Coexpression of ESBL, Amp C and MBL in gram negative bacilli

Ruturaj M. Kolhapure, Ashwin Kumar, HRV Rajkumar


Background: Resistant bacteria are emerging worldwide as a threat to the favourable outcome of common infections in community and hospital settings. Extended Spectrum Beta-Lactamases (ESBLs), AmpC β lactamases and Metallo-β Lactamases (MBL) are the three important mechanism of resistance to beta lactam drugs in the bacteria. The objective of the study was to screen gram negative isolates for co-expression of extended spectrum β-lactamase, Amp C β-lactamase and Metallo β-lactamase production.

Methods: In this study 50 (27 male & 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured.

Results: Seven hundred and six isolates from various clinical samples from Kamineni institute of medical sciences Hospital, Narketpally, were processed during the period of October 2010 to September 2012. Gram negative bacilli were identified by colony morphology, gram stain, motility, enzyme detection tests, etc. ESBL detection was carried but by two procedures like double disc synergy tests (DDST) and phenotypic confirmatory disc diffusion test (PCDDT). AmpC Beta-lactamase detection was done by AmpC Disc Test. MBL production was tested by Imipenem-EDTA combined disc test.

Conclusions: Klebsiella was the commonest isolate (28.47%) followed by E coli (26.48%), Pseudomonas aeruginosa (19.54%), Enterobacter (8.92%), Acinetobacter (8.92%) and Citrobacter (7.64%). A total of 272 out of 706 gram negative isolates were ESBL producers. ESBL production was seen more in E. coli followed by Klebsiella and P. aeruginosa. A total of 73 out of 706 isolates were inducible Amp C producers. AmpC production was seen more in Acinetobacter. A total of 65 out of 706 isolates were MBL producers. MBL Production was seen more in E. coli.



ESBL, Amp C, MBL, Resistance, Isolates, Bacteria, Superbugs, Culture and Sensitivity

Full Text:



Chaudhary U, Aggarwal R. Extended spectrum beta lactamases (ESBLs) – An emerging threat to clinical therapeutics. Ind J Med Microbiol. 2004;22(2):75-80.

Kumar MS, Lakshmi V, Rajagopalan R. Occurrence of extended spectrum betalactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Ind J Med Microbiol. 2006;24(3):208-11.

Bhattacharya S. ESBL – From petri dish to the patient. Ind J Med Microbiol. 2006;24(1):204.

Rodrigues C, Joshi P, Jani SH, Alphonse M, Radhakrishnan R, Mehta A. Detection of betalactamases in nosocomial gram negative clinical isolates. Ind J Med Microbiol. 2004;24(4):247-50.

Singhal S, Mathur T, Khan S, Upadhyay DJ, Chugh S, Gaind R, et al. Evaluation of methods for Amp C betalactamase in gram negative clinical isolates from tertiary care hospitals. Ind J Med Microbiol. 2005;23(2):120-4.

Walsh TR, Toleman MA, Poirel L, Nordmann P. Metallo-beta-lactamases: the quiet before the storm? ClinMicrobiol Rev. 2005;18(2):306-25.

Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, Woods G. Color atlas and textbook of diagnostic microbiology. 6th ed. Lippincott Williams and Wilkins. 2006;945-1021.

Clinical Laboratory Standards Institutes. Performance Standards for antimicrobial susceptibility testing, XVI International Supplement (M100-S16). Wayne, Pennsylvania, USA: National Committee for Clinical Laboratory Standards, 2006.

Behera B, Mathur P, Das A, Kapil A, Sharma V. An evaluation of four different phenotypic techniques for detection of metallo-beta-lactamase producing Pseudomonas aeruginosa. Ind J Med Microbiol. 2008;26(3):233-7.

Irfan S, Zafar A, Guhar D, Absan T, Hasan R. Metallobetalactamase producing clinical isolates of Acinetobacter species and Pseudomonas aeruginosa from intensive care unit patients of a tertiary care hospital. Ind J Med Microbiol. 2008;26(3):243-5.

Varaiya A, Kulkarni M, Bhalekar P, Dogra J. Incidence of metallobetalactamase producing Pseudomonas aeruginosa in diabetes and cancerpatients. Ind J Pathol Microbiol. 2008;51(2):200-3.

Taneja N, Rao P, Arora J, Dogra A. Occurrence of ESB Land Amp C betalactamases and susceptibility to newer antimicrobial agents incomplicated UTI. Ind J Med Res. 2008;127:85-8.

Shukla I, Tiwari R, Agrawal M. Prevalence of extended spectrum betalactamase producing Klebsiella pneumoniaein a tertiary care hospital. Ind J Med Microbiol. 2004;22(2):87-91.

Sinha P, Sharma R, Rishi S, Sharma R, Sood S, Pathak D. Prevalence ofextended spectrum beta lactamase and Amp C betalactamase producers amongEscherichia coli isolates in a tertiary care hospital in Jaipur. Ind J PatholMicrobiol. 2008;51(3):367-9.

Oberoi L, Singh N, Sharma P, Aggarwal A. ESBL, MBL and Amp C β lactamases producing superbugs. JCDR. 2012:1-4.

Mendiratta DK, Deotale V, Narang P.MBL producing Pseudomonas aeruginosa in a hospital from rural area. Indian J Med Res. 2005;121:701-3.

Chatterjee SS ,karmacharya R ,Madhup SK. Study of prevalence of co-expression of newer β lactamases in gram negative bacilli. IJMM. 2010;28(3):267-8.