Joji Ronni Mol, Al-Mahameed Ali Ebrahim, Jishi Thamer Al, Fatani Dania Ismail, Saeed Nermin K, Jaradat Ahmed, Ezzat Hicham, Bindayna Khalid Mubarak
Departments of Microbiology, Immunology and Infectious Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Manama, Kingdom of Bahrain.
Ann Thorac Med. 2021 Jul-Sep;16(3):287-293. doi: 10.4103/atm.ATM_523_20. Epub 2021 Feb 19.
with AmpC β-lactamase are multidrug-resistant organisms and represent a significant challenge to patient care. This study aims to determine the prevalence of plasmid-derived AmpC β-lactamase among extended spectrum β-lactamases (ESBL)-producing strains in Bahrain.
It was a cross-sectional study. A total of 185 ESBL-producing isolates were recovered from clinically significant specimens from January 2018 to December 2019. The samples underwent initial screen for cefoxitin resistance by disc diffusion test and subsequent phenotypic confirmation of AmpC production with phenyl boronic acid assays as well as genotypic analysis by multiplex polymerase chain reactions for AmpC subtypes. Drug-resistant features of these clinical isolates were also examined.
Twenty-nine ESBL-producing isolates were cefoxitin resistant. Phenotypic and genotypic analyses confirmed that 8 and 12 cefoxitin-resistant isolates are AmpC positive, respectively. These AmpC producers are multidrug resistant, and Escherichia coli is the dominant strain among them.
Plasmid-mediated spread of AmpC is present in clinically relevant species in Bahrain. Rational antimicrobial therapy against these multidrug-resistant organisms and continued surveillance of antimicrobial resistance mechanisms among the clinical isolates are recommended for optimal patient care.
产AmpCβ-内酰胺酶的细菌是多重耐药菌，对患者护理构成重大挑战。本研究旨在确定巴林产超广谱β-内酰胺酶（ESBL）菌株中质粒介导的AmpCβ-内酰胺酶的流行情况。
这是一项横断面研究。2018年1月至2019年12月期间，从具有临床意义的标本中总共分离出185株产ESBL菌株。样本首先通过纸片扩散法进行头孢西丁耐药性初筛，随后用苯硼酸试验进行AmpC产生的表型确认，并通过多重聚合酶链反应对AmpC亚型进行基因分型分析。还检测了这些临床分离株的耐药特征。
29株产ESBL菌株对头孢西丁耐药。表型和基因分型分析分别证实8株和12株头孢西丁耐药菌株AmpC呈阳性。这些产AmpC的菌株具有多重耐药性，其中大肠杆菌是优势菌株。
巴林临床相关菌种中存在质粒介导的AmpC传播。为了实现最佳的患者护理，建议针对这些多重耐药菌采取合理的抗菌治疗，并持续监测临床分离株中的耐药机制。
