PREVALENCE OF AMPC Î’-LACTAMASES IN CLINICAL ISOLATES OF E. COLI FROM A TERTIARY CARE RURAL HOSPITAL
Keywords:
Cefoxitin resistance, Escherichia coli, AmpC b lactamases, Combined disc diffusion test and Disk approximation testAbstract
Objective: Organisms over expressing AmpC (Ambler Class C) β-lactamases are of clinical concern because they restrict therapeutic options causing treatment failures and are increasing in occurrence worldwide. So the present study was to undertaken with the aim to know the prevalence of plasmid mediated AmpC and inducible AmpC β-lactamases in clinical isolates of E. coli in our tertiary care rural hospital.
Methods: 74 cefoxitin resistant E. coli isolates were tested for AmpC production by combined disc diffusion test and disk approximation test.
Results: Out of 74 cefoxitin resistance E. coli isolated from various clinical specimen 25(33.78%) showed AmpC β-lactamases production. PMABL was seen in 22(29.73%) and inducible AmpC in 3(4.05%). Among 25 AmpC producing E. coli, 8(32%) were from urine, 5(20%) from miscellaneous, 4(16%) from sputum and 12% respectively from stool and Pus and in Blood 2(8%). Age-wise higher distribution of AmpC β-lactamase was in an age group below 1yr (44.44%) and in age group of 20-39yrs (40%). The higher distribution of AmpC b lactamases producer from Medicine, Obgy, ICU(20% respectively) paediatric 16%,surgery 8%, TB 12% and lower from OPD(4%). In our study, multidrug resistance has been observed among the PMABL producing strains. Higher resistance was seen in gentamicin 22(88%), ciprofloxacin 23(92%), ceptazidime 25(100%), cefaclor 25(100%). Whereas PMABL isolates was susceptible to tigecycline (100%), meropenem (92%), amikacin(60%).
Conclusion: The overall prevalence of 10.50% AmpC β-lactamase in E. coli and Multidrug resistance is a matter of concern. So identification of AmpC may help in formulating the hospital infection control committee decreasing the selective antibiotic pressure.
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