伊朗布什尔省临床分离株中质粒介导的AmpC β-内酰胺酶的检测

Detection of plasmid-mediated AmpC β-lactamases in clinical isolates from Bushehr province, Iran.

作者信息

Faghihi Khatereh, Tajbakhsh Saeed, Fouladvand Moradali, Latifi Behrouz, Yousefi Forough

机构信息

Department of Microbiology and Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran.

出版信息

Iran J Microbiol. 2023 Jun;15(3):373-382. doi: 10.18502/ijm.v15i3.12897.

DOI:10.18502/ijm.v15i3.12897

PMID:37448670

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10336279/

Abstract

BACKGROUND AND OBJECTIVES

Plasmid-mediated AmpC producers are considered an increasing concern. The aim of this study was to investigate the prevalence of plasmid-mediated AmpC β-lactamases (pAmpCs) in isolates.

MATERIALS AND METHODS

A total of 228 clinical isolates of were collected in Bushehr province, Iran, from December 2017 to February 2019. Cefoxitin disks were applied for screening AmpC-producing isolates. Furthermore, 3 phenotypic confirmatory tests including combine disk test (CDT), double disk synergy test (DDST) and modified three dimensional test (M3DT) were used. Finally, the presence of pAmpC genes was tested by multiplex PCR.

RESULTS

We identified 18 pAmpC-KP isolates among the 228 isolates (7.9%): 12 DHA (66.6%) and 6 CMY (33.3%). In the present study only 47% of cefoxitin-resistant isolates were pAmpC producers. The sensitivity of CDT, DDST, and M3DT was 89%, 67% and 100% and the specificity was 90%, 90% and 85%, respectively. In addition, M3DT displayed a higher rate of efficiency (92%) than CDT (89%) and DDST (79%) in detecting plasmid-meditated AmpC producers.

CONCLUSION

DHA was the most prevalent pAmpC beta-lactamase in this study. DDST and CDT tests proved inefficient to detect two and six pAmpC producers, respectively, while M3DT represented the best overall performance.

摘要

背景与目的

质粒介导的AmpC产生菌日益受到关注。本研究旨在调查分离株中质粒介导的AmpCβ-内酰胺酶（pAmpCs）的流行情况。

材料与方法

2017年12月至2019年2月期间，在伊朗布什尔省共收集了228株临床分离株。应用头孢西丁纸片筛选产AmpC的分离株。此外，还使用了3种表型确证试验，包括联合纸片试验（CDT）、双纸片协同试验（DDST）和改良三维试验（M3DT）。最后，通过多重PCR检测pAmpC基因的存在情况。

结果

在228株分离株中，我们鉴定出18株产pAmpC的肺炎克雷伯菌（7.9%）：12株DHA型（66.6%）和6株CMY型（33.3%）。在本研究中，仅47%的头孢西丁耐药分离株是pAmpC产生菌。CDT、DDST和M3DT的敏感性分别为89%、67%和100%，特异性分别为90%、90%和85%。此外，在检测质粒介导的AmpC产生菌方面，M3DT的效率（92%）高于CDT（89%）和DDST（79%）。