Analysis of Extended Spectrum Beta Lactamase Frequency in Klebsiella spp Isolates

Abstract

The issue of increasing resistance to antibiotics in recent years has become an important problem all over the world. Our aim is to determine the antimicrobial resistance profile and Extended Spectrum Beta-Lactamase (ESBL) rates in Klebsiella spp isolates to prevent the gradual increase in multi-resistant isolates as a result of unconscious antibiotic use thereby contributing to the faster effective treatment of infections. A total of 100 Klebsiella spp were isolated and identified from various clinical specimens. Antibiotic susceptibility tests were performed using the Kirby-Bauer method. The presence of extended-spectrum beta-lactamases (ESBL) was detected using the Double Disc Synergy Test (DDST) and E-test methods. The rates of ESBL-producing strains were 46.1% in 6 K. oxytoca and 56.3% in 49 K. pneumoniae. These strains were found to be 38% in 38 adult patients and 17% in 17 pediatric patients, and this difference was statistically significant (p <0.05). The ESBL rate was 31% in 31 male patients and 24% in 24 female patients, and this difference was not statistically significant (p>0.05). This rate was found to be high in patients hospitalized in the pediatric service and intensive care unit. 67 out of 100 strains were found to be suspicious for ESBL by Disk Diffusion Test (DDT). DDST and E-tests were applied as confirmatory tests. The sensitivity of the DDST and E tests was 100%. Screening for ESBL in Klebsiella spp and other members of Enterobacteriaceae isolates is necessary to reduce further selection and spread of these increasingly broad-spectrum antimicrobial-resistant enteric pathogens.

Keywords

• Klebsiella spp
• Extended Spectrum Beta-lactamase (ESBL)
• Double Disc Synergy Test
• E-Test

Klebsiella spp İzolatlarında Genişletilmiş Spektrumlu Beta Laktamaz Sıklığının Analizi

Abstract

Son yıllarda antibiyotik direncinin artması konusu tüm dünyada önemli bir sorun haline gelmiştir. Amacımız, Klebsiella spp izolatlarında antimikrobiyal direnç profilini ve Genişletilmiş Spektrumlu Beta- Laktamaz (ESBL) oranlarını belirleyerek bilinçsiz antibiyotik kullanımı sonucunda multi-dirençli izolatlarda kademeli artışı önlemek ve böylece enfeksiyonların daha hızlı etkin tedavisine katkıda bulunmaktır. Çeşitli klinik örneklerden toplam 100 Klebsiella türü izole edilmiş ve tanımlanmıştır. Antibiyotik duyarlılık testleri Kirby-Bauer yöntemi kullanılarak yapıldı. Genişletilmiş spektrumlu beta-laktamazların (GSBL) varlığı, Çift Disk Sinerji (DDST) ve E-test yöntemleri kullanılarak tespit edildi. GSBL üreten suşların oranları 6 K. oxytoca (%46,1) ve 49 K. pneumoniae (%56,3) idi. Bu suşlar 38 erişkin hastada %38, 17 pediatrik hastada %17 olarak bulundu. Sonuçlarımız istatistiksel olarak anlamlıydı (p<0,05). GSBL oranı 31 erkek hastada %31, 24 kadın hastada %24 idi ve cinsiyete göre bu fark anlamlı bulunmamıştır (p>0,05). Çocuk servisi ve yoğun bakım ünitesinde yatan hastalarda bu oran yüksek bulundu. Disk Difüzyon Testi (DDT) ile 100 suştan 67'si ESBL açısından şüpheli bulundu. Doğrulayıcı testler olarak DDST ve E-testleri uygulandı. DDST ve E testlerinin duyarlılığı %100 idi. Klebsiella spp ve Enterobacteriaceae izolatlarının diğer üyelerinde ESBL taraması, giderek artan geniş spektrumlu antimikrobiyal dirençli enterik patojenlerin daha fazla seçimini ve yayılmasını azaltmak için gereklidir.

Keywords

• Klebsiella spp
• Genişletilmiş Spektrumlu Beta-laktamaz (ESBL)
• Çift Disk Sinerji Testi
• E-Testi

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