2016, Cilt 46, Sayı 2, Sayfa(lar) 088-096 |
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Detection of CTX-M Enzymes in ESBL (Extended-Spectrum Beta-Lactamases) Producing Escherichia coli and Klebsiella spp Isolates |
Esra DENİZ ÖGEDEY1, Füsun CÖMERT1, Füruzan KÖKTÜRK2, Canan KÜLAH1, Elif AKTAŞ1 |
1Bülent Ecevit Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Zonguldak 2Bülent Ecevit Üniversitesi Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Zonguldak |
Keywords: CTX-M, Escherichia coli, ESBL, Klebsiella spp. |
Objective: The aim of this study is to evaluate ESBL
production and CTX-M enzyme types in Escherichia coli
and Klebsiella spp isolates obtained from patients admitted
to our hospital.
Material and Method: A total of 593 isolates from various
clinical specimens of patients between June 2009 and
December 2009 were included in the study. Antibiotic
susceptibility test was performed by Kirby-Bauer disk
diffusion method. ESBL production was confirmed by
double-disc synergy and E tests.The minimal inhibitory
concentrations of cefotaxim for the isolates with ESBL
were detected by agar dilution method. Polymerase chain
reaction was used to determine the CTX-M enzyme types
including CTX-M group, CTX-M-1 group, CTX-M-2 group,
CTX-M-8 group, CTX-M-9 group, CTX-M-25 group, CTXM-
15, CTX-M-3, and CTX-M-10 types.
Results: ESBL production was found in 33.7% (200/593) of
the isolates (34.3% for E. coli and 31.3% for Klebsiella
isolates). ESBL production was significantly high in isolates
from inpatients. Resistance to ciprofloxacin, levofloxacin,
amoxicillin/clavulanic acid, piperacillin/tazobactam,
gentamicin, amikacin, tobramycin, trimetoprimsulphametoxazol
and nitrofurantoin was significantly
higher in ESBL producing isolates. CTX-M enzymes were
found in 192 (96%) of the 200 ESBL producing isolates. Of
the CTX-M producing isolates, CTX-M-1, CTX-M-2, CTXM-
8 and CTX-M-9 groups were found in 96.8% (186/192),
5.2% (10/192), 1% (2/192) and 1.5% (3/192), respectively.
CTX-M-15 was found in 165 of the 186 (88.7%) CTX-M-1
group ESBL producing isolates.
Conclusions: High rates of ESBL production was found
among the isolates in our hospital. The most common
enzyme type was CTX-M-1 group, CTX-M-15 being the
most common enzyme type.
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