Detection and genotype analysis of AmpC β‑lactamase in Klebsiella pneumoniae from tertiary hospitals

Liu,Xiang‑Qun; Liu,Yong‑Rui

doi:10.3892/etm.2016.3295

Detection and genotype analysis of AmpC β‑lactamase in Klebsiella pneumoniae from tertiary hospitals

Authors:
- Xiang‑Qun Liu
- Yong‑Rui Liu
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Affiliations: Department of Pneumology, Xuzhou City Hospital Affiliated to Xuzhou Medical College, Xuzhou, Jiangsu 221002, P.R. China
Published online on: April 27, 2016 https://doi.org/10.3892/etm.2016.3295
Pages: 480-484

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Abstract

The aim of the present study was to investigate the phenotype and genotype of plasmid‑mediated AmpC (pAmpC) β‑lactamase in Klebsiella pneumoniae and its antibiotic resistance. A total of 130 non‑repetitive clinical isolates of Klebsiella pneumoniae, obtained from tertiary hospitals, were phenotypically screened for pAmpC β‑lactamase production with the cefoxitin disk diffusion test. β‑lactamase genes in the screened isolates were detected using multiplex polymerase chain reaction (PCR); carbapenemase genes in pAmpC β‑lactamase‑producing isolates that were resistant to imipenem were detected using PCR. Out of the 130 isolates of Klebsiella pneumoniae, 62 strains (47.7%) were resistant to cefoxitin, including 14 strains (10.8%) positive for pAmpC β‑lactamase (DHA type), among which 12 strains (85.7%) were susceptible to imipenem, and 2 strains, which were carrying Klebsiella pneumoniae carbapenemase (KPC)‑2 gene, were resistant to imipenem. The pAmpC β‑lactamase‑producing Klebsiella pneumoniae isolates from the tertiary hospitals were mainly of DHA‑1 genotype, and the majority were susceptible to carbapenems; drug‑resistant strains were associated with KPC‑2 expression.

