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Phenotypic detection of AmpC β-lactamases, extended-spectrum- β-lactamases and metallo-β-lactamases in Enterobacteriaceae using a resazurin microtitre assay with inhibitor-based methods.

Teethaisong, Y and Eumkeb, G and Chumnarnsilpa, S and Autarkool, N and Hobson, J and Nakouti, I and Hobbs, G and Evans, K (2016) Phenotypic detection of AmpC β-lactamases, extended-spectrum- β-lactamases and metallo-β-lactamases in Enterobacteriaceae using a resazurin microtitre assay with inhibitor-based methods. Journal of Medical Microbiology. ISSN 1473-5644

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Abstract

Dissemination of antibiotic resistance in Enterobacteriaceae mediated by AmpC, ESBL and MBL β-lactamases is clinically significant. A simple, relatively quick method for the detection of these resistance phenotypes would greatly improve chemotherapeutic recommendation. This technology would provide valuable input in our surveillance of resistance on a global stage, particularly if the methodology could be applicable to resource poor settings. A resazurin microtitre plate (RMP) assay incorporating cloxacillin, clavulanic acid, and EDTA for the rapid phenotypic identification of AmpC, Extended-spectrum-β-lactmase (ESBL), metallo-β-lactamase (MBL) and the co-existence of β-lactamases has been developed. A total of 47 molecularly characterised Enterobacteriaceae clinical isolates producing AmpCs, ESBLs, co-producers of ESBL and AmpC, MBLs, and co-producers of ESBL and MBL were phenotypically examined using the RMP assay. The ceftazidime (CAZ)-based and cefotaxime (CTX)-based RMP assay successfully detected all 16 AmpC, 14 ESBL, 9 MBL producers, 6 ESBL-AmpC co-producers, and 2 ESBL-MBL co-producers without false positive results. The CAZ-based assay was more reliable in detecting AmpC alone, while the CTX-based assay performed better in identifying co-producers of ESBL and AmpC. There was no difference in detection of ESBL and MBL producers. The findings of the present study suggest that use of the RMP assay with particular β-lactamase inhibitors explicitly detects three different β-lactamases, as well as co-existence of β-lactamases within 6 h after initial isolation of the pathogen. This assay is applicable to carry out in any laboratory, is cost-effective and easy to interpret. It could be implemented in screening patients, controlling infection and for surveillance purposes.

Item Type: Article
Uncontrolled Keywords: 07 Agricultural And Veterinary Sciences, 11 Medical And Health Sciences, 06 Biological Sciences
Subjects: R Medicine > RS Pharmacy and materia medica
Divisions: Pharmacy & Biomolecular Sciences
Publisher: Microbiology Society
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Date Deposited: 16 Aug 2016 14:31
Last Modified: 13 Sep 2016 09:04
DOI or Identification number: 10.1099/jmm.0.000326
URI: http://researchonline.ljmu.ac.uk/id/eprint/4033

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