Characterization of beta-lactamases from urinary isolates of Escherichia coli in Tehran

BACKGROUND: Knowledge of antimicrobial resistance patterns in E. coli, the predominant pathogen associated with urinary tract infections (UTI) is important as a guide in selecting empirical antimicrobial therapy. METHODS: To describe the antimicrobial susceptibility of E. coli associated with UTI in a major university hospital in Tehran (Iran), seventy-six clinical isolates of E. coli were studied for susceptibility to beta-lactam antibiotics by the disc diffusion method and Minimal Inhibitory Concentrations determination. RESULTS: All isolates were resistant to ampicillin, amoxicillin and oxacillin. Resistance to the other tested antibiotics was shown to be 93.4% to cefradine, 76.3% to carbenicillin, 47.3% to cefazoline, 50% to cefalexin and 32.8% to cephalothin while 1.3% expressed resistance to cefoxitime, and 2.6% were resistant to ceftizoxime and ceftriaxone. Two isolates (2.4%) harbored extended spectrum beta-lactamases (ESBL) shown by the double disc diffusion method. Substrate hydrolysis by ultra violet spectroscopy showed that 87.4% harbored penicillinases, 9% produced cephlosporinases and 3.6% degraded both substrates. Clavulanic acid inhibited enzyme activity in 82.9%, of which 78.95% was penicillinases (group IIa) and 3.95% was cephalosporinases (group IIb) of the Bush classification system. The rest of the isolates (6.58 %) were placed in group IV beta-lactamases. No group III beta-lactamase was found, as EDTA inhibited none of the enzymes. DNA amplification by polymerase chain reaction using specific primers for ampC, TEM and SHV type beta-lactamases for all of the isolates showed that 47 organisms (60%) carried the TEM gene and 18 isolates (24%) harbored blaTEM and ampC genes. About 26% of the organisms harbored SHV type enzymes. CONCLUSION: These results indicate that E. coli can posses a variety of beta-lactamases that are responsible for beta-lactam resistance.     

A huge ovarian cyst in a hysterectomized bitch

A 11-year-old, spayed, female mixed breed-dog was presented with an abdominal mass that was detected 1 month ago. Upon abdominal palpation a large, firm, oval shaped, movable mass was found in the mid-abdominal region. Survey radiograph of the abdomen demonstrated an oval soft tissue dense mass located on the right side of the abdominal cavity. A large, heteregenous and cystic mass with solid components occupying the majority of the abdomen and a small, cystic mass with solid components caudal to the left kidney were identified by transabdominal ultrasonography. Computed tomography scans revealed bilateral ovarian masses, and a small volume of retroperitoneal fluid on the right side. A cystic, but otherwise solid mass located in the right ovary and small retained left ovary encapsulated in the ovarian bursa were excised surgically by midline laparotomy. Histopathological examination of the excised mass from the right side revealed a large cystic structure consistent with an ovarian cyst and multiple corpora lutea and follicles at different maturational stages were detected in the left ovary. The precise origin of the ovarian cyst could not be determined by morphological appearance. Immunohistochemical staining suggested a cyst of surface epithelial origin. At re-examination 6 months after the surgery, the bitch appeared healthy and the clinical findings were all normal. To our knowledge, the cyst described here is the largest reported in an incompletely ovariohysterectomized bitch.