Singla Pooja, Sikka Rama, Deeep Antariksh, Gagneja Deep, Chaudhary Uma
Demonstrator, Department of Microbiology, PT. B.D. Sharma PGIMS Rohtak, India .
Professor, Department of Microbiology, PT. B.D. Sharma PGIMS Rohtak, India .
J Clin Diagn Res. 2014 Apr;8(4):DC16-9. doi: 10.7860/JCDR/2014/8008.4289. Epub 2014 Apr 15.
Acinetobacter baumannii is an important cause of health care associated infections which are difficult to control and treat, because of widespread antimicrobial resistance which is possessed by this organism.
The aim of the present study was to know the prevalence of ESBLs and AmpC β-lactamases in clinical isolates of Acinetobacter spp. which were cultured from various clinical specimens by using different phenotypic methods.
Study was conducted over a period of one year at the Microbiology Department of a tertiary care teaching hospital. A total of 100 consecutive, non-duplicate strains of Acinetobacter species which were isolated from various clinical samples were included.
All the isolates were identified by standard microbiological procedures and antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion technique. Isolates which showed reduced susceptibilities to third generation cephalosporins were tested for ESBL production by CLSI double disc synergy method and also by using sulbactam as an inhibitory agent. Isolates which showed reduced susceptibilities to cefoxitin were tested for AmpC detection by doing AmpC disc test.
SPSS, version 17 was used to calculate p-value. If the p-value was <0.05, it was considered to be significant.
Out of 100 isolates, 82 were Acinetobacter baumannii and 18 were Acinetobacter lwoffii. ESBL were mentioned in 4% of the Acinetobacter isolates and in 77% of the isolates by using clavulanic acid and sulbactam as inhibitory agents respectively. AmpC β-lactamase production was detected in 60% isolates of Acinetobacter spp. Co-production of both ESBL and AmpC enzymes were seen in 29% of the Acinetobacter strains.
Failure in detecting β-lactamases contributes to their uncontrolled spread and therapeutic failures. Hence, these β-lactamases should be detected routinely and they should be reported to clinicians in time, so that inappropriate use of antibiotics can be stopped in time.
鲍曼不动杆菌是医疗保健相关感染的重要病因，由于该菌具有广泛的抗菌耐药性，使得这些感染难以控制和治疗。
本研究的目的是通过不同的表型方法，了解从各种临床标本中培养出的不动杆菌属临床分离株中ESBLs和AmpCβ-内酰胺酶的流行情况。
在一家三级护理教学医院的微生物科进行了为期一年的研究。纳入了从各种临床样本中分离出的100株连续、非重复的不动杆菌菌株。
所有分离株均通过标准微生物学程序进行鉴定，抗菌药物敏感性试验采用 Kirby-Bauer 纸片扩散法。对显示对第三代头孢菌素敏感性降低的分离株，通过CLSI双纸片协同法以及使用舒巴坦作为抑制剂来检测ESBL的产生。对显示对头孢西丁敏感性降低的分离株，通过进行AmpC纸片试验检测AmpC。
使用SPSS 17版计算p值。如果p值<0.05，则认为具有统计学意义。
在100株分离株中，82株为鲍曼不动杆菌，18株为洛菲不动杆菌。分别使用克拉维酸和舒巴坦作为抑制剂时，4%的不动杆菌分离株和77%的分离株中检测到ESBL。在60%的不动杆菌属分离株中检测到AmpCβ-内酰胺酶的产生。29%的不动杆菌菌株中同时检测到ESBL和AmpC酶。
未能检测到β-内酰胺酶会导致其不受控制地传播和治疗失败。因此，应常规检测这些β-内酰胺酶，并及时向临床医生报告，以便及时停止不适当的抗生素使用。
