• Title/Summary/Keyword: double disk synergy test

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Prevalence of CTX-M-type Extended-Spectrum $\beta$-Lactamases Producing Escherichia coli and Klebsieilla pneumoniae Isolates in General Hospitals in 2005 (임상에서 분리된 CTX-M형 Extended-Spectrum $\beta$-Lactamases를 생산하는 Escherichia coli와 Klebsiella pneumoniae의 유행)

  • Kim, Yun-Tae;Kim, Tae-Un
    • Microbiology and Biotechnology Letters
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    • v.34 no.4
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    • pp.342-351
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    • 2006
  • The aim of this study was to survey susceptibilities of Escherichia coli and Klebsiella pneumoniae isolates against cefotaxime and to determine the prevalences of CTX-M type extended-spectrum $\beta$-lactamases (ESBLs) producing E. coli and K. pneumoniae in Korea. During the period of February to July, 2005, 153 E. coli and 52 K. neumoniae isolates were collected from 2 hospitals in Busan. Antimicrobial susceptibilities to cefotaxime were tested by the disk diffusion method. ESBL production of E. coli and K. pneumoniae was determined by the double disk synergy test. MICs of $\beta$-lactam antibiotics were determined by the agar dilution method. Blac$_{CTX-M}$ genes of the organism were detected by PCR. Among 153 isolates of E. coli and 52 isolates of K. neumoniae, 27 (17.6%) and 25 (48.0%) were intermediate or resistant to cefotaxime, respectively. Twenty-three (15.0%) isolates out of 153 E. coli and 13 (25.0%) out of 52 K. neumoniae isolates showed positive results for ESBL by the double disk synergy test. Twenty isolates out of 23 ESBL producing E. coli and 12 out of 13 ESBL producing K. neumoniae isolates harbored biacTx-M gene,11 of ESBL producing E. coli and 12 of ESBL producing K. neuinoniae isolates harbored bla$_{CTX-M}$ gene, 11 of the ESBL producing E. coli and 2 of ESBL producing K. neumoniae isolates harbored bla$_{TEM}$ gene, and 1 of the ESBL producing E. coli and 12 of ESBL producing K. neumoniae isolates harbored bla$_{SHV}$ gene. E. coli and K. neumoniae isolates producing CTX-M-type ESBLs were not uncommon in Korea. It is thought that continuous survey are necessary for inspecting the spread and novel variants of CTX-M-type ESBL genes. Further me]'e investigation and research on ESBL producing strains are needed in order to prevent the spread of resistant bacteria.

Phenotypic and Genotypic Detection of Metallo-β-Lactamase Producing Pseudomonas aeruginosa

  • Yang, Byoung-Seon;Hong, Keun-Seok;Jung, Seung-Bong;Kwon, Young-Hoon;Jeong, Jong-Yoon;Lee, Min-Joo;Lee, Hye-In;Park, Mi-Seon;Choi, Seung-Gu
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.2
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    • pp.81-85
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    • 2012
  • This study was undertaken to evaluate phenotypic and genotypic methods for detection of Metallo-Beta-Lactamases (MBLs) among nosocomial Pseudomonas aeruginosa. Of the 50 P. aeruginosa isolates from clinical specimens, 20 were evaluated for carbapenem resistance and screened for MBL by double-disk synergy test and combined-disk test. Nineteen strains (95%) were found to be MBL producers among the 20 P. aeruginosa. MBL positives were further confirmed by Polymerase Chain Reaction (PCR). For the IMP and VIM types of MBLs, PCR analysis was performed on 19 of the 20, and 10 were positive for VIM MBL type. This study reports the validation of a simple and accurate MBL detection method that can be easily incorporated into the daily routine of a clinical laboratory. Early detection of MBL-carrying organisms, including those with susceptibility to carbapenems, is of paramount clinical importance, as it allows rapid initiation of strict infection control practices as well as therapeutic guidance for confirmed infection.Key Words : Hepatitis A virus (HAV), Anti-HAV, Hospital workers, Prevalence, Vaccination

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The Types of Extended-Spectrum $\beta$-Lactamase (ESBL) Produced by Enteric Bacteria, Klebsiella pneumoniae and Escherichia coli Isolated from Sewage of Wastewater Treatment Plant at Minragdong in Busan, Korea (부산 민락동 오수처리장에서 분리된 장내세균 Klebsiella pneumoniae와 Escherichia coli가 생성한 광범위 베타 락탐(Extended-Spectrum $\beta$-Lactamase, ESBL) 분해효소의 유형)

