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2011, Cilt 41, Sayı 4, Sayfa(lar) 149-154
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Extended Spectrum Beta-Lactamase Production and Antimicrobial Resistance Rates of the Escherichia coli and Klebsiella Strains Isolated From Various Clinical Specimens in 82nd Year State Hospital, Rize, Turkey
Ayşegül ÇOPUR ÇİÇEK1, Zeynep ŞENTÜRK KÖKSAL2, Ayşe ERTÜRK3, Seher Aziret GETİR2, Osman Birol ÖZGÜMÜŞ1
1Rize Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalı
2Rize 82. Yıl Devlet Hastanesi Klinik Mikrobiyoloji Laboratuvarı
3Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı
Keywords: Escherichia coli, Klebsiella species, extended spectrum beta-lactamases

Objective: In this study, antimicrobial susceptibilities of Escherichia coli and Klebsiella strains isolated from various clinical specimens sent to the clinical microbiology laboratory in 82nd Year General State Hospital in Rize, Turkey during February 2010 - March 2011, were investigated retrospectively.

Materials and Methods: Clinical specimens such as urine, sputum, wound and the others were inoculated on eosine methylene blue (EMB) agar and blood agar; blood samples were inoculated into biphasic Rosmedia (GBL) medium, and subcultured onto EMB and sheep blood agars according to the routine procedures. The microorganisms were identified by biochemical reactions and conventional methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Presumptive identification of extended spectrum beta-lactamase (ESBL) producing E. coli and Klebsiella strains was done by double-disk synergy test.

Results: A total of 501 E. coli and 90 Klebsiella strains were isolated from the clinical specimens. Seventeen percent of E. coli (n=85) and 21.1% of Klebsiella (n=19) were ESBL-producers. ESBL positivity was more frequent among outpatients than inpatients. ESBL-positive strains were found to be more resistant to amoxicillin/clavulanic acid, ampicillin, ceftriaxone and cefazolin than the ESBL negative strains. The most effective antibiotics against both ESBL producers and non-producers were carbapenems and amikacin.

Conclusion: The high rate of ESBL positivity among outpatient isolates emphasizes the need to improve rational use of antimicrobial agents.


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