Escherichia coli ve Klebsiella pneumoniae izolatlarında kolistin direncinin ve heterodirencin araştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çoklu ilaç dirençli bakteriler insanlarda yüksek mortalite ve morbiditeye sebep olması nedeni ile önemli bir halk sağlığı sorunudur. Kolistin, çoğu dirençli gram negatif bakteri için son basamak antibiyotik seçeneği olarak önemli bir konumda yer almaktadır. Bu çalışmanın amacı; E. coli ve K. pneumoniae suşlarında kolistin direnç ve heterodirenç varlığını araştırmak ve bunların genetik ilişkisini incelemektir. Kasım 2020 – Mayıs 2021 tarihleri arasında, TÜSAUM Mikrobiyoloji Laboratuvarı'na klinik ve yoğun bakım ünitelerinden gönderilen idrar, balgam, BOS, periton, plevra, eklem sıvısı, kan kültürü, aspirat, doku biyopsi ve yara sürüntüsü gibi materyallerde üreyen 100 E. coli ve 154 K. pneumoniae olmak üzere toplam 254 izolat çalışmaya dahil edildi. Tüm suşlarda SMD yöntemiyle kolistin duyarlılığı değerlendirildi. E. coli suşlarında kolistin direnci saptanmazken, 25 K. pneumoniae suşunda kolistin direnci saptandı. Kolistin duyarlı saptanan tüm suşlara gradiyent strip test yöntemiyle heterodirenç taraması yapıldı, heterodirençli bakteri saptanmadı. Ayrıca GSBL pozitif ve/veya karbapenem dirençli 8 kolistin duyarlı bakteri, heterodirenç açısından PAP analizi ile değerlendirildi, heterodirençli bakteri saptanmadı. Kolistin dirençli 25 K. pneumoniae suşunda PCR yöntemiyle mcr 1-5 gen bölgeleri araştırıldı, tüm örnekler negatif saptandı. Kolistin MİK değeri yüksek saptanan iki K. pneumoniae suşuna MLST analizi uygulandı, kolistin direncinin yanı sıra penisilin, sefalosporin ve karbapenem direncinin sık görüldüğü ST14 ve ST2096 klonları olduğu saptandı.
Multiple drug-resistant bacteria are an important public health problem because it causes high mortality and morbidity in humans. Colistin is in an important position as a last-resort antibiotic option for most of resistant gram-negative bacteria. The aim of this study; is to investigate the presence of colistin resistance and heteroresistance in E. coli and K. pneumoniae strains and examine their genetic relationship. Between November 2020 and May 2021, a total of 254 isolates, including 100 E. coli and 154 K. pneumoniae strains isolated from materials such as urine, sputum, CSF, peritoneum, pleura, joint fluid, blood culture, aspirate, tissue biopsy and wound swab sent from clinical and intensive care units to Microbiology Laboratory of Trakya University Hospital, were included in the study. Colistin susceptibility was evaluated by the BMD method in all strains. While colistin resistance was not detected in E. coli strains, colistin resistance was detected in 25 K. pneumoniae strains. Heteroresistance screening was performed on all colistin-susceptible strains using the gradient strip test method, and no heteroresistant bacteria were detected. In addition, eight ESBL-positive and/or carbapenem-resistant colistin-sensitive strains were evaluated for heteroresistance by the PAP method, heteroresistant bacteria were not detected. mcr 1-5 genes were investigated by PCR method in 25 colistin-resistant K. pneumoniae strains, and all samples were negative. MLST analysis was performed on two K. pneumoniae strains with high colistin MIC values. It was determined that there are ST14 and ST2096 clones in which colistin resistance and penicillin, cephalosporin, and carbapenem resistance are common.
Multiple drug-resistant bacteria are an important public health problem because it causes high mortality and morbidity in humans. Colistin is in an important position as a last-resort antibiotic option for most of resistant gram-negative bacteria. The aim of this study; is to investigate the presence of colistin resistance and heteroresistance in E. coli and K. pneumoniae strains and examine their genetic relationship. Between November 2020 and May 2021, a total of 254 isolates, including 100 E. coli and 154 K. pneumoniae strains isolated from materials such as urine, sputum, CSF, peritoneum, pleura, joint fluid, blood culture, aspirate, tissue biopsy and wound swab sent from clinical and intensive care units to Microbiology Laboratory of Trakya University Hospital, were included in the study. Colistin susceptibility was evaluated by the BMD method in all strains. While colistin resistance was not detected in E. coli strains, colistin resistance was detected in 25 K. pneumoniae strains. Heteroresistance screening was performed on all colistin-susceptible strains using the gradient strip test method, and no heteroresistant bacteria were detected. In addition, eight ESBL-positive and/or carbapenem-resistant colistin-sensitive strains were evaluated for heteroresistance by the PAP method, heteroresistant bacteria were not detected. mcr 1-5 genes were investigated by PCR method in 25 colistin-resistant K. pneumoniae strains, and all samples were negative. MLST analysis was performed on two K. pneumoniae strains with high colistin MIC values. It was determined that there are ST14 and ST2096 clones in which colistin resistance and penicillin, cephalosporin, and carbapenem resistance are common.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Mikrobiyoloji, Microbiology
