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Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods

OBJECTIVES: The aim of this study was to compare the current screening methods and to evaluate confirmation tests for phenotypic plasmidal AmpC (pAmpC) detection. METHODS: For this evaluation we used 503 Enterobacteriaceae from 18 Dutch hospitals and 21 isolates previously confirmed to be pAmpC posi...

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Autores principales: Reuland, E. Ascelijn, Hays, John P., de Jongh, Denise M. C., Abdelrehim, Eman, Willemsen, Ina, Kluytmans, Jan A. J. W., Savelkoul, Paul H. M., Vandenbroucke-Grauls, Christina M. J. E., al Naiemi, Nashwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958353/
https://www.ncbi.nlm.nih.gov/pubmed/24642853
http://dx.doi.org/10.1371/journal.pone.0091396
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author Reuland, E. Ascelijn
Hays, John P.
de Jongh, Denise M. C.
Abdelrehim, Eman
Willemsen, Ina
Kluytmans, Jan A. J. W.
Savelkoul, Paul H. M.
Vandenbroucke-Grauls, Christina M. J. E.
al Naiemi, Nashwan
author_facet Reuland, E. Ascelijn
Hays, John P.
de Jongh, Denise M. C.
Abdelrehim, Eman
Willemsen, Ina
Kluytmans, Jan A. J. W.
Savelkoul, Paul H. M.
Vandenbroucke-Grauls, Christina M. J. E.
al Naiemi, Nashwan
author_sort Reuland, E. Ascelijn
collection PubMed
description OBJECTIVES: The aim of this study was to compare the current screening methods and to evaluate confirmation tests for phenotypic plasmidal AmpC (pAmpC) detection. METHODS: For this evaluation we used 503 Enterobacteriaceae from 18 Dutch hospitals and 21 isolates previously confirmed to be pAmpC positive. All isolates were divided into three groups: isolates with 1) reduced susceptibility to ceftazidime and/or cefotaxime; 2) reduced susceptibility to cefoxitin; 3) reduced susceptibility to ceftazidime and/or cefotaxime combined with reduced susceptibility to cefoxitin. Two disk-based tests, with cloxacillin or boronic acid as inhibitor, and Etest with cefotetan-cefotetan/cloxacillin were used for phenotypic AmpC confirmation. Finally, presence of pAmpC genes was tested by multiplex and singleplex PCR. RESULTS: We identified 13 pAmpC producing Enterobacteriaceae isolates among the 503 isolates (2.6%): 9 CMY-2, 3 DHA-1 and 1 ACC-1 type in E. coli isolates. The sensitivity and specificity of reduced susceptibility to ceftazidime and/or cefotaxime in combination with cefoxitin was 97% (33/34) and 90% (289/322) respectively. The disk-based test with cloxacillin showed the best performance as phenotypic confirmation method for AmpC production. CONCLUSIONS: For routine phenotypic detection of pAmpC the screening for reduced susceptibility to third generation cephalosporins combined with reduced susceptibility to cefoxitin is recommended. Confirmation via a combination disk diffusion test using cloxacillin is the best phenotypic option. The prevalence found is worrisome, since, due to their plasmidal location, pAmpC genes may spread further and increase in prevalence.
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spelling pubmed-39583532014-03-27 Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods Reuland, E. Ascelijn Hays, John P. de Jongh, Denise M. C. Abdelrehim, Eman Willemsen, Ina Kluytmans, Jan A. J. W. Savelkoul, Paul H. M. Vandenbroucke-Grauls, Christina M. J. E. al Naiemi, Nashwan PLoS One Research Article OBJECTIVES: The aim of this study was to compare the current screening methods and to evaluate confirmation tests for phenotypic plasmidal AmpC (pAmpC) detection. METHODS: For this evaluation we used 503 Enterobacteriaceae from 18 Dutch hospitals and 21 isolates previously confirmed to be pAmpC positive. All isolates were divided into three groups: isolates with 1) reduced susceptibility to ceftazidime and/or cefotaxime; 2) reduced susceptibility to cefoxitin; 3) reduced susceptibility to ceftazidime and/or cefotaxime combined with reduced susceptibility to cefoxitin. Two disk-based tests, with cloxacillin or boronic acid as inhibitor, and Etest with cefotetan-cefotetan/cloxacillin were used for phenotypic AmpC confirmation. Finally, presence of pAmpC genes was tested by multiplex and singleplex PCR. RESULTS: We identified 13 pAmpC producing Enterobacteriaceae isolates among the 503 isolates (2.6%): 9 CMY-2, 3 DHA-1 and 1 ACC-1 type in E. coli isolates. The sensitivity and specificity of reduced susceptibility to ceftazidime and/or cefotaxime in combination with cefoxitin was 97% (33/34) and 90% (289/322) respectively. The disk-based test with cloxacillin showed the best performance as phenotypic confirmation method for AmpC production. CONCLUSIONS: For routine phenotypic detection of pAmpC the screening for reduced susceptibility to third generation cephalosporins combined with reduced susceptibility to cefoxitin is recommended. Confirmation via a combination disk diffusion test using cloxacillin is the best phenotypic option. The prevalence found is worrisome, since, due to their plasmidal location, pAmpC genes may spread further and increase in prevalence. Public Library of Science 2014-03-18 /pmc/articles/PMC3958353/ /pubmed/24642853 http://dx.doi.org/10.1371/journal.pone.0091396 Text en © 2014 Reuland et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Reuland, E. Ascelijn
Hays, John P.
de Jongh, Denise M. C.
Abdelrehim, Eman
Willemsen, Ina
Kluytmans, Jan A. J. W.
Savelkoul, Paul H. M.
Vandenbroucke-Grauls, Christina M. J. E.
al Naiemi, Nashwan
Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods
title Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods
title_full Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods
title_fullStr Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods
title_full_unstemmed Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods
title_short Detection and Occurrence of Plasmid-Mediated AmpC in Highly Resistant Gram-Negative Rods
title_sort detection and occurrence of plasmid-mediated ampc in highly resistant gram-negative rods
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958353/
https://www.ncbi.nlm.nih.gov/pubmed/24642853
http://dx.doi.org/10.1371/journal.pone.0091396
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