First report of TEM-116 and OXA-10 extended-spectrum β-lactamase in clinical isolates of Alcaligenes species from Kuala Lumpur, Malaysia.

There is an alarming increase of extended-spectrum β-lactamases (ESBL) being present mainly in Enterobacteriaceae and other non-fermenting gram-negative bacteria, such as Alcaligenes faecalis which is the only species present in that genus that is clinically relevant. We investigated Alcaligenes species from 7 cases (6 inpatients and 1 outpatient) at our tertiary hospital. Four patients had urinary tract infections and one each with systemic lupus erythematosus, pulmonary stenosis and diabetic ulcer. All 7 isolates were identified as Alcaligenes sp. using 16S rRNA gene sequences and antimicrobial susceptibility was determined using the Vitek 2 system with the AST-GN87 cards. All strains were resistant to cefazolin; 6 were resistant to trimethoprim/sulfamethoxazole; 5 exhibited resistance to ampicillin/sulbactam, cefepime, tobramycin, ciprofloxacin, and nitrofurantoin while 5 strains had multidrug resistance profiles. All strains (7/7) expressed ESBL activity, PCR screening and sequencing showed evidence of blaTEM-116 (7/7) and blaOXA-10 (4/7) genes and we believe this is the first report on the presence of TEM-116 and OXA-10 in Alcaligenes sp.. A combination of both genes was present in 4 strains. All 7 strains were found to have at least one ESBL gene probably contributing to drug resistance.