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Journal of Clinical Microbiology, May 2000, p. 1791-1796, Vol. 38, No. 5
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Occurrence and Detection of AmpC Beta-Lactamases among Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates at a Veterans Medical Center

Philip E. Coudron,1,* Ellen S. Moland,2 and Kenneth S. Thomson2

Pathology and Laboratory Medicine Service/113, McGuire Veterans Affairs Medical Center, Richmond, Virginia 23249-0001,1 and Department of Medical Microbiology and Immunology, Creighton University School of Medicine, Omaha, Nebraska 681782

Received 21 September 1999/Returned for modification 26 November 1999/Accepted 18 February 2000

AmpC beta-lactamases are cephalosporinases that confer resistance to a wide variety of beta -lactam drugs and that may thereby create serious therapeutic problems. Although reported with increasing frequency, the true rate of occurrence of AmpC beta-lactamases in Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis remains unknown. We tested a total of 1,286 consecutive, nonrepeat isolates of these three species and found that, overall, 45 (3.5%) yielded a cefoxitin zone diameter less than 18 mm (screen positive) and that 16 (1.2%) demonstrated AmpC bands by isoelectric focusing. Based on the species, of 683 E. coli, 371 K. pneumoniae, and 232 P. mirabilis isolates tested, 13 (1.9%), 28 (7.6%), and 4 (1.7%), respectively, demonstrated decreased zone diameters and 11 (1.6%), 4 (1.1%), and 1 (0.4%), respectively, demonstrated AmpC bands. Cefoxitin resistance was transferred for all but 8 (E. coli) of the 16 AmpC producers. We also describe a three-dimensional extract test, which was used to detect phenotypically isolates that harbor AmpC beta-lactamase. Of the 45 cefoxitin-resistant isolates, the three-dimensional extract test accurately identified all 16 AmpC producers and 28 of 29 (97%) isolates as non-AmpC producers. Interestingly, most (86%) isolates in the latter group were K. pneumoniae isolates. These data confirm that, at our institution, E. coli, K. pneumoniae, and P. mirabilis harbor plasmid-mediated AmpC enzymes.

* Corresponding author. Mailing address: Pathology and Laboratory Medicine Service/113, McGuire Veterans Affairs Medical Center, 1201 Broad Rock Blvd., Richmond, VA 23249-0001. Phone: (804) 675-5809. Fax: (804) 675-5518. E-mail: Philip.Coudron{at}med.va.gov.

Journal of Clinical Microbiology, May 2000, p. 1791-1796, Vol. 38, No. 5
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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