Genetic and Kinetic Characterization of the Novel AmpC β-Lactamases DHA-6 and DHA-7

Pérez-Llarena, Francisco José; Zamorano, Laura; Kerff, Frédéric; Beceiro, Alejandro; Garcı́a, Patricia; Miró, Elisenda; Larrosa, Nieves; Gómez‐Bertomeu, Frederic; Méndez, José A.; González-López, Juan José; Oliver, Antonio; Galleni, Moreno; Navarro, Ferrán; Bou, Germán

doi:10.1128/aac.03144-14

Cited by 10 publications

(8 citation statements)

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“…DHA-type AmpC BLs were first described in Salmonella enteritidis in 1997, [ 16 ] with 11 variants being identified since then. [ 17 ] DHA-type AmpC BLs are common in Klebsiella pneumoniae , while they are rarer in E coli than CMY-type BLs. [ 18 ] Notably, in a Korean study, DHA-type BLs were present in 2.7% of cefoxitin-resistant E coli cases.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Kim

Yi²,

Kim³

et al. 2018

Medicine

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Rationale:Infective endocarditis (IE) is a life-threatening disease, mostly caused by gram-positive bacteria. Gram-negative bacteria were identified as a causative organism in relatively small number of cases. Although, antibiotic-resistant Escherichia coli is common cause of gram-negative endocarditis, AmpC beta-lactamase (BL)-harboring E coli is very rare cause of IE. Furthermore, emphysematous endocarditis is also a very rare manifestation of E coli infection.Patient concerns:We report a case of 80-year-old female patient presenting with dizziness, fever, and altered mental status, who was finally diagnosed with emphysematous endocarditis caused by E coli harboring an AmpC BL gene.Diagnosis:Her chest computed tomography revealed air bubbles surrounding the annulus of a mitral valve and a transesophageal echocardiogram revealed a hyperechogenic mass fixed on the posteromedial side of the mitral annulus with 2 eccentric mitral regurgitation jets. Blood cultures grew E coli which harbored the DHA-type AmpC BL. The organism belonged to a B2 phylogenic group, and multilocus sequence typing analyses revealed that the strains were of ST-95.Interventions:She was treated with meropenem following the resistant profiles, and surgery was recommended by the healthcare professional, but denied by the patient's guardians. She was transferred to another hospital due to a refusal for further treatment.Lessons:Emphysematous endocarditis is an uncommon complication of E coli bacteremia. Certain phylogenetic groups may be associated with development of E coli endocarditis.

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Section: Discussionmentioning

confidence: 99%

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Kim

Yi²,

Kim³

et al. 2018

Medicine

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“…Plasmid-mediated AmpC β-lactamases pose a big challenge to infection control due to the fact that the AmpC gene can be expressed in larger amounts and has high transmissibility to other bacterial species [ 37 ]. Plasmid-mediated AmpC genes that have been reported in Enterobacter species include DHA-type which has been reported in Spain [ 15 ], Taiwan [ 38 ] and Algeria [ 39 ]; CIT and ACC genes in Thailand [ 35 ], and FOX/MOX genes in Egypt [ 40 ]. This report represents the first identification of a novel DHA gene in a Malaysian E .…”

Section: Discussionmentioning

confidence: 99%

“…pneumoniae strain M40 was used as the positive control [ 32 ], while distilled water was used as the negative control. To determine the full length sequence of DHA positive isolate, primers obtained from Pérez-Llarena et al [ 15 ] with slight modification, DHAfw (5’-ATGAAAAAATCGTTATCTGCAACAC-3’) and DHArv (5’-TTATTCCAGTGCACTCAAAATAGC-3’) were used. The amplification include initial denaturation at 95°C for 15 min, followed by 30 cycles of denaturation at 94°C for 30 sec, annealing at 54°C for 90 sec and extension at 72°C for 1 min, and a final extension step at 72°C for 10 min.…”

