Salmuna Zeti Norfidiyati, Zulkefli Alyaa Farhan, Nik Mohd Noor Nik Zuraina, Ahmad Bakri Nur Saidah
Medical Microbiology and Parasitology, Universiti Sains Malaysia School of Medical Sciences, Kota Bharu, MYS.
Cureus. 2024 Jul 18;16(7):e64829. doi: 10.7759/cureus.64829. eCollection 2024 Jul.
We describe four patients with a positive culture of AmpC β-lactamases-producing () despite the fact that our understanding of plasmid-mediated AmpC β-lactamases (pAmpC) is currently limited. Three out of four cases of AmpC β-lactamases-producing were isolated from a urine sample, and one was from a peritoneal fluid sample. All four isolates are resistant to cefoxitin disc and were subjected to a confirmatory AmpC phenotypic test (AmpC induction test) and monoplex polymerase chain reaction (PCR) for the determination of six pAmpC genotypes (blaDHA, blaEBC, blaMOX, blaFOX, blaACC, and blaCIT). All four isolates tested negative for the AmpC induction test, while monoplex PCR analysis was positive only for the blaDHA pAmpC genotype and negative for all five other genotypes (blaEBC, blaMOX, blaFOX, blaACC, and blaCIT). A common clinical characteristic across all patients was fever. One patient was treated for perforated sigmoid diverticulitis, while the other three patients were treated for acute pyelonephritis or urinary tract infections (UTIs). Each patient improved significantly and was successfully discharged.
我们描述了4例尽管目前我们对质粒介导的AmpCβ-内酰胺酶（pAmpC）的了解有限，但仍培养出产AmpCβ-内酰胺酶（）的患者。4例产AmpCβ-内酰胺酶的病例中有3例分离自尿液样本，1例分离自腹腔液样本。所有4株分离菌对头孢西丁纸片耐药，并接受了AmpC表型确证试验（AmpC诱导试验）和单重聚合酶链反应（PCR）以确定6种pAmpC基因型（blaDHA、blaEBC、blaMOX、blaFOX、blaACC和blaCIT）。所有4株分离菌的AmpC诱导试验均为阴性，而单重PCR分析仅对blaDHA pAmpC基因型呈阳性，对其他5种基因型（blaEBC、blaMOX、blaFOX、blaACC和blaCIT）均为阴性。所有患者的一个共同临床特征是发热。1例患者接受了乙状结肠憩室穿孔的治疗，而其他3例患者接受了急性肾盂肾炎或尿路感染（UTI）的治疗。每位患者均明显好转并成功出院。