  • Lee, Hun-Ku
    • Korean Journal of Microbiology
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    • v.45 no.2
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    • pp.163-169
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    • 2009
  • This study was performed to investigate the type of extended-spectrum $\beta$-lactamases (ESBL) produced by bacteria isolated from the sewage of wastewater treatment plant at Minragdong, Suyong-gu in Busan. The facility is located at sushi restaurants and guides its drain water to the wastewater treatment plant at Yonghodong, Nam-gu in Busan. Samples were collected on January, 2009. A total of 19 strains were selected as potential ESBL positive strains through a double disk synergy test. On the basis of the results from biochemical tests including indole, methyl-red, Voges-Proskauer, Simmon's citrate, decarboxylase-dihydrolase and sugar-fermentation tests, the 19 strains were identified with 16 strains of Escherichia coli and 3 strains of Klebsiella pneumoniae. Out of 19 strains, 4 transconjugants against Escherichia coli J53, which is sodium azide resistant recipient strain, were obtained. The plasmids isolated from transconjugants were used for PCR analysis. The type of each extended-spectrum $\beta$-lactamase (ESBL) produced by the strains was determined on the basis of isoelectric focusing analysis and DNA sequencing. The results indicated that the types of ESBL from Klebsiella pneumoniae were SHV-12 (3 strains), and Escherichia coli was SHV-12/TEM-1 (1 strain), respectively.

Evaluation of EDTA-based Three Methods to Detect IMP-1 and VIM-2 Type Metallo-${\beta}$-Lactamase-Producing Clinical Isolates of Imipenem Resistant Acinetobacter and Pseudomonas spp.

  • Hong, Seung-Bok;Shin, Kyung-A;Hwang, Seock-Yeon
    • Biomedical Science Letters
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    • v.17 no.2
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    • pp.135-140
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    • 2011
  • We compared three EDTA-based phenotypic screening methods for detecting IMP-1 and VIM-2 type metallo-${\beta}$- lactamase (MBL)-producing isolates of Acinetobacter and Pseudomonas spp., EDTA-double disk synergy test (EDTADDST), Etest MBL, and imipenem (IPM)-EDTA disk test. A total of 183 isolates (65 Acinetobacter spp. and 118 Pseudomonas spp. showing IPM resistance), confirmed to MBL genes by PCR, were used. The criteria for MBL production were (i) presence of a synergistic zone between IPM and EDTA disks in EDTA-DDST, (ii) reduction of IPM minimal inhibitory concentration by ${\geq}$ 3 twofold dilutions in the presence of EDTA in the Etest MBL, and (iii) ${\geq}$ 7 mm increase in the inhibition zone around the IPM plus EDTA disks compared with a sole IPM disk in the IPM-EDTA disk test. In this study using 87 MBL-producing and 96 MBL-nonproducing isolates, the sensitivities/specificities of EDTA-DDST, Etest MBL and IPM-EDTA disk tests were 94.3/78.1%, 89.7/91.7%, and 97.7/95.8%, respectively. When the threshold for the increase of the inhibition zone around the IPM plus EDTA disk over a sole IPM disk was altered to ${\geq}$ 5 mm and ${\geq}$ 8 mm for Acinetobacter spp. and Pseudomonas spp., respectively, the sensitivity and specificity of the test were 98.9% and 96.9%, respectively. Of the three EDTA-based phenotypic tests, the IMP-EDTA disk test was superior for detection of MBL-producing isolates.

A Novel Plasmid-Mediated ${\beta}-lactamase$ that Hydrolyzes Broad-Spectrum Cephalosporins in a Clinical Isolate of Klebsiella pneumoniae

  • Kwak, Jin-Hwan;Kim, Mu-Yong;Chol, Eung-Chil
    • Archives of Pharmacal Research
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    • v.24 no.6
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    • pp.590-596
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    • 2001
  • A new extended-spectrum ${\beta}-lactamase$ with an isoelectric point (pl) of 6.2 was detected in Klebsiella pneumoniae Fl 61 that was isolated from a patient with infection. This strain was highly resistant to the third or fourth generation cephalosporins such as cceftazidime ceftriaxone, cefoperzaone, and cefpirome. Analysis of this strain by the double disk diffusion test showed synergies between amoxicillin-clavulanate (AMX-CA) and cefotaxime, and AMX-CA and aztreonam, which suggested that this strain produced a extended-spectrum ${\beta}-lactamase$ (ESBL). Cenetic analysis revealed that the resistance was due to the presence of a 9.4-kb plasmic, designated as pkpl 61, encoding for new ${\beta}-lactamase$ gene (bla). Sequence analysis showed that a new bla gene of pkpl 61 differed from $bla_{TEM-1}$ by three mutations leading to the following amino acid substitutions: $Val_{84}{\rightarrow}lie,{\;}Ala_{184}{\rightarrow}Val,{\;}and{\;}Gly_{238}{\rightarrow}Ser$. These mutations have not been reported previously in the TIM type ${\beta}-lactamases$ produced by clinical strains. The novel ${\beta}-lactamase$ was overexpressed in E. coli and purified by ion exchange chromatography on Q-Sepharose and CM-Sepharose, and then further purified by gel filtration on Sehadex G-200. The catalytic activity of th8 purified ${\beta}-lactamase$ was confirmed by the nitrocefin disk.

