Department of Microbiology and Molecular Biology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Ophthalmic Res. 2012;47(1):52-6. doi: 10.1159/000322807. Epub 2011 Jun 29.
To evaluate resistances mediated by extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases among Gram-negative bacteria recovered from ocular infections.
As per the Clinical Laboratory Standards Institute M100-S-16 document, a total of 135 Gram-negative bacilli were recovered from ocular specimens and were subjected to phenotypic confirmation for ESBL production by the double-disc synergy test, cephalosporin and clavulanate combination disc test and E test, and, for AmpC β-lactamase, the modified double-disc approximation method and AmpC disc test.
In the double-disc synergy test, 21 (15.5%) isolates showed positive results against the cefpodoxime disc, 19 (14%) against cefpodoxime and cefotaxime, 15 (11%) against cefpodoxime, cefotaxime and ceftriaxone and 10 (7%) isolates were against cefpodoxime, cefotaxime, ceftriaxone and ceftazidime discs. In the cephalosporin/clavulanate combination disc test, 19 (14%) isolates showed positive results against cefotaxime with clavulanic acid and 10 (7%) isolates against ceftazidime with clavulanic acid. In the E test, 10 (7%) isolates displayed positive results against ceftazidime and 19 (14%) against cefotaxime. In the AmpC disc test for phenotypic confirmation, indentations were observed in 15 (11%) isolates with flattening also occurring in 10 (7%) isolates.
The incidences of ESBL- and AmpC β-lactamase-mediated resistances are found to be 7 and 18.5% among ocular isolates, respectively, and are more prevalent among the strains of Escherichia coli and Klebsiella pneumoniae.
评估从眼部感染中分离的革兰氏阴性菌产生的超广谱β-内酰胺酶(ESBL)和 AmpC β-内酰胺酶的耐药性。
根据临床实验室标准化协会 M100-S-16 文件,从眼部标本中分离出 135 株革兰氏阴性杆菌,通过双碟协同试验、头孢菌素和克拉维酸联合碟试验和 E 试验进行 ESBL 产生的表型确认,以及改良的双碟近似法和 AmpC 碟试验进行 AmpC β-内酰胺酶的表型确认。
在双碟协同试验中,21 株(15.5%)分离株对头孢泊肟碟片呈阳性反应,19 株(14%)对头孢泊肟和头孢噻肟呈阳性反应,15 株(11%)对头孢泊肟、头孢噻肟和头孢曲松呈阳性反应,10 株(7%)分离株对头孢泊肟、头孢噻肟、头孢曲松和头孢他啶碟片呈阳性反应。在头孢菌素/克拉维酸联合碟片试验中,19 株(14%)分离株对头孢噻肟加克拉维酸呈阳性反应,10 株(7%)分离株对头孢他啶加克拉维酸呈阳性反应。在 E 试验中,10 株(7%)分离株对头孢他啶呈阳性反应,19 株(14%)分离株对头孢噻肟呈阳性反应。在 AmpC 碟片试验中,15 株(11%)分离株出现凹陷,10 株(7%)分离株出现平坦。
眼部分离株中 ESBL 和 AmpC β-内酰胺酶介导的耐药率分别为 7%和 18.5%,在大肠杆菌和肺炎克雷伯菌中更为普遍。