Phenotypic and genotypic detection of ESBL mediated cephalosporin resistance in Klebsiella pneumoniae: Emergence of high resistance against cefepime, the fourth generation cephalosporin

Grover, Shyam Sunder; Sharma, Meenakshi; Chattopadhya, D; Kapoor, Hema; Pasha, Syed Tazeen; Singh, Gajendra

doi:10.1016/j.jinf.2005.12.001

Cited by 42 publications

(33 citation statements)

References 32 publications

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“…47 % of our E. coli isolates were ESBL producers, followed by 45% of K. pneumoniae. It might be possible that the high level of multi-drug resistance was most probably due to production of extended spectrum beta lactamases in these isolates [12,14,15]. to overcome this problem, unnecessary antibiotic therapy should be limited.…”

Section: Discussionmentioning

confidence: 99%

Urinary Tract Infection: Aetiology and Antimicrobial Resistance Pattern in Infants From A Tertiary Care Hospital in Northern India

Kaur

Sharma

Malhotra

et al. 2014

JCDR

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Section: Discussionmentioning

confidence: 99%

Urinary Tract Infection: Aetiology and Antimicrobial Resistance Pattern in Infants From A Tertiary Care Hospital in Northern India

Kaur

Sharma

Malhotra

et al. 2014

JCDR

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“…This was the first report identifying CTX-M type ESBL from clinical isolates of E. coli and K. pneumoniae from South India [24]. Grover et al [25] of New Delhi in 2006 reported the prevalence of TEM and SHV in ESBL producing Gramnegative bacteria to be up to 88.8 %. Sekar et al [26] of Chennai reported that 44.4 % of E. coli and 35.29 % K. pneumoniae strains were found to be positive for bla CTX-M gene by PCR in 2006.…”

Section: Iso-electric Focusingmentioning

confidence: 85%

First Report of OXA-4, an ESBL Isolated from Pseudomonas aeruginosa a South Indian Strain

Kingsley¹,

Verghese²

2012

Indian J Microbiol

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The OXA-type b-lactamases are so named because of their oxacillin-hydrolyzing abilities. In this study we characterize an extended spectrum b-lactamase, designated OXA-4, produced by a clinical isolate of Pseudomonas aeruginosa. ESBL production was detected by double disk synergy test. The P. aeruginosa isolate was obtained from endotracheal suction tip of 84 years old male patient diagnosed with CVA and hypertension. ESBL producing OXA b-lactamases was detected by PCR with primers specific to the conserved regions of the coding genes. Iso electric focusing was done to confirm the significance, sequencing the amplified product was also done. In the phenotypic identification, the strain was highly resistant to third generation cephalosporins and also to imipenem. The PCR amplified product for OXA b-lactamase was viewed at 919 bp. The pI point for the same was identified at 7.2. With the help of sequencing the amplified OXA b-lactamase was identified as OXA-4 gene. Here we report P. aeruginosa producing OXA-4 ESBL for the first time in the Indian subcontinent.

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“…This method has been successfuly used all over the world (M'ZALI et al, 2000;GROVER et al, 2006), although it also presents limitations, like (BROWN et al, 2000).…”

Section: Resultsmentioning

confidence: 99%

“…In this study, all 55 strains initially screened as positive in KBD were confirmed by this test. However, it requires an extra agar plate to be inoculated, what makes it difficult to incorporate into a routine disk testing system, and it is also comparatively expensive (M'ZALI et al, 2000;MACKENZIE el al., 2002).Recently molecular methods have been described as sensitive and specific, however they are expensive, time consuming and require specialized equipment and expertise (GROVER et al, 2006).…”

Section: Resultsmentioning

confidence: 99%

Métodos de triagem e de confirmação para detecção de BLEAs (beta lactamases de espectro ampliados) em isolados de Klebsiella pneumoniae

Vespero¹,

Perugini²,

Saridakis³

2007

Semin. Cienc. Biol. Saude

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ESBLs (extended-spectrum ß-lactamases) are enzymes produced by Enterobacteriaceae, especially Klebsiella pneumoniae, which mediate resistance to extended-spectrum ß-lactams and aztreonam. Considering the importance of detecting ESBLs producing strains, in this study, usual screening and confirmatory assays were compared. One hundred and seven strains of K. pneumoniae, isolated from patients with urinary tract infection, were screened for ESBLs production according to NCCLS 2005 guidelines, using broth microdilution in the Microscan Walkaway (Dade Behering) and Kirby-Bauer disk diffusion (KBD) test. Fifty-five strains selected as possible ESBL producers (51,4%), were submitted to confirmatory assays: E-test, double disk (DD) approximation and clavulanic acid (CA) association. Production of ESBLs was detected by the five methods used in 38 (69%) strains and 10 (18,2%) were negative only in DD. Seven strains (12,7%) did not present suggestive breakpoints in the Microscan Walkaway and were negative in the DD test, whereas the KBD values for the same strains obtained were indicative of ESBLs production. These results suggest that the combination of KBD breakpoints determination and CA association can be used as an efficient, alternative and less expensive system than the E-test. Key words: K .pneumoniae. Extended-spectrum ß-lactamases (ESBLs). Screening. ResumoBLEAs (ß-lactamases de espectro estendido) são enzimas produzidas por várias espécies de Enterobacteriaceae, principalmente Klebsiella pneumoniae, as quais conferem resistência aos ß-lactâmicos de espectro ampliado e aztreonam. Considerando a importância da detecção de BLEAs, neste estudo foram comparados métodos de triagem e de confirmação. As 107 amostras de K. pneumoniae, isoladas de pacientes com infecção urinária foram triadas quanto à produção de BLEAs, segundo normas do NCCLS 2005, utilizando microdiluição em caldo no Microscan Walkaway e teste de disco difusão de Kirby-Bauer (KBD). As 55 cepas selecionadas foram submetidas a ensaios de confirmação como possíveis produtoras de BLEAs (51,4%): E-test, aproximação com discos duplos (DD) e associação com ácido clavulânico (CA). A produção de BLEAs foi detectada pelos cinco métodos em 38 (69%) amostras e 10 amostras (18,2%) foram negativas para o teste DD. Sete amostras (12,7%) não apresentaram valores sugestivos no método automatizado e também foram negativos no teste de DD, mas os valores dos halos no teste de KBD foram indicativos da produção de BLEAs. Estes resultados sugerem que o uso combinado do método KBD e associação com CA podem ser utilizados como um sistema alternativo eficiente e menos dispendioso que o E-test. Palavras-chave: K.pneumoniae. Beta-lactamases de espectro ampliado (BLEAs). Triagem.

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Phenotypic and genotypic detection of ESBL mediated cephalosporin resistance in Klebsiella pneumoniae: Emergence of high resistance against cefepime, the fourth generation cephalosporin

Cited by 42 publications

References 32 publications

Urinary Tract Infection: Aetiology and Antimicrobial Resistance Pattern in Infants From A Tertiary Care Hospital in Northern India

Urinary Tract Infection: Aetiology and Antimicrobial Resistance Pattern in Infants From A Tertiary Care Hospital in Northern India

First Report of OXA-4, an ESBL Isolated from Pseudomonas aeruginosa a South Indian Strain

Métodos de triagem e de confirmação para detecção de BLEAs (beta lactamases de espectro ampliados) em isolados de Klebsiella pneumoniae

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