge in clinics due to their high rate of antibiotic resistance. This study aimed to detect AmpC ?-lactamases in K. pneumoniae isolated from hospitalized patients with a surgical history. Materials and Methods: This cross-sectional study was performed on 120 urine catheter samples. After antibiotic susceptibility testing, plasmid-mediated AmpC was detected by double-disc plus combined disc test (DCDT) and three-dimensional extract test (TDET). The genotypic detection of plasmid-mediated AmpC was carried out using multiplex-polymerase chain reaction (PCR). Results: Of 120 samples, 60 (50%) instances of K. pneumoniae were isolated. The highest and lowest resistance rates were related to cefotaxime (CTX) (50%) and ciprofloxacin (CIP) (23.3%), respectively. 18.3% (n: 11) K. pneumoniae showed an AmpC phenotype in DCDT and TDET tests. AmpC genotyping showed that the prevalence of CIT, DHA, EBC, and ACC genotypes were 47.1%, 35.3%, 29.5%, and 23.6%, respectively. MOX and FOX genotypes were not identified in the isolates of interest. Conclusion: AmpC ?-lactamase identification tests should be considered a routine microbiology workup for gram-negative microorganisms. Multiplex-PCR can identify the plasmid AmpC genotypes. ?

Keywords

AmpC

Klebsiella pneumoniae

double-disc plus combined test

three-dimensional extract test.

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Author(s):

Roghayeh Gholizadeh Doran Mahalleh:[PubMed][Scholar]
Nadia Kazemi Pour:[PubMed][Scholar]
Farokh Rokhbakhsh-Zamin:[PubMed][Scholar]