AmpC β-Lactamase Variable Expression in Common Multidrug-Resistant Nosocomial Bacterial Pathogens from a Tertiary Hospital in Cairo, Egypt

Abstract

The emergence of AmpC (pAmpC) β-lactamases conferring resistance to the third-generation cephalosporins has become a major clinical concern worldwide. In this study, we aimed to evaluate the expression of AmpC β-lactamase encoding gene among the pathogenic Gram-positive and Gram-negative resistant bacteria screened from clinical samples of Egyptian patients enrolled into El-Qasr El-Ainy Tertiary Hospital in Cairo, Egypt. A total of 153 bacterial isolates of the species Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus faecium were isolated from patients diagnosed with urinary tract infection (UTI), respiratory tract infection (RTI), and wound infections. The total number of E. faecium isolates was 53, comprising 29 urine isolates, 5 sputum isolates, and 19 wound swab isolates, whereas the total number of P. aeruginosa isolates was 49, comprising 27 urine isolates, 7 sputum isolates, and 15 wound swab isolates, and that of the K. pneumoniae isolates was 51, comprising 20 urine isolates, 25 sputum isolates, and 6 wound swab isolates. Our results indicated that there is no significant difference in the expression of AmpC β-lactamase gene among the tested bacterial species with respect to the type of infection and/or clinical specimen. However, the expression patterns of AmpC β-lactamase gene markedly differed according to the antibacterial resistance characteristics of the tested isolates.

Molecular Epidemiology of Extended-Spectrum Beta-Lactamase and AmpC Producing Enterobacteriaceae among Sepsis Patients in Ethiopia: A Prospective Multicenter Study

“…In the current study, 14% of Enterobacteriaceae harbored at least one AmpC gene while seven strains had multiple AmpC genes. However, a higher AmpC detection was reported in Cairo, Egypt [ 16 ]. Several variants of AmpC were detected, with bla ACT ( n = 25) as the most common variant, which was in accordance with another study [ 19 ].…”

“…Enterobacteriaceae that produce AmpC enzymes can also hydrolyze β-lactams and inhibitor–β-lactam combinations [ 15 ]. AmpC may be encoded in the chromosomes or plasmids of most members of Enterobacteriaceae [ 16 ]. Around the globe, several AmpC genes are detected in Enterobacteriaceae and of these genes the bla CMY and bla DHA families are the most common [ 17 , 18 , 19 , 20 ].…”

Association of multidrug resistance behavior of clinical Pseudomonas aeruginosa to pigment coloration

“…Fortunately, a number of rapid methods have been developed to identify such MDR species and antibiotic susceptibility within a couple of hours from clinical isolates that have benefited from the reduction in increasing mortality [ 32 – 35 ]. Common characteristics for P. aeruginosa to represent the MDR behavior in clinical strains are the presence of drug resistance genes or its mutant variety in bacterial plasmid or in its genome, high expression of a β-lactamase group of enzymes, and up-regulation of drug efflux pump have been documented [ 36 – 39 ]. Interestingly, a recent effort using proteomic profiling has characterized antibiotics sensitive and MDR clinical strains of P. aeruginosa that provided non-genetic changes associated with antibiotic susceptibility responses [ 40 ].…”

Multidrug Resistance Behaviors of Clinical Pseudomonas aeruginosa Strains Associated to Pigment Coloration

“…Common characteristics for P. aeruginosa to represent the MDR behavior in clinical strains are presence of drug resistance genes or its mutant variety in bacterial plasmid or in its genome, high expression of β-lactamase group of enzymes, and up regulation of drug efflux pump have been documented [36][37][38][39]. Interestingly, a recent effort using proteomic profiling has characterized antibiotics sensitive and MDR clinical strains of P. aeruginosa that provided non-genetic changes associated with antibiotic susceptibility responses [40].…”