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Antibiotic Resistance of Hemolytic Escherichia coli Isolated from Animals in Korea (동물에서 분리된 용혈성 대장균의 항생제 내성)

  • Lee, Gye-Nam;Park, Yong-Ho;Jeong, Byeong-Yeol;Lee, Yeon-Hui
    • Korean Journal of Microbiology
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    • v.39 no.4
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    • pp.293-295
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    • 2003
  • Total 70 isolates of Escherichia coli obtained from pigs were studied. Forty four isolates had $\textregistered$-hemolytic activity which was heat labile. Minimum inhibitory concentration test indicated that 40 isolates (57.1%), 15 isolates (21.4%), 23 isolates (32.9%), and 5 isolates (7.1%) were resistant to ampicillin, cephalothin, gentamicin, and norfloxacin, respectively. None of them were extended spectrum $\textregistered$-lactamases (ESBLs) producer when the double disk synergy test (DDST) was performed.

Prevalence of Extended-spectrum β-Lactamase and Quinolone Resistance Genes in Escherichia coli Clinical Isolates and their Antibiotic Resistance (임상검체로부터 분리된 Escherichia coli 의 Extended-spectrum β-lactamase와 퀴놀론 내성 유전자의 출현빈도 및 항생제 내성)

  • Lee, Min Hyeok;Hwang, Yeoung Min;Baik, Keun Sik;Cho, Hyun Wook;Seong, Chi Nam
    • Journal of Life Science
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    • v.23 no.5
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    • pp.703-709
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    • 2013
  • The aim of this study was to investigate the prevalence of Extended-spectrum ${\beta}$-lactamase (ESBL) gene and quinolone resistance determinant (qnr) and the pattern of antibiotic resistance in the ESBL-producing Escherichia coli clinical isolates. The 42 ESBL-producing strains from total 274 isolates were detected using a double disk synergy test. They were isolated from various specimens, such as urine (28 strains), sputum (6 strains), pus (3 strains), wound (2 strains), blood (2 strains), and tissue (1 strain). Using the PCR with the specific primers ESBL, ESBL and qnr gene types were determined. Thirty-five strains possessed one or two ESBL genes. CTX-M-1 type was the most abundant followed by CTX-M-9 type and TEM, but SHV, CTX-M-2, and CTX-M-8 gene types were not detected. qnr gene types were detected from ten isolates in the order of qnrB4, qnrB1, and qnrS. Coexistence of ESBL and qnr genes was found. ESBL-producing isolates showed high resistance against some antibiotics, such as cefotaxmie (80.0%), levofloxacin (82.9%), and ampicillin (100%). Neither a synergy effect from the coexistence of ESBL and qnr genes on antibiotic resistance nor a correlation between the production of qnr gene and quinolone resistance were found.

High Prevalence and Genotypic Characterization of Metallo-β-Lactamase (MBL)-Producing Acinetobacter spp. Isolates Disseminated in a Korean Hospital (국내 대학병원에서 분리된 Metallo-β-Lactamase (MBL) 생성 Acinetobacter spp. 분리주의 높은 출현율과 유전형 특징)

  • Yum, Jong Hwa
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.4
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    • pp.444-452
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    • 2019
  • Carbapenem resistance, mediated by the major acquired metallo-β-lactamase (MBL) genes, has been increasingly reported, particularly for clinical isolates of Acinetobacter spp. Of the 191 nonduplicate clinical isolates of the carbapenem-nonsusceptible Acinetobacter spp. evaluated, 125 isolates (65.4%) were positive for the modified imipenem or meropenem-Hodge test, and 49 isolates (25.7%) were positive for the imipenem-EDTA+SMA double disk synergy test (DDS). PCR and sequencing of the blaVIM-2-allele and blaIMP-1-allele showed that 29 A. baumannii isolates and 1 A. calcoaceticus isolate had blaVIM-2, whereas 16 A. baumannii isolates and 2 A. calcoaceticus isolates had blaIMP-6; 1 isolate of the A. genomospecies 3 had blaVIM-2 and blaAIM-1. All the above MBL genes belong to class 1 integron. The size of class 1 integron encompassing blaVIM-2 or blaIMP-6 ranges from 2.8 kb to 3.2 kb in clinical isolates of A. baumannii, and 3.2 kb to 3.5 kb in clinical isolates of A. genomospecies 3. blaVIM-2 was most often located first or second in the class 1 integron, and these integrons often included aacA4. Due to dispersion of the MBL-producing Acinetobacter spp. as well as integron, which may encompass various resistance genes, there is an expectation for the increase of multidrug resistant Gram-negative bacteria, including resistance of carbapenems such as imipenem or meropenem. Hence, the development of new antimicrobial agents for treating severe Acinetobacter spp. infections is needed.

Prevalence and Diversity of MBL Gene-Containing Integrons in Metallo-β-Lactamase (MBL)-Producing Pseudomonas spp. Isolates Disseminated in a Korean Hospital

  • Yum, Jong Hwa
    • Biomedical Science Letters
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    • v.25 no.4
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    • pp.321-330
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    • 2019
  • Carbapenem is recently considered as the last resort of the therapeutics for gram negative bacterial infection. Increasing of organisms producing metallo-β-lactamase (MBL), we have difficulty in choosing the antimicrobial agents. Among 345 clinical isolates of Pseudomonas spp., 61 isolates (17.7%) were positive for the modified imipenem or meropenem-Hodge test and 55 isolates (15.9%) were positive for the imipenem-EDTA + SMA double disk synergy test (DDS). PCR and sequencing of blaVIM-2-allele and blaIMP-1-allele showed that 17 isolates of Pseudomonas aeruginosa, 9 isolates of Pseudomonas taiwnensis and 2 Pseudomonas plecoglossicida had blaVIM-2, and 22 isolates of P. aeruginosa and one Pseudomonas otitidis had blaIMP-6. These MBL genes were all in class 1 integron. The size of class 1 integron with blaVIM-2 ranged from 3.5 kb to 5.5 kb in clinical isolates of Pseudomonas spp. including P. aeruginosa. blaVIM-2 was most often located first in the class 1 integron, sometimes in the second or third position, and these integrons often had aacA4 or aadA1. Strict infection control measures are needed to more effectively prevent further spread of these MBL-producing Pseudomonas spp. In addition, MBL-producing Pseudomonas spp. is expected to continue to spread in various countries and regions.

Characterization of Extended-Spectrum $\beta$-Lactamases (ESBL) Producing Klebsiella and Enterobacter Isolated from Sewerage Plant Drain Water at Kwang-An in Pusan (광안리 오수처리장에 분리된 Extended-Spectrum $\beta$-Lactamase (ESBL) Klebsiella와 Enterobacter의 유형)

  • 이훈구
    • Korean Journal of Microbiology
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    • v.37 no.4
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    • pp.277-283
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    • 2001
  • The emergence of extended spectrum beta-lactamase(ESBL) producing bacteria is causing very serious problems in Korea. Although there have been many reports about these bacteria isolated from patients and clinical specimens, there is no report of ESBL-producing organisms isolated from natural evironment in Korea. This is the first study on the ESBL producing bacteria out of the medical system in Korea. Twenty-six ESBL producing bacteria were isolated only from sewerage plant drain water at Kwang-an beach among the sampling collected sites including snakehead fish plants in Myungi, Aquaculture Engineering Lab. in Pukyong National University and two public-bathrooms in Pusan, Korea. ESBL producing bacteria were identified by double-disk synergy test, conjugation, isoelectric focusing values and PCR. The species of ESBL producing bacteria were Enterobacter cloacae(4 strains), E. sakazakii(8 strains), Klebsiella pneumoniae subsp. pneumoniae(8 strains) and K. pneumoniae subsp. ozaenae(6 strains). TEM and SHV specific PCR products were detected from all the ESBL strains produced TEM+SHV products on the PCR plates. The pI values of ESBL produced by Klebsiella pneumoniae subsp. pneumoniae, K. pneumoniae subsp. ozaenae, Enterobacter cloacae, and E. sakazakii were 5.9, 5.9+5.4; 5.9, $5.9+5.4;{\ge}8.5$, 8.0+5.4, and 8.0+5.4, respectively on the IEF. Seven strains of the isolates were transfered their genes to E. coli RG488 $Rif^r$ by conjugation.

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