Abstract Issue

Volume 14 Issue 2 (February) 2025

Original Articles

Comparison of confirmatory phenotypic methods for amp c beta lactamases detection among clinical isolates of enterobacterales from a tertiary care hospital
Dr. R Nagalakshmi, Dr. L Gracia Paul, Dr. J B Akbar Saleem

Introduction: Enterobacterales have become increasingly resistant to antibiotics, especially beta (β)-lactam agents, the mainstay of treatment for infections caused by them. One among the major mechanisms causing resistance to β-lactam antibiotics are the AmpC β-lactamase production. Amp C b-lactamases are clinically significant because they confer resistance to penicillins, cephalosporins, oxyimino-cephalosporins. Detection of AmpC is important not only to improve the clinical management of patients suffering from infections but it would also provide us with sound epidemiological data. Hence, the present study aims to determine the prevalence of AmpC β- lactamase producing Enterobacterales among clinical isolates isolated in our hospital and compare the various phenotypic confirmatory methods for AmpC detection. Methodology: Screening For Ampc Β- Lactamase Production was done using Cefoxitin (30-μg) disc was used for cefoxitin disc diffusion technique. Phenotypic Confirmatiory Methods for Ampc Β- Lactamase Detection: was done using 1.Phenyl boronic acid method-PBA (Inhibitor based method) 2. Cefoxitin Cloxacillin-Double disc synergy test (CC-DDS). 3. Amp C TRIS EDTA disc test.4. Disk approximation test (Induction based method): Results: 90 (52%) of the 173 examined isolates demonstrated resistance to the initial cefoxitin screening test. Of these, 19 (21.12%) were classified as Klebsiella pneumoniae and 71 (78.88%) as Escherichia coli. Cefoxitin Cloxacillin Double Disc Synergy (CC-DDS) test, revealed a zone difference of more than 4mm in 46 (51.11%) of the isolates. 39 (43.33%) of the isolates tested positive for Amp C synthesis using the Disc Approximation Test. 37 (41.11%) of the isolates exhibited an indentation close to the EDTA disc, according to the TRIS EDTA technique. Finally the Phenylboronic Acid technique revealed a zone difference of greater than 5mm in 38 (42.22%) of the isolates. Conclusion: The observation that the Cefoxitin Cloxacillin Double Disc Synergy (CC-DDS) method exhibited a higher detection rate when compared to other phenotypic confirmatory methods in our study is of particular significance. It is advised that the CC-DDS approach be taken into consideration for routine Amp C detection when necessary in light of these findings. Its user-friendliness is one of its noteworthy benefits, which makes it a viable and affordable choice for labs and medical facilities where AmpC detection is required.

 
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