Prevalence, multidrug-resistance and risk factors for AmpC β-lactamases producing Escherichia coli from hospitalized patients

  • Rosy Bala Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
  • Varsha A Singh Department of Microbiology, RajmataVijayarajeScindia Medical College, Bhilwara, Rajasthan, India
  • Nitin Gupta Department of Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
  • Pue Rakshit Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
Keywords: E.coli, AmpC β- lactamase, multiplex PCR, multidrug resistance, MDR, mPCR

Abstract

Introduction: Multi-drug resistance among AmpC β-lactamases producing Escherichia coli isolates is alarming. The study aimed to know the prevalence and presumptive antibiogram of AmpC producing Escherichia coli isolates and to determine the associated risk factors.

Methodology: Escherichia coli isolated from various clinical specimens from hospitalized patients during the study period (January 2018- December 2018) were taken for the study. Standard biochemical reactions were used for organism identification. Antibiotic susceptibility testing was done using Kirby-Bauer method as per CLSI guidelines. Cefoxitin resistance was taken as screening tool to detect AmpC producing strains. The phenotypic confirmation was done using modified three-dimensional test. Multiplex PCR was used to detect pAmpC.

Results: A total non-duplicate consecutive 470 Escherichia coli were isolated from various clinical specimens of hospitalized patients during the study period. Cefoxitin resistance was observed in 51.9% (244/470). Modified three dimensional test was positive in 115/244 (47.1%) strains. Genotypic characterization of phenotypic positive AmpC strains showed presence of CIT and DHA genes among 33/115 and 19/115 isolates respectively. The overall prevalence of pAmpC producing E. coli was found to be 52/470 (11.1%). Multidrug resistance (MDR) was observed in 42/52 (80.7%) pAmpC strains. Antimicrobial use, prolonged hospitalization and interventions were associated risk factors for AmpC producing isolates.

Conclusions: A high prevalence of multidrug resistance among AmpC producing strains suggests plasmid mediated spread of drug resistance in E. coli. Every hospital should formulate and implement infection control policies at-least for the risk group patients to control the dissemination of such microbes as infection prevention is better than infection control.

Author Biographies

Varsha A Singh, Department of Microbiology, RajmataVijayarajeScindia Medical College, Bhilwara, Rajasthan, India

Professor & Head, Dept. of Microbiology

Rajmata Vijaya Raje Scindia Medical College, Bhilwara.

Pue Rakshit, Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India

Msc Student, Dept of Microbiology

MMIMSR, Mullana.

Published
2020-12-31
How to Cite
1.
Bala R, Singh VA, Gupta N, Rakshit P (2020) Prevalence, multidrug-resistance and risk factors for AmpC β-lactamases producing Escherichia coli from hospitalized patients. J Infect Dev Ctries 14:1466-1469. doi: 10.3855/jidc.13483
Section
Brief Original Articles