Bir Üçüncü Basamak Hastanesinde Enterobactericeae ’lar Tarafından Üretilen Geniş Spektrumlu Beta Laktamazlar ve Antimikrobiyal Duyarlılık Paternleri

Öz

ABSTRACT Objective: This research aims to characterize extended-spectrum beta-lactamase (ESBL) producers and assess the antimicrobial susceptibility patterns of Enterobacteriaceae isolated from clinical care patients in the Aksaray province, Turkey, spanning from January 2017 to December 2021. Material and Methods: Clinical strains will be microbiologically isolated and identified. Antibiotic resistance profiles of Enterobacteriaceae isolates will be determined, and the presence of the blaCTX-M gene will be investigated using molecular methods. Results: Initially, 1752 clinical strains were isolated and identified using VITEK® 2 with an automated ID and susceptibility system. Subsequently, identified and suspected isolates were subjected to PCR for blaCTX-M gene detection. Klebsiella pneumoniae (43.95%) was more common than other species, including Escherichia coli (45.89%). Antimicrobial susceptibility revealed resistance percentages of 86.62% to ampicillin, 76.33% to amoxicillin/clavulanic acid, 64.52% to cefuroxime, 59.14% to trimethoprim/sulfamethoxazole, 59.99% to ceftriaxone, 58.35% to ceftazidime, and 54.39% to ciprofloxacin. Fosfomycin, nitrofurantoin, imipenem, and amikacin exhibited sensitivity in 45.49% of urine isolates. ESBL positivity was observed in 47.63% of E. coli and 61.16% of K. pneumoniae isolates. Conclusions: The prevalence of ESBL-producing E. coli was relatively high. Antimicrobial resistance is a complex issue influenced by widespread antibiotic usage. Insights from trend research can contribute to a broader assessment of antibiotic resistance profiles in Turkish provinces. Keywords: Enterobacteriaceae; antimicrobial resistance; ESBL; blaCTX-M; Aksaray. ÖZET Amaç: Bu çalışma, Ocak 2017 ile Aralık 2021 tarihleri arasında Türkiye'nin Aksaray ilindeki çeşitli kliniklerden elde edilen Enterobacteriaceae izolatlarının geniş spektrumlu beta-laktamaz (GSBL) üretme oranlarını ve antimikrobiyal duyarlılık paternlerini belirlemeyi amaçlamaktadır. Gereç ve Yöntem: Laboratuvarda, klinik örneklerden suşlar izole edilecek ve mikrobiyolojik olarak tanımlanacaktır. Ardından Enterobacteriaceae izolatlarının antibiyotik direnç profilleri belirlenecek ve bu izolatlardaki blaCTX-M geninin varlığı moleküler yöntemlerle araştırılacaktır. Bulgular: Çalışma boyunca toplamda 1752 klinik suş, VITEK® 2 sistemi kullanılarak otomatik bir ID ve duyarlılık sistemi ile tanımlandı. Tanımlanan ve şüphelenilen izolatlar, blaCTX-M geninin varlığının tespiti için PCR'ye tabi tutuldu. Sonuçlar, Escherichia coli'nin (E.coli) (%45,89) en yaygın tür olduğunu, onu Klebsiella pneumoniae (K.pneumoniae) (%43,95) ve daha düşük yüzdelerle diğer türlerin izlediğini gösterdi. Antimikrobiyal duyarlılık paterni, ampisiline %86,62, amoksisilin/klavulanik aside %76,33, sefuroksime %64,52, trimetoprim/sülfametoksazol'e %59,14, seftriaksona %59,99, seftazidime %58,35 ve siprofloksasine %54,39 oranında direnç gösterdi. İdrar izolatlarının %45,49'u fosfomisin, nitrofurantoin, imipenem ve amikasine duyarlılık gösterdi. Şüphelenilen türe göre E. coli için GSBL sıklığının %47,63, K. pneumoniae için %61,16 olduğu bulundu. Sonuç: Genel olarak, çalışma, GSBL üreten E. coli'nin nispeten yüksek yaygınlığını tespit etti. Antimikrobiyal direnç, toplumdaki yüksek antibiyotik tüketimi nedeniyle karmaşık bir sorun olarak ortaya çıkmaktadır. Bu çalışmadan elde edilen veriler, Türkiye illerindeki antibiyotik direnç profillerinin daha kapsamlı bir şekilde değerlendirilmesine yardımcı olabilecek niteliktedir. Anahtar Kelimeler: Enterobacteriaceae; antimikrobiyal direnç; GSBL; blaCTX-M; Aksaray.

Anahtar Kelimeler

• enterobacteriaceae
• antimicrobial direnç
• gsbl
• blactx-m
• aksaray

Antimicrobial Susceptibility Patterns and Extended-Spectrum β-Lactamase Production by Enterobacterales in a Tertiary Hospital

Abstract

Objective: This research aims to characterize extended-spectrum beta-lactamase (ESBL) producers and assess the antimicrobial susceptibility patterns of Enterobacteriaceae isolated from clinical care patients in the Aksaray province, Turkey, spanning from January 2017 to December 2021. Material and Methods: Clinical strains will be microbiologically isolated and identified. Antibiotic resistance profiles of Enterobacteriaceae isolates will be determined, and the presence of the blaCTX-M gene will be investigated using molecular methods. Results: Initially, 1752 clinical strains were isolated and identified using VITEK® 2 with an automated ID and susceptibility system. Subsequently, identified and suspected isolates were subjected to PCR for blaCTX-M gene detection. Klebsiella pneumoniae (43.95%) was more common than other species, including Escherichia coli (45.89%). Antimicrobial susceptibility revealed resistance percentages of 86.62% to ampicillin, 76.33% to amoxicillin/clavulanic acid, 64.52% to cefuroxime, 59.14% to trimethoprim/sulfamethoxazole, 59.99% to ceftriaxone, 58.35% to ceftazidime, and 54.39% to ciprofloxacin. Fosfomycin, nitrofurantoin, imipenem, and amikacin exhibited sensitivity in 45.49% of urine isolates. ESBL positivity was observed in 47.63% of E. coli and 61.16% of K. pneumoniae isolates. Conclusions: The prevalence of ESBL-producing E. coli was relatively high. Antimicrobial resistance is a complex issue influenced by widespread antibiotic usage. Insights from trend research can contribute to a broader assessment of antibiotic resistance profiles in Turkish provinces.

Keywords

• Enterobacterales
• Antimicrobial resistance
• ESBL
• bla CTX-M

Kaynakça

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