2023, Cilt 53, Sayı 2, Sayfa(lar) 075-083 |
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Investigation of Extended Spectrum β-lactamase, Carbapenemase and AmpC β-lactamase by Phenotypic Methods in Carbapenem-resistant Klebsiella spp. and Escherichia coli Isolates |
Filiz Orak1, Esra Kaya1, Murat Aral1, Adem Doğaner2 |
1Kahramanmaraş Sütçü İmam Üniversitesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Kahramanmaraş, Türkiye 2Kahramanmaraş Sütçü İmam Üniversitesi, Biyoistatistik ve Tıbbi Bilişim Anabilim Dalı, Kahramanmaraş, Türkiye |
Keywords: Escherichia coli, Klebsiella spp., beta-lactamase |
Objective: Carbapenem resistance has become an important public health problem due to its high mortality and
limited treatment options. Therefore, there is a need for reliable and simple tests that detect the carbapenem
resistance mechanism in a short time. The aim of this study was to determine the presence of carbapenemase,
ESBL, and AmpC in carbapenem-resistant Klebsiella spp. and Escherichia coli isolates using disc diffusion,
combined disc and disc antagonism test methods on the same plate.
Methods: Carbapenem-resistant Klebsiella spp. and E.coli isolates routinely isolated from patient culture
samples in a university hospital between December 2017 and December 2018, were included in the study.
Combined disk method was used as confirmatory test for ESBL, KPC type and metallo-beta-lactamase, and
temocillin disk diffusion test was used for OXA-48 type carbapenemase in line with the recommendations of
the European Committee for Antimicrobial Susceptibility Testing. The disc diffusion test was used for plasmidmediated
AmpC beta-lactamase identification and the disc antagonism test for inducible (chromosomal) AmpC
beta-lactamase. BAA-1705 K. pneumoniae producing KPC-2 type carbapenemase was used as the control strain.
Results: Carbapenem resistance was detected in a total of 75 isolates, of which 74.6% (n=56) were Klebsiella
pneumoniae, 22.6% (n=17) Escherichia coli, 1.3% (n=1) Klebsiella ozanea and 1.3% (n=1) were Klebsiella
aerogenes. Metallo-beta-lactamase type carbapenemase-associated resistance was determined in 24(31,5%)
isolates, ESBL in 17(22,3%), AmpC in 4 (5,2%) isolates, and OXA-48-related resistance in 31(40,7%) isolates.
Conclusion: Rapid detection of resistance mechanisms is important for appropriate antimicrobial therapy and
infection control measures. The method we used in the study creates an easy and applicable algorithm.
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