@article{article_968387, title={Investigation of three different methods for detection of ESBL production and antibiotic resistance percentage of ESBL producing Gram negative bacteria}, journal={Türk Hijyen ve Deneysel Biyoloji Dergisi}, volume={72}, pages={131–138}, year={2015}, author={Güzel, Mustafa and Genç, Yasemin and Aksoy, Altan and Moncheva, Penka and Hristova, Petya}, keywords={Extended spectrum beta- lactamase, chromogenic agar, antimicrobial susceptibility}, abstract={Objective: In this study, it was aimed to evaluate the efficacy of chromogenic agar for rapid and accurate identification of bacteria producing extended spectrum beta-lactamase ESBL and to investigate the antibiotic resistance rates of 105 bacteria that were determined to produce ESBL.Methods: ESBL production was investigated using combined disc method, E-test and chromogenic agar. Additionally, susceptibility patterns of these strains to 21 antibiotics were studied according to the criteria of CLSI Clinical and Laboratory Standards Institute . Zone diameters categorized as susceptible were evaluated, and strains showing intermediate susceptibility were considered as resistant. Fisher’s chi-square test was used in statistical analysis.Results: A hundred and five strains 81 Escherichia coli, 24 Klebsiella spp. were found to produce ESBL by combined disc method, while 96 strains were found to produce ESBL by E-test and 99 strains by chromogenic agar. The sensitivity and positive predictive value of chromogenic agar for ESBL production was 94.8% and 91.9%, respectively. All strains were found to be resistant to cefuroxime, cefazolin and cefotaxime, the antibiotics that ESBL producing strains are considered to be resistant to. Among beta-lactam/beta-lactamase inhibitor combinations, the highest resistance was meropenem ve ertapenem dirençli toplam 8 %7,6 suş tespit edilmiş olup en düşük direnç oranı karbapenem grubu antibiyotiklerde saptanmıştır. Beta-laktam/betalaktamaz inhibitörü kombinasyonları, aminoglikozidler, trimetoprim – sülfametoksazol ve kloramfenikole Klebsiella spp. suşlarının E. coli’den daha dirençli olduğu fakat kinolonlara E. coli suşlarının daha dirençli olduğu tespit edilmiştir p < 0.05 . Sonuç: GSBL tespitinde kromojenik agar kullanımının bir avantaj sağlamadığı, GSBL üreten suşlarda en düşük direnç oranına sahip antibiyotiklerin karbapenemler olduğu, GSBL üreten bakterilerin türlerinin direnç oranlarını belirlemede ve tedavide kullanılacak antibiyotiğin seçiminde önemli olduğu görülmüştür.Conclusion: It was observed that the use of chromogenic agar has no advantage in detecting ESBL enzymes, the lowest resistance rate in ESBL producing strains was to carbapenems, and the species of ESBL producing bacteria was important in determining the resistance rates and selection of the appropriate antibiotic for treatment}, number={2}, publisher={T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü}