Detection and genotype analysis of AmpC β-lactamase in Klebsiella pneumoniae from tertiary hospitals

Liu, Xiang‐Qun; Liu, Yong‐Rui

doi:10.3892/etm.2016.3295

Cited by 24 publications

(12 citation statements)

References 33 publications

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“…Moreover, the rate of positive detection of AmpC type β-lactamase was 14%, with only the DHA type being detected. DHA has been reported as the most frequent among AmpC β-lactamase-producing KP isolates in many studies ( Shi et al, 2013 ; Liu and Liu, 2016 ), which was in line with our study. Therefore, DHA is speculated to be the most common type of AmpC β-lactamase in China.…”

Section: Discussionsupporting

confidence: 93%

Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infections in Eastern China

et al. 2017

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Background: The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses an immediate threat to treatment worldwide. This retrospective study assessed the molecular epidemiology and determined the risk factors for and outcomes of CRKP infections in a general teaching hospital in Shanghai, China.Methods: From January 2013 to July 2015, 100 consecutive unique CRKP isolates isolated from hospitalized patients were collected. Isolates were screened for antibiotic resistance genes by polymerase chain reaction and molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Patients infected with CRKP comprised the case group and were compared to the control group of patients infected with carbapenem-susceptible Klebsiella pneumoniae. Therapeutic effects were compared in the CRKP infection group.Results: Among the 100 CRKP isolates, the percentages of multidrug-resistant, extensively drug-resistant (XDR), and pandrug-resistant were 50.0, 50.0, and 0%, respectively. All the CRKP isolates produced KPC-2 and could be divided into 18 PFGE clusters (A–O) and 70 subtypes. No dominant intra-hospital PFGE type was detected using a cutoff of 80% similarity. The ratio of CRKP infection to colonization was 51 to 49. Risk factors correlated with CRKP infection included pulmonary disease (p = 0.038), ICU stay (p = 0.002), invasive ventilation (p = 0.009), blood transfusion (p = 0.028), parenteral nutrition (p = 0.004), sputum suction (p = 0.006), medical history of previous hospitalization (p = 0.022), exposure to antibiotics 90 days before infection (p = 0.030), and antibiotic exposure during hospital stay including carbapenems (p = 0.013), enzyme inhibitors (p = 0.021), nitroimidazoles (p = 0.029), and glycopeptides (p = 0.000). Multivariable analysis showed that sputum suction (odds ratio 3.090, 95% confidence intervals 1.004–9.518, p = 0.049) was an independent risk factor for CRKP infections. Patients infected with CRKP with longer carbapenems treatment course (p = 0.002) showed better outcome.Conclusion: This study showed the severity of CRKP infection in eastern China. Sputum suction was an independent risk factor for CRKP infection. Prolonged duration of treatment with carbapenems benefited the patients infected with CRKP.

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Section: Discussionsupporting

confidence: 93%

Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infections in Eastern China

et al. 2017

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“…A limited number of antibiotic treatment options are available in infections caused by AmpC-producing K. pneumoniae. Carbapenems have emerged as a primary agent for management of infections due to AmpCproducing K. pneumoniae [9]. However, it has been reported that AmpC betalactamase can increase the MIC value of carbapenems and confer resistance to this class of antibiotics [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to resistance to penicillins and most cephalosporins, unlike ESBLs, AmpC-producing organisms can degrade cephamycins [8]. AmpC beta-lactamase-producing organisms show more extensive antibiotic resistance features in comparison with other ESBLs-producing organisms [9]. It has been reported that AmpC beta-lactamase can confer resistance to cefepime (fourth-generation cephalosporin antibiotic) and also can increase the minimum inhibitory concentration (MIC) value of carbapenems [9,10].…”

Section: Introductionmentioning

confidence: 99%

First report of coexistence of AmpC beta-lactamase genes in Klebsiella pneumoniae strains isolated from burn patients

Ghanavati

Darban-Sarokhalil

Navab-Moghadam

et al. 2017

AMicr

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Klebsiella spp. are among the most frequently isolated bacteria from burn wounds. These organisms are among the most important opportunistic pathogens, causing hospital-acquired and healthcare-associated infections worldwide. Limited information is available about prevalence of AmpC-producing Klebsiella pneumoniae from burn patients. Therefore, the aim of this study was to determine the characterization of AmpC beta-lactamase among K. pneumoniae isolated from burn patients. Samples were collected from wound specimens of patients with burn injury from a burn hospital in Tehran during 18 months (March 2015 to August 2016). For phenotypic detection of AmpC beta-lactamase, disk diffusion method with cefoxitin was used for screening, AmpC disk test and boronic acid inhibitor-based method were used as confirmatory tests. Polymerase chain reaction (PCR) was performed to screen all isolates with AmpC genes including ACCM, DHAM, EBCM, FOXM, MOXM, and CITM. Finally, PCR products were validated using sequencing. During this study, 102 isolates of K. pneumoniae were collected. Among these isolates, 52.9% suspected as AmpC producer by disk agar diffusion cefoxitin screening method. By confirmatory phenotypic methods, 19.6% of isolates considered as AmpC producer. Molecular analysis revealed 43.1% of cefoxitin-resistant isolates harbored at least one of the AmpC genes including CITM (22.5%), EBCM (21.5%), DHAM (7.8%), and FOXM (0.98%). In addition, 5.8% of isolates harbored two AmpC genes and 2.9% harbored three AmpC genes. In conclusion, K. pneumoniae is becoming a serious problem in burn patients. Accurate and precise methods and guidelines should be designed for detection of antibiotic-resistant mechanisms. Our data showed the high rate of AmpC beta-lactamase among K. pneumoniae isolated from burn patients, which limit the treatment options. Therefore, the results of this study can provide evidence to help for appropriate treatment of burn patients.

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“… 10 Multi-drug resistant K. pneumoniae , which is one of the major reason for nosocomial infections, poses a serious threat in the clinical practice because of the difficulties in the diagnosis due to the production of Carbapenemase and ESBLs/AmpC enzymes. 11 …”

Section: Introductionmentioning

confidence: 99%

Andrographis paniculata extract inhibit growth, biofilm formation in multidrug resistant strains of Klebsiella pneumoniae

Sah

Rasool

Hemalatha

2020

Journal of Traditional and Complementary Medicine

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Background and aim Andrographis paniculata (Kalmegh), a valuable ancient medicinal herb is used in the treatment of several diseases in most Asian countries including India. Klebsiella pneumoniae is an opportunistic pathogen causing nosocomial infections in human. We have investigated the antimicrobial susceptibility and the presence of AmpC gene in K . pneumoniae strain isolated from the sputum of the patient. Experimental procedure Antibiotic susceptibility test and phenotypic detection of AmpC/ESBL beta-lactamase were performed by combined disc diffusion test. The CEA of A. paniculata was analyzed for its antibacterial potential against susceptible and resistant strains of K. pneumoniae through the broth microdilution method. Molecular detection of AmpC gene was carried by polymerase chain reaction (PCR). Results Antibiotic susceptibility test displayed that the clinical isolate of K. pneumoniae were resistant towards cephalosporins, quinolone and monobactam but susceptible to carbapenems. Combined disk diffusion demonstrated AmpC +ve /ESBL –ve beta-lactamase. 250 μg/ml of CEA extract confirmed the inhibition of bacterial growth and biofilm formation compared to the antibiotic. CEA treated K. pneumoniae displayed a reduction of AmpC by polymerase chain reaction. Conclusion The present study illustrates that CEA extract of A. paniculata demonstrated potentiality to control K. pneumoniae growth and biofilm formation. CEA was able to suppress the expression of gene encoding AmpC. This study proves to be an economical approach to control the growth of K. pneumoniae which causes serious infections.

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Detection and genotype analysis of AmpC β-lactamase in Klebsiella pneumoniae from tertiary hospitals

Cited by 24 publications

References 33 publications

Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infections in Eastern China

Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infections in Eastern China

First report of coexistence of AmpC beta-lactamase genes in Klebsiella pneumoniae strains isolated from burn patients

Andrographis paniculata extract inhibit growth, biofilm formation in multidrug resistant strains of Klebsiella pneumoniae

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