Section: Methodsmentioning

confidence: 99%

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Genotypic and Phenotypic Detection of AmpC β-lactamases in Enterobacter spp. Isolated from a Teaching Hospital in Malaysia

et al. 2016

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ObjectivesThe objective of this study was to determine the occurrence of chromosomal and plasmid-mediated β-lactamases (AmpC) genes in a collection of Malaysian isolates of Enterobacter species. Several phenotypic tests for detection of AmpC production of Enterobacter spp. were evaluated and the agreements between tests were determined.MethodsAntimicrobial susceptibility profiles for 117 Enterobacter clinical isolates obtained from the Medical Microbiology Diagnostic Laboratory, University Malaya Medical Centre, Malaysia, from November 2012—February 2014 were determined in accordance to CLSI guidelines. AmpC genes were detected using a multiplex PCR assay targeting the MIR/ACT gene (closely related to chromosomal EBC family gene) and other plasmid-mediated genes, including DHA, MOX, CMY, ACC, and FOX. The AmpC β-lactamase production of the isolates was assessed using cefoxitin disk screening test, D69C AmpC detection set, cefoxitin-cloxacillin double disk synergy test (CC-DDS) and AmpC induction test.ResultsAmong the Enterobacter isolates in this study, 39.3% were resistant to cefotaxime and ceftriaxone and 23.9% were resistant to ceftazidime. Ten (8.5%) of the isolates were resistant to cefepime, and one isolate was resistant to meropenem. Chromosomal EBC family gene was amplified from 36 (47.4%) E. cloacae and three (25%) E. asburiae. A novel blaDHA type plasmid-mediated AmpC gene was identified for the first time from an E. cloacae isolate. AmpC β-lactamase production was detected in 99 (89.2%) of 111 potential AmpC β-lactamase producers (positive in cefoxitin disk screening) using D69C AmpC detection set. The detection rates were lower with CC-DDS (80.2%) and AmpC induction tests (50.5%). There was low agreement between the D69C AmpC detection set and the other two phenotypic tests. Of the 40 isolates with AmpC genes detected in this study, 87.5%, 77.5% and 50.0% of these isolates were positive by the D69C AmpC detection set, CC-DDS and AmpC induction tests, respectively.ConclusionsBesides MIR/ACT gene, a novel plasmid-mediated AmpC gene belonging to the DHA-type was identified in this study. Low agreement was noted between the D69C AmpC detection set and two other phenotypic tests for detection of AmpC production in Enterobacter spp. As plasmid-mediated genes may serve as the reservoir for the emergence of antibiotic resistance in a clinical setting, surveillance and infection control measures are necessary to limit the spread of these genes in the hospital.

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“…13 The first isolation of bla DHA (DHA7) gene from E.cloacae has been recently reported in Spain. 14 The increase in antibiotic resistance among gram negative bacilli mediated through Amp C β-lactamases shows that their laboratory detection and characterization are important for clinical, epidemiological and infection control point of view. 22 -Double sided E strips containing cefotetan (0.5-32 µgm/ml) with or without cloxacillin are applied on Mueller Hinton agar plate which is evenly inoculated with 0.5 McFarland suspension of the test inoculate according to manufacturer's instructions.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance Mediated through Amp C β- Lactamases

Jog¹

2018

IJCMR

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Antimicrobial resistance is a global problem. Developing country like India is facing it more where infectious disease burden is high.Penicillins and Cephalosporins are widely used antibiotics to deal with various infections. These antibiotics have four membered β-lactam ring in it's molecule which is essential for it's antibacterial activity.Bacteria produce Extended spectrum β-lactamase (ESBL) which made the newer generation of antibiotics ineffective. Amp C β-lactamases are important cephalosporinases encoded on chromosomes of many Enterobacteriaceae and they confer resistance to third generation cephalosporins and β-lactamase inhibitor/ β-lactam antibiotics. Amp C β-lactamases are either chromosomally or plasmid mediated. Various phenotypic tests are used by researchers like Amp C disk test, Modified Threedimensional test, Boronic acid disk test method, Cefoxitin Agar Medium (CAM), Amp C E test, Cefoxitin Hodge test to detect Amp C β-lactamase producing organisms.Multiplex PCR is used for genotypic detection of Amp C β-lactamase. Different studies have shown Amp C β-lactamase production in E.coli, K.pneumoniae, Proteus spp., Citrobacterspp., Pseudomonasspp, Providentiaspp., Acinetobacter.Routine screening for detection of Amp C β-lactamase producing organisms should be done to avoid treatment failure and increased medical care cost.

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Genetic and Kinetic Characterization of the Novel AmpC β-Lactamases DHA-6 and DHA-7

Cited by 10 publications

References 20 publications

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Emphysematous endocarditis caused by AmpC beta-lactamase-producing Escherichia coli

Genotypic and Phenotypic Detection of AmpC β-lactamases in Enterobacter spp. Isolated from a Teaching Hospital in Malaysia

Antimicrobial Resistance Mediated through Amp C β- Lactamases

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