Hayvanlarda Klinik Vakalardan İzole Edilmiş Çoklu Antibiyotik Direnci Bulunan Bakterilerde Dezenfektan Dirençliliği

Öz

Bu çalışmada, klinik vakalardan izole edilmiş çoklu antibiyotik direncine (MDR) sahip bakterilerde, qacA/B, qacC/D, qacE, qac∆E1, qacG, qacH, qacJ ve acrA gibi dezenfektan direnç genlerinin varlığının PCR yöntemiyle araştırılması amaçlandı. Bu amaçla 10 adet Staphylococcus aureus, 22 adet Escherichia coli, 6 adet Pseudomonas aeruginosa ve 3 adet Klebsiella pneumoniae ve birer adet Salmonella Kentaky, Salmonella Typhymirıum, Salmonella Infantum olmak üzere toplamda 44 adet izolat kullanıldı. Dezenