Enterobacterales Üyelerinde Nadir Bir Plazmid Aracılı A Sınıfı Beta Laktamaz Olan IBC-1'in Araştırılması

Year 2021, Volume: 11 Issue: 2, 81 - 87, 25.08.2021

Gülşen Altınkanat Gelmez , Ufuk Hasdemir Güner Söyletir

https://doi.org/10.26650/experimed.2021.928330

Abstract

Amaç: Bu çalışmanın amacı, tüm dünyada sıklıkla gözlemlenen geniş spektrumlu beta laktamazları (GSBL) TEM, SHV ve CTX-M ve nadir görülen IBC-1 beta laktamaz enziminin varlığını araştırmaktır.

Gereç ve Yöntem: Marmara Üniversitesi Hastanesinde yatan has-taların klinik örneklerinden izole edilen, fenotipik olarak GSBL üre-ten ve IBC-1 fenotipi gösteren 30 köken çalışmaya dahil edilmiştir. Antibiyotik duyarlılık testleri disk difüzyon ve agarda dilüsyon yön-temi ile gerçekleştirilmiştir. GSBL enzimlerinin fenotipik olarak sap-tanmasında E-test ve çift disk sinerji yöntemi kullanılmıştır. GSBL üretiminden sorumlu olan genlerinin varlığını saptamak amacıyla polimeraz zincir reaksiyonu (PZR) yapılmıştır.

Bulgular: Kökenlerin tamamı, imipeneme duyarlı bulunurken, am-pisilin, amoksisilin klavulanik asit, piperasilin, seftazidim ve trime-toprim sülfametaksazole dirençli olarak; saptanmıştır. E-test yön-temiyle 4 köken tanımsız, 26 köken ise GSBL pozitif saptanmıştır. Çift disk sinerji yöntemi ile 2 köken fenotipik olarak IBC-1 pozitif iken, 5 köken şüpheli pozitif olarak belirlenmiştir. Kökenlerimizin blaTEM, blaSHV ve blaCTX-M genlerini taşıma oranı sırasıyla %73,3, %60 ve %56,6 olarak belirlenmiştir. blaIBC geni ise hiçbir kökende sap-tanmamıştır.

Sonuç: İlk olarak Yunanistan’da saptanan IBC-1 enzimi ülkemiz için henüz bir tehlike oluşturmazken GSBL pozitif kökenlerde TEM, SHV ve CTX-M enzimlerinin oranı oldukça yüksek olarak tespit edilmiş-tir.

Keywords

ESBL, IBC-1, E. coli, K. pneumoniae, E. cloacae

Investigation of IBC-1, a Rare Plasmid-Mediated Class A Beta-lactamase in Members of Enterobacterales

Abstract

Objective: The aim of the study was to investigate the presence of extended -spectrum beta-lactamases (ESBL) TEM, SHV, and CTX-M which are frequently observed all over the world, and the rare IBC-1 betalactamase enzyme.

Material and Method: Thirty strains that isolated from various clinical samples from inpatient at Marmara University Hospital, which were phenotypically positive for ESBL, and IBC-1were included in the study. Antimicrobial susceptibility tests were per-formed both by disk diffusion and agar dilution tests. E-test and double-disc synergy method (DDS) were used for phenotypic detection of ESBLs. The presence of ESBL genes was detected by polymerase chain reaction (PCR).

Results: All strains were susceptible to imipenem while ampicil-lin, amoxicillin-clavulanic acid, piperacillin, ceftazidime, and trimethoprim-sulfamethoxazole were resistant. While 4 strains were unidentified, 26 strains were detected as ESBL positive by E-test. Two strains were phenotypically positive for IBC-1 with DDS, while 5 strains were identified as doubtful. The rate of carrying the blaTEM, blaSHV, and blaCTX-M genes of strains was 73.3%, 60%, and 56.6%, respectively. The blaIBC gene was not detected in any of the strains.

Conclusion: While the IBC-1 enzyme, which was first detected in Greece, have not caused a threat to our country yet, the rate of TEM, SHV, and CTX-M enzymes were found to be quite high.

Keywords

GSBL, IBC-1, E. coli, K. pneumoniae, E. cloacae

References

• 1. Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev 2005; 18(4): 657-86. [CrossRef] google scholar
• 2. Akova M. Dikkat Genişlemiş Spektrumlu Beta Laktamaz (GSBL) Var! ANKEM Dergisi 2004; 18(2): 98-103. google scholar
• 3. Stürenburg E, Mack D. Extended Spectrum Beta Lactamases Imp-lications for The Clinical Microbiology Laboratory, Therapy and Infection Control. J Infect 2003; 47: 273-95. [CrossRef] google scholar
• 4. Giakkoupi P, Tzouvelekis SL, Tsakris A, Loukova V, Sofianou D, Tze-lepi E. IBC-1 a Novel Integron Associated Class A Beta Lactamases with Extended Spectrum Properties Produced by an Enterobacter cloacae Clinical Strain. Antimicrob Agents Chemother 2000; 44(9): 2247-53. [CrossRef] google scholar
• 5. Vourli S, Tzouvelekis SL, Tzelepi E, Lebessi NJ, Miriagou V. Chara-cterization of in In111 a Class 1 Integron That Carries the Exten-ded-Spectrum Beta-Lactamase Gene bla IBC-1. FEMS Microbiol Lett 2003; 225: 149-53. [CrossRef] google scholar
• 6. Vourli S, Tzouvelekis SL, Tzelepi E. Characterization of Klebsiella pneumoniae Clinical Strain Producing a Rare Extended Spectrum Beta Lactamase (IBC-1). Int J Antimicrob Agents 2003; 21(5): 4957. [CrossRef] google scholar
• 7. Tzelepi E, Managa C, Platsouka E, Sofianou D, Paniara O, Legakis NJ, et al. Extended Spectrum Beta Lactamase Types in Klebsiella pneumoniae and E. coli in Two Greek Hospitals. Int J Antimicrob Agents 2003; 21: 285-8. google scholar
• 8. Lebessi E, Stamos G, Foustoukou M, Vourli S, Legakis NJ, Tzouvele-kis LS. Performance of Methods for Detection Of Extended- Spe-ctrum Beta-Lactamases Applied to Clinical Enterobacterial Strains Producing IBC-Type of Beta-Lactamases. J Clin Microbiol 2003; 41(2): 912. [CrossRef] google scholar
• 9. Clinical and Laboratory Standards Institute. Performance Standar-ds for Antimicrobial Susceptibility Testing. 22th ed. CLSI Supple-ment M100. Wayne, PA: CLSI, 2004. google scholar
• 10. Öksüz L, Gürler N. Escherichia coli ve Klebsiella spp. Suşlarında Genişlemiş Spektrumlu Beta Laktamazların Tiplendirilmesi ve Plaz-mid Profil Analizi. Mikrobiyoloji Bülteni 2009; 43: 183-94. google scholar
• 11. Bradford PA. Extended Spectrum Beta Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat. Clin Microbiol Rev 2001; 14(4): 93351. [CrossRef] google scholar
• 12. Shaikh S, Fatima J, Shakil S, Rizvi SM, Kamal MA. Antibiotic resis-tance and extended spectrum beta-lactamases: Types, epidemio-logy and treatment. Saudi J Biol Sci 2015; 22(1): 90-101. [CrossRef] google scholar
• 13. Naas T, Poirel L, Nordmann P. Minor extended-spectrum beta-lac-tamases. Clin Microbiol Infect 2008; Suppl 1: 42-52. google scholar
• 14. Kartali G, Tzelepi E, Pournaras S, Kontopoulou C, Kontos F, Sofia-nou D, et al. Outbreak of Infections Caused by Enterobacter cloa-cae Producing the Integron-Associated Beta Lactamase IBC-1 in a Neonatal Intensive Care Unit of a Greek Hospital. Antimicrob Agents Chemother 2002; 46(5): 1577-80. [CrossRef] google scholar
• 15. Bonnin RA, Jousset AB, Emeraud C, Oueslati S, Dortet L, Naas T. Genetic Diversity, Biochemical Properties, and Detection Methods of Minor Carbapenemases in Enterobacterales. Front Med (Lau-sanne) 2021; 20(7): 616490. [CrossRef] google scholar
• 16. Cicek AC, Saral A, Iraz M, Ceylan A, Duzgun AO, Peleg AY, et al. OXA-and GES-type-lactamases predominate in extensively drug-resis-tant Acinetobacter baumannii isolates from a Turkish University Hospital. Clin Microbiol Infect 2014; 20: 410-5. [CrossRef] google scholar
• 17. Naas T, Dortet L, Iorga BI. Structural and Functional Aspects of Class A Carbapenemases. Curr Drug Targets 2016; 17(9): 1006-28. [CrossRef] google scholar
• 18. Bektaş A, Güdücüoğlu H, Gürsoy NC, Berktaş M, Gültepe BS, Parlak M, et al. Genişlemiş Spektrumlu Beta-Laktamaz (GSBL) Üreten Esc-herichia coli ve Klebsiella pneumoniae Suşlarının GSBL Genlerinin Araştırılması. FLORA Dergisi 2018; 23(3): 116-23. [CrossRef] google scholar
• 19. Copur Cicek A, Saral A, Ozad Duzgun A, Yasar E, Cizmeci Z, Ozlem Balci P,et al. Nationwide study of Escherichia coli producing extended-spectrum β-lactamases TEM, SHV and CTX-M in Turkey. J Antibiot (Tokyo) 2013; 66(11): 647-50. [CrossRef] google scholar
• 20. Dağlar D, Ongüt G, Oğünç D, Ozhak Baysan B, Demirbakan H, et al. Toplum kaynaklı üriner sistem enfeksiyonu etkeni Escherichia coli suşlarında GSBL enzim tiplerinin izoelektrik odaklama ve poli-meraz zincir reaksiyonu yöntemleri ile araştırılması. Mikrobiyol Bul 2010; 44(3): 367-74. google scholar