Meenakshi, C (2015) Evaluation of Conventional Methods with Molecular Methods for the Detection of AmpC Beta Lactamase in Enterobacteriaceae among Clinical Isolates. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
AIM OF THE STUDY: The aim of the study is the evaluation of conventional methods with molecular methods for the detection of AmpC beta lactamase in Enterobacteriaceae among clinical isolates in Tirunelveli medical college hospital. MATERIALS AND METHODS: The study included 50 strains of various enterobacteriaceae species isolated from clinical samples(Urine,pus). These isolates were screened for AmpC β lactamase by Disc diffusion method with Cefoxitin, Modified hodge test,AmpC Disc test and the genotype (BlaAmpC) was confirmed by Polymerase chain Reaction. RESULTS: A total of 50 (urine[n=45], pus[n=5]) non-duplicate Cefoxitin resistant isolates from clinical samples which includes E.coli (n=23 ), Klebsiella pneumonia (n=21), Klebsiella oxytoca (n= 6) were taken for this study. Modified Hodge test detected 16 (32%) AmpC positive isolates indicated by clover leaf pattern. Among these, eight isolates (34.8%) were E.coli and another eight isolates (38.1) were Klebsiella pneumoniae. AmpC disc test detected 18 AmpC positive isolates. Among these, ten isolates (43.5%) were E.coli and seven isolates (33.3%) were Klebsiella pneumoniae, one isolate (16.6%) was Klebsiella oxytoca. Real time PCR detected bla AmpC gene in twenty one (42%) of the 50 screen positive isolates. Among these, eleven isolates (47.8%) were E.coli, 10 isolates (47.6%) were Klebsiella pneumoniae. The sensitivity, specificity of Modified hodge test and AmpC disc test were 71.42%, 96.55%, and 80.95%, 96.55% respectively. In AmpC-positive isolates, the resistance to third generation Cephalosporins was high, reaching 100% for Ceftriaxone and Ceftazidime and Ceftazidime+clavulanic acid and were resistant in 43%, 81%,75% and 80% respectively to Amikacin, Gentamicin, Nitrofurantoin and Norfloxacin. CONCLUSION: This study highlights the prevalence of AmpC enzyme production among clinical samples and also bla AmpC among AmpC producers. Modified Hodge test is simple to do and less costlier. AmpC disc test is to be considered as a diagnostic tool for AmpC detection in routine laboratory because of its high sensitivity, rapid and easy interpretation. In the present study, MDR among AmpC positive study isolates was high suggesting plasmid mediated spread. Dissemination of AmpC producers within the hospital or between the different regions of our country may become significant public health issue. Hence, recognition of AmpC may enhance hospital infection control rate by making the physician to think about the selection of suitable antibiotics.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Enterobacteriaceae ; AmpC ; MHT ; AmpC disc ; test ; PCR. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Punitha K |
| Date Deposited: | 23 May 2018 03:27 |
| Last Modified: | 27 May 2018 06:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8041 |
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