Abudlateef Anoar, K., Omer, S., Majid, B., Hama Rahim, H., Muhammed, S. (2018). PHENOTYPIC DETECTION OF AMPC β-LACTAMASE ENZYME IN GRAM-NEGATIVE BACILLI. , 8(2), 57-66. doi: 10.17656/jsmc.10152
Khanda Abudlateef Anoar; Sherko Ali Omer; Bayan Taha Majid; Hero Ali Hama Rahim; Shno Jalal Muhammed. "PHENOTYPIC DETECTION OF AMPC β-LACTAMASE ENZYME IN GRAM-NEGATIVE BACILLI". , 8, 2, 2018, 57-66. doi: 10.17656/jsmc.10152
Abudlateef Anoar, K., Omer, S., Majid, B., Hama Rahim, H., Muhammed, S. (2018). 'PHENOTYPIC DETECTION OF AMPC β-LACTAMASE ENZYME IN GRAM-NEGATIVE BACILLI', , 8(2), pp. 57-66. doi: 10.17656/jsmc.10152
Abudlateef Anoar, K., Omer, S., Majid, B., Hama Rahim, H., Muhammed, S. PHENOTYPIC DETECTION OF AMPC β-LACTAMASE ENZYME IN GRAM-NEGATIVE BACILLI. , 2018; 8(2): 57-66. doi: 10.17656/jsmc.10152

PHENOTYPIC DETECTION OF AMPC β-LACTAMASE ENZYME IN GRAM-NEGATIVE BACILLI

JOURNAL OF SULAIMANI MEDICAL COLLEGE
Article 2, Volume 8, Issue 2, 2018, Pages 57-66    PDF (573.73 K)
DOI: 10.17656/jsmc.10152
Authors
Khanda Abudlateef Anoar1; Sherko Ali Omer1; Bayan Taha Majid1; Hero Ali Hama Rahim2; Shno Jalal Muhammed3
1Department of Microbiology, College of Medicine, University of Sulaimani.
2Hewa Teaching Hospital, Sulaimani Directorate of Health.
3Surgical Teaching Hospital, Sulaimani Directorate of Health.
Abstract
Background 
Bacterial resistance to antimicrobials are achieved by several mechanisms including production of enzymes such as β-lactamases; according to Ambler classification, β-lactamases are classified into four classes, A to D. AmpC β-lactamase production is related to chromosomal or plasmid genes expression in Gram-negative bacteria. 
 
Objectives 
To determine AmpC β-lactamase production among hospital isolates of Enterobacteriaceae and non-fermener Gram-negative bacilli in Sulaimani providence and to evaluate different phenotypic methods for detection of AmpC β-lactamase.
 
Materials and Methods
A total of 108 Gram-negative bacilli bacterial isolates collected from different infections in several governmental hospitals in Sulaimani city were assessed for β-lactamase production. The isolates were identified using biochemical methods. Antimicrobial susceptibility test was performed by Bauer-Kirby disk diffusion method using 14 antimicrobial agents including cefoxitin. Cefoxitin-resistant isolates were tested for AmpC production by four phenotypic tests including disk approximation test, disk antagonism test, hodge test, and AmpC disk test.
 
Results
Among 108 isolates, 47 (43.5%) were Escherichia coli and 35 (32.4%) were Pseudomonas aeruginosa. From the isolates, 98.1% were resistant to ampicillin while 71.3% were sensitive to imipenem and 68 isolates (63%) were resistant to cefoxitin. We found that 59 out of 68 to cefoxitin-resistant isolates (86.8%) produce AmpC by hodge test while other tests detected less AmpC production. In regard to hodge test, specificity of the other three tests reached 100% while sensitivity ranged from 55.93 in disk approximation test to 79.66% from both disk antagonism test and AmpC disk test.
 
Conclusion
AmpC b-lactamase production was common among Gram-negative bacilli from hospital isolates. Cefoxitin screening followed by hodge test for AmpC production was the best test to find b-lactamase producers. Different AmpC b-lactamase production tests can be used according to the tested bacteria.
 
Keywords
AmpC β-lactamase detection; Enterobacteriaceae; Gram-negative bacilli; Sulaimani
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