Phenotypic Detection and Antibiogram of Î²âlactamaseâproducing Proteus Species in a Tertiary Care Hospital, India

Pal N; Hooja S; Sharma R; Maheshwari RK

Phenotypic Detection and Antibiogram of β‑lactamase‑producing Proteus Species in a Tertiary Care Hospital, India

Author(s):

Pal N*, Hooja S, Sharma R and Maheshwari RK

Background: Proteus species cause a variety of communityâÂ�?�?Â�?�? and hospitalâÂ�?�?Â�?�?acquired illnesses. Synthesis of βâÂ�?�?Â�?�?lactamases is the predominant mechanism for resistance to βâÂ�?�?Â�?�?lactam antibiotics. Among the βâÂ�?�?Â�?�?lactamases, extended spectrum βâÂ�?�?Â�?�?lactamases (ESBLs) and AmpC βâÂ�?�?Â�?�?lactamases are the most common. Aim: The objective of this study was to determine the occurrence of ESBL and AmpC βâÂ�?�?Â�?�?lactamases in Proteus species among various clinical isolates at a tertiary care hospital, India. Materials and Methods: This study was done to identify various species of Proteus from clinical samples (n = 3922). Antimicrobial susceptibility was performed by Kirby–Bauer disc diffusion method. ESBL production was detected by modified doubleâÂ�?�?Â�?�?disc synergy test and indirect modified threeâÂ�?�?Â�?�?dimensional tests and AmpC βâÂ�?�?Â�?�?lactamase production by AmpC disc test and modified Hodge test. Results: Proteus species were isolated in 5.4% (101/1876) specimens. Three Proteus species isolated were Proteus mirabilis 62.4% (63/101), Proteus vulgaris 29.7% (30/101), and Proteus penneri 7.9% (8/101). ESBL producers confirmed by both tests were of 88.1% (89/101). Only AmpC βâÂ�?�?Â�?�?lactamase was produced by four isolates. Coproduction of ESBL and AmpC βâÂ�?�?Â�?�?lactamase was observed in 58.4% (52/89) of isolates. Twelve isolates were nonâÂ�?�?Â�?�?βâÂ�?�?Â�?�?lactamase producers. Multidrug resistance (MDR) was found in 95.1% (96/101) of isolates, 50.5% (51/101) were possibly extensively drug resistant and none were pan drug resistant. None of the isolates were resistant to piperacillinâÂ�?�?Â�?�?tazobactam. P. penneri isolates exhibited high resistance to most of the antibiotics. Conclusions: A high prevalence of ESBL and AmpC βâÂ�?�?Â�?�?lactamases was found that concurrently showed MDR. Phenotypic methods for the detection of βâÂ�?�?Â�?�?lactamases are easy and simple and can be implemented in routine diagnostic laboratories along with susceptibility testing. These data will assist the clinicians in the management and control of infections.

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