title: Emergence of CMY-2- and DHA-1-type AmpC β-lactamases inEnterobacter cloacaeisolated from several hospitals of Qazvin and Tehran, Iran.
abstract: OBJECTIVE
  The emergence of plasmid-mediated AmpC (pAmpC) β-lactamases conferring resistance to third-generation cephalosporins has become a major clinical concern worldwide. The aims of this study were to determine the prevalence of pAmpC-producingE. cloacaeisolates and typing of them in Qazvin and Tehran provinces, Iran.
  
  
  METHODS
  A total of 120 cefoxitin non-susceptible isolates ofE. cloacaewere obtained from educational hospitals of Qazvin and Tehran, Iran. Bacterial identification was performed by standard laboratory methods and API 20E strips. Susceptibility to cefoxitin was determined by Kirby-Bauer disk diffusion method. PCR and sequencing were employed to detect pAmpC families' genes (ACC, FOX, MOX, DHA, CIT and EBC) and the clonal relatedness of pAmpC-positive isolates was evaluated by enterobacterial repetitive intergenic consensus (ERIC)-PCR method.
  
  
  RESULTS
  In total, 20 (16.7%) isolates ofE. cloacaewere positive for presence of pAmpC genes among thoseblaDHA-1(14.2%) was the most common gene followed byblaCMY-2(2.5%). Results of ERIC-PCR showed that that the prevalence of DHA-1 and CMY-2-producingE. cloacaeisolates was not due to clonal outbreaks.
  
  
  CONCLUSIONS
  In present study, we showed the first emergence of DHA-1 and CMY-2 types of pAmpC-producingE. cloacaeisolates in Iran. The appearance of pAmpC should be considered as a warning for the implementation of appropriate infection control and therapeutic policies in order to prevent the dissemination of these resistant organisms in our hospital settings.
authors.affiliation: Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Peymani
authors.affiliation: Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Taghi
authors.initials: T
authors.lastname: Naserpour-Farivar
authors.affiliation: Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Moein
authors.initials: M
authors.lastname: Yeylagh-Beygi
authors.affiliation: Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Shahiin
authors.initials: S
authors.lastname: Bolori
keywords: ERIC-PCR; Enterobacter cloacae; PAmpC