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Healthcare Associated Infections Caused by Gram-negative Bacilli in Adult Intensive Care Units: Identification of AmpC Beta-Lactamases Mediated Antimicrobial Resistance

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Last updated: 05 Jan 2025

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Abstract

Background: Healthcare associated infections (HAIs) caused by AmpC β-lactamases producers are clinically significant as they can mediate resistance to cephalosporins, penicillins, monobactams and cephamycins. Objectives: To find out the prevalence of AmpC producers among Gram-negative bacilli recovered from HAIs in adult intensive care units (ICUs) and to identify the risk factors associated with AmpC β-lactamases production. In addition, we compared the antimicrobial resistance patterns in AmpC positive and negative isolates. Methodology: A prospective study was conducted over one year duration on samples collected from patients suffering from HAIs in the adult ICUs of Mansoura Emergency Hospital, Mansoura- Egypt. Isolated Gram-negative bacilli were subjected to cefoxitin disk diffusion test to screen for AmpC production. Presumptive AmpC producers were then confirmed by AmpC disk test, disk approximation test and AmpC E test. Results: Out of the recovered 240 Gram-negative bacilli, 73 isolates (30.4%) were AmpC producers. Acinetobacter baumannii represented the highest AmpC production (44.4%). Significant risk factors for AmpC β-lactamases production included previous exposure to antibiotic therapy, prolonged duration of antibiotic therapy before development of HAIs and presence of a central line or endotracheal tube. Resistance to all tested antimicrobials, with the exclusion of imipenem and meropenem, was significantly associated with AmpC producers. Conclusion: Increased prevalence of AmpC producers among Gram-negative isolates was observed in our study. Thus, early detection of AmpC producing bacteria is necessary to avoid treatment failure. Establishment of antibiotic stewardship policy and enhanced infection prevention and control measures are necessary to avoid spread of resistant infections in ICUs.

DOI

10.21608/ejmm.2019.282671

Keywords

Healthcare associated infections, Antimicrobial resistance, AmpC Beta lactamases

Authors

First Name

Amira

Last Name

Sultan

MiddleName

M.

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

amira110sultan@yahoo.com

City

Mansoura

Orcid

0000-0002-6707-9599

First Name

Nawal

Last Name

Gouda

MiddleName

S.

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

-

City

-

Orcid

-

First Name

Heba

Last Name

Eldegla

MiddleName

E.

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

heba_degla@yahoo.com

City

-

Orcid

-

First Name

Mohammad

Last Name

Sultan

MiddleName

A.

Affiliation

Anaesthesia Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

-

City

-

Orcid

-

First Name

Mostafa

Last Name

Nabeeh

MiddleName

M.

Affiliation

Neurosurgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

-

City

-

Orcid

-

First Name

Manal

Last Name

Nomir

MiddleName

M.

Affiliation

Clinical Pathology, Mansoura University Student Hospital, Mansoura, Egypt

Email

-

City

-

Orcid

-

Volume

28

Article Issue

2

Related Issue

39228

Issue Date

2019-04-01

Receive Date

2023-01-28

Publish Date

2019-04-01

Page Start

61

Page End

68

Print ISSN

1110-2179

Online ISSN

2537-0979

Link

https://ejmm.journals.ekb.eg/article_282671.html

Detail API

https://ejmm.journals.ekb.eg/service?article_code=282671

Order

282,671

Type

New and original researches in the field of Microbiology.

Type Code

2,038

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Microbiology

Publication Link

https://ejmm.journals.ekb.eg/

MainTitle

Healthcare Associated Infections Caused by Gram-negative Bacilli in Adult Intensive Care Units: Identification of AmpC Beta-Lactamases Mediated Antimicrobial Resistance

Details

Type

Article

Created At

28 Dec 2024