title: Detection of AmpC β-lactamase producing bacteria isolated in neonatal sepsis.
abstract: OBJECTIVE
  The objective of this study was to determine the occurrence and antimicrobial profile of AmpC β-lactamase producing bacteria.
  
  
  METHODS
  The study was conducted at The Children's Hospital and The Institute of Child Health Lahore, Pakistan, during September 2011 to June 2012. A total number of 1,914 blood samples of suspected neonatal septicemia were processed. Isolates were identified using Gram's staining, API 20E and API 20NE tests. Gram negative isolates were screened for AmpC β-lactamase production against ceftazidime, cefotaxime and cefoxitin resistance and confirmed by inhibitor based method.
  
  
  RESULTS
  Total number of 54 (8.49%) Gram positive and 582 (91.5%) Gram negative bacteria were identified. Among Gram negative isolates 141 (22%) were AmpC producers and found to be 100% resistant to co-amoxiclav, cefoxitin, ceftazidime, cefotaxime, cefuroxime, cefixime, ceftriaxone, cefpodoxime, gentamicin, amikacin and aztreonam. Less resistance was observed against cefepime (30.4%), sulbactam-cefoperazone (24.8%), piperacillin-tazobactam (10.6%), ciprofloxacin (20.5%) and meropenem (2.1%). All the isolates were found sensitive to imipenem. The patients harbored AmpC β-lactamases were on various interventions in which intravenous line was noted among (51.1%), naso-gastric tube (37.6%), ambu bag (8.5%), endotracheal tube (3.5%), ventilator (2.1%) and surgery (0.7%).
  
  
  CONCLUSIONS
  Extensive use of invasive procedures and third generation cephalosporins should be restricted to avoid the emergence of AmpC beta-lactamases in neonates.
authors.affiliation: Sonia Salamat, M.Phil. Department of Microbiology, Government College University, Lahore, Pakistan.
authors.forename: Sonia
authors.initials: S
authors.lastname: Salamat
authors.affiliation: Hasan Ejaz, PhD, Department of Microbiology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ejaz
authors.affiliation: Aizza Zafar, M.Phil, Department of Microbiology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
authors.forename: Aizza
authors.initials: A
authors.lastname: Zafar
authors.affiliation: Humera Javed, M.Phil, Department of Microbiology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
authors.forename: Humera
authors.initials: H
authors.lastname: Javed
keywords: AmpC β-lactamase detection; Antimicrobial resistance; Multidrug resistant bacteria; Neonatal sepsis