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2017, Cilt 47, Sayı 4, Sayfa(lar) 190-196
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Molecular Epidemiology of Carbapenem Resistance in Clinical Isolates of Acinetobacter spp
Murat TELLİ1, Mete EYİGÖR2, Berna KORKMAZGİL1, Neriman AYDIN1, Mustafa Altay ATALAY3
1Adnan Menderes Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Aydın
2Akdeniz Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Antalya
3Erciyes Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Kayseri
Keywords: Acinetobacter baumannii, carbapenem, resistance, epidemiology

Objective: Acinetobacter baumannii can develop multi-drug resistance and is an important pathogen in hospital-acquired infections. Carbapenems are the choice of treatment for A. baumannii strains resistant to multidrug therapy. The aim of this study is to detect carbapenem resistance mechanisms detected in A. baumannii strains, and to investigate molecular epidemiology of this resistance.

Material and Methods: We investigated 122 Acinetobacter spp. strains and identified with fully automated identification system. Antimicrobial susceptibilities were tested and interpreted according to the CLSI guidelines. In these strains, metallo-beta-lactamase genes (IMP, VIM, GIM, SPM, SIM, NDM-1) and oxacillinase genes (OXA-23, OXA-24, OXA-51, OXA-58) were investigated with PCR. Clonal distribution was investigated with PFGE.

Results: We obtained forty-two carbapenem resistant isolates. Using ARDRA assay 41 of these strains were identified as A. baumannii and one as Acinetobacter spp. All carbapenem resistant isolates were also resistant to cefoperazone/sulbactam, piperacillin/tazobactam and ceftazidime. Other resistance rates were 95% to ciprofloxacin, 86% to amikacin, 21% to tigecycline and 12% to polymyxin. None of the isolates were resistant to colistin. Thirty isolates were found to belong to a unique clone (A). Of the carbapenem resistant isolates 18 (78%) were OXA-23 group and 5 (12%) were OXA-58 group resistance gene positive. OXA-24 group of resistance genes was not observed in any of the isolates. Of the carbapenem resistant isolates 23 (54%) harboured only OXA-51 genes. Both OXA-23 and OXA-58 genes were observed in four isolates. Other karbapenemase genes IMP; VIM, GIM, SPM, SIM, were not detected in any of the isolates while NDM-1 was positive in only one that was non-A. baumannii.

Conclusion: In conclusion, carbapenem resistance rate was 34% and all Acinebacter spp. strains were A. baumannii except one. Oxacillinase group of enzymes were found to be more responsible (most frequent OXA-51) from carbapenem resistance. Thirty strains belonged to a unique clone and this hospital clone was considered to be responsible for the spread of resistance. NDM-1 resistance gene and other metallo-beta-lactamase genes were not found in these strains.


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