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1.	Neyestanaki DK, Mirsalehian A, Rezagholizadeh F, Jabalameli F, Taherikalani M and Emaneini M: Determination of extended spectrum beta-lactamases, metallo-beta-lactamases and AmpC-beta-lactamases among carbapenem resistant Pseudomonas aeruginosa isolated from burn patients. Burns. 40:1556–1561. 2014. View Article : Google Scholar : PubMed/NCBI
2.	Gupta G, Tak V and Mathur P: Detection of AmpC β lactamases in gram-negative bacteria. J Lab Physicians. 6:1–6. 2014. View Article : Google Scholar : PubMed/NCBI
3.	Belas A, Salazar AS, Gama LT, Couto N and Pomba C: Risk factors for faecal colonisation with Escherichia coli producing extended-spectrum and plasmid-mediated AmpC β-lactamases in dogs. Vet Rec. 175:2022014. View Article : Google Scholar : PubMed/NCBI
4.	Wassef M, Behiry I, Younan M, El Guindy N, Mostafa S and Abada E: Genotypic identification of AmpC β-lactamases production in gram-negative bacilli isolates. Jundishapur J Microbiol. 7:e85562014. View Article : Google Scholar : PubMed/NCBI
5.	Balıkçı H, Açıkgöz ZC, Güvenman S, Celikbilek N and Ozdem B: Detection of plasmid-mediated AmpC beta-lactamase production in Escherichia coli and Klebsiella spp. isolates. Mikrobiyol Bul. 48:82–93. 2014.(In Turkish). PubMed/NCBI
6.	Paltansing S, Kraakman M, van Boxtel R, Kors I, Wessels E, Goessens W, Tommassen J and Bernards A: Increased expression levels of chromosomal AmpC β-lactamase in clinical Escherichia coli isolates and their effect on susceptibility to extended-spectrum cephalosporins. Microb Drug Resist. 21:7–16. 2015. View Article : Google Scholar : PubMed/NCBI
7.	Helmy MM and Wasfi R: Phenotypic and molecular characterization of plasmid mediated AmpC β-lactamases among Escherichia coli, Klebsiella spp., and Proteus mirabilis isolated from urinary tract infections in Egyptian hospitals. Biomed Res Int. 2014:1715482014. View Article : Google Scholar : PubMed/NCBI
8.	Mohamudha PR, Harish BN and Parija SC: Molecular description of plasmid-mediated AmpC β-lactamases among nosocomial isolates of Escherichia coli & Klebsiella pneumoniae from six different hospitals in India. Indian J Med Res. 135:114–119. 2012. View Article : Google Scholar : PubMed/NCBI
9.	Grover N, Sahni AK and Bhattacharya S: Therapeutic challenges of ESBLS and AmpC beta-lactamase producers in a tertiary care center. Med J Armed Forces India. 69:4–10. 2013. View Article : Google Scholar : PubMed/NCBI
10.	Jones-Dias D, Manageiro V, Ferreira E and Louro D: Antibiotic Resistance Surveillance Program in Portugal (ARSIP) participants; Caniça M: Diversity of extended-spectrum and plasmid-mediated AmpC β-lactamases in Enterobacteriaceae isolates from Portuguese health care facilities. J Microbiol. 52:496–503. 2014. View Article : Google Scholar : PubMed/NCBI
11.	Singla P, Sikka R, Deeep A, Gagneja D and Chaudhary U: Co-production of ESBL and AmpC β-lactamases in clinical isolates of A. baumannii and A. lwoffii in a tertiary care hospital from northern India. J Clin Diagn Res. 8:DC16–DC19. 2014.PubMed/NCBI
12.	Begum S, Hasan F, Hussain S and Ali Shah A: Prevalence of multi drug resistant Acinetobacter baumannii in the clinical samples from tertiary care hospital in Islamabad, Pakistan. Pak J Med Sci. 29:1253–1258. 2013.PubMed/NCBI
13.	Freitas F, Machado E, Ribeiro TG, Novais Â and Peixe L: Long-term dissemination of acquired AmpC β-lactamases among Klebsiella spp. and Escherichia coli in Portuguese clinical settings. Eur J Clin Microbiol Infect Dis. 33:551–558. 2014. View Article : Google Scholar : PubMed/NCBI
14.	Tugal D, Lynch M, Hujer AM, Rudin S, Perez F and Bonomo RA: Multi-drug-resistant Klebsiella pneumoniae pancreatitis: A new challenge in a serious surgical infection. Surg Infect (Larchmt). 16:188–193. 2015. View Article : Google Scholar : PubMed/NCBI
15.	Souna D, Amir AS, Bekhoucha SN, Berrazeg M and Drissi M: Molecular typing and characterization of TEM, SHV, CTX-M, and CMY-2 β-lactamases in Enterobacter cloacae strains isolated in patients and their hospital environment in the west of Algeria. Med Mal Infect. 44:146–152. 2014. View Article : Google Scholar : PubMed/NCBI
16.	Qin X, Zerr DM, Weissman SJ, Englund JA, Denno DM, Klein EJ, Tarr PI, Kwong J, Stapp JR, Tulloch LG and Galanakis E: Prevalence and mechanisms of broad-spectrum beta-lactam resistance in Enterobacteriaceae: A children's hospital experience. Antimicrob Agents Chemother. 52:3909–3914. 2008. View Article : Google Scholar : PubMed/NCBI
17.	Andrews JM BSAC Working Party On Susceptibility Testing ft: BSAC standardized disc susceptibility testing method. J Antimicrob Chemother. 48:43–57. 2001. View Article : Google Scholar : PubMed/NCBI
18.	Pérez-Pérez FJ and Hanson ND: Detection of plasmid-mediated AmpC beta-lactamase genes in clinical isolates by using multiplex PCR. J Clin Microbiol. 40:2153–2162. 2002. View Article : Google Scholar : PubMed/NCBI
19.	Nicola FG, Nievas J and Smayevsky J: Evaluation of phenotypic methods for the detection of KPC carbapenemases in Klebsiella pneumoniae. Rev Argent Microbiol. 44:290–302. 2012.(In Spanish). PubMed/NCBI
20.	Reardon S: Antibiotic resistance sweeping developing world. Nature. 509:141–142. 2014. View Article : Google Scholar : PubMed/NCBI
21.	Voets GM, Platteel TN, Fluit AC, Scharringa J, Schapendonk CM, Stuart JC, Bonten MJ and Hall MA: National ESBL Surveillance Working Group: Population distribution of beta-lactamase conferring resistance to third-generation cephalosporins in human clinical Enterobacteriaceae in the Netherlands. PLoS One. 7:e521022012. View Article : Google Scholar : PubMed/NCBI
22.	Bonnedahl J, Hernandez J, Stedt J, Waldenström J, Olsen B and Drobni M: Extended-spectrum β-lactamases in Escherichia coli and Klebsiella pneumoniae in Gulls, Alaska, USA. Emerg Infect Dis. 20:897–899. 2014. View Article : Google Scholar : PubMed/NCBI
23.	Markovska R, Schneider I, Marteva-Proevsk Y, Mitov I, Barernfeind A and Markova B: First detection of the AmpC beta-lactamase ACC-1 in a Klebsiella pneumoniae isolate in Bulgaria. J Chemother. 24:307–308. 2012. View Article : Google Scholar : PubMed/NCBI
24.	Shanthi J and Balagurunathan R: Characterisation of heteroresistant subcolonies for MBL, AmpC genes in Klebsiella pneumoniae and Acinetobacter baumannii. Indian J Med Microbiol. 32:210–211. 2014. View Article : Google Scholar : PubMed/NCBI
25.	Brenwald NP, Andrews J and Fraise AP: Activity of mecillinam against AmpC beta-lactamase-producing Escherichia coli. J Antimicrob Chemother. 58:223–224. 2006. View Article : Google Scholar : PubMed/NCBI
26.	Pai H, Kang CI, Byeon JH, Lee KD, Park WB, Kim HB, Kim EC, Oh MD and Choe KW: Epidemiology and clinical features of bloodstream infections caused by AmpC-type-beta-lactamase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother. 48:3720–3728. 2004. View Article : Google Scholar : PubMed/NCBI
27.	Rao SP, Rama PS, Gurushanthappa V, Manipura R and Srinivasan K: Extended-spectrum beta-lactamases producing Escherichia coli and Klebsiella pneumoniae: A multi-centric study across Karnataka. J Lab Physicians. 6:7–13. 2014. View Article : Google Scholar : PubMed/NCBI
28.	Shafiq M, Rahman H, Qasim M, Ayub N, Hussain S, Khan J and Naeem M: Prevalence of plasmid-mediated AmpC β-lactamases in Escherichia coli and Klebsiella pneumonia at tertiary care hospital of Islamabad, Pakistan. Eur J Microbiol Immunol (Bp). 3:267–271. 2013. View Article : Google Scholar : PubMed/NCBI
29.	Ding H, Yang Y, Lu Q, Wang Y, Chen Y, Deng L, Wang A, Deng Q, Zhang H, Wang C, et al: The prevalence of plasmid-mediated AmpC beta-lactamases among clinical isolates of Escherichia coli and Klebsiella pneumoniae from five children's hospitals in China. Eur J Clin Microbiol Infect Dis. 27:915–921. 2008. View Article : Google Scholar : PubMed/NCBI
30.	Alvarez M, Tran JH, Chow N and Jacoby GA: Epidemiology of conjugative plasmid-mediated AmpC beta-lactamases in the United States. Antimicrob Agents Chemother. 48:533–537. 2004. View Article : Google Scholar : PubMed/NCBI
31.	Peng JH, Sun ZY, Zhou YL and Lv J: Study on the gene type of plasmid AmpC enzyme producing Klebsiella pneumonia. Zhong Hua Yi Yuan Gan Ran Xue Za Zhi. 17:1072–1075. 2007.(In Chinese).
32.	Shi W, Li K, Ji Y, Jiang Q, Wang Y, Shi M and Mi Z: Carbapenem and cefoxitin resistance of Klebsiella pneumoniae strains associated with porin OmpK36 loss and DHA-1 β-lactamase production. Braz J Microbiol. 44:435–442. 2013. View Article : Google Scholar : PubMed/NCBI
33.	Shi WF, Zhou J and Qin JP: Transconjugation and genotyping of the plasmid-mediated AmpC beta-lactamase and extended-spectrum beta-lactamase genes in Klebsiella pneumoniae. Chin Med J (Engl). 122:1092–1096. 2009.PubMed/NCBI
34.	Queenan AM and Bush K: Carbapenemases: The versatile beta-lactamases. Clin Microbiol Rev. 20:440–458. 2007. View Article : Google Scholar : PubMed/NCBI
35.	Yigit H, Queenan AM, Anderson GJ, et al: Novel carbapenem-hydrolyzing β-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumonia. Antimicrob Agents Ch. 45:1151–1161. 2001. View Article : Google Scholar
36.	Zhao SP, Jiang MJ and Zong GZ: Comparison of detection methods for drug sensitivity of KPC-producing Klebsiella pneumonia. Zhong Hua Shi Yan He Lin Chuang Gan Ran Bing Za Zhi. 6:5–7. 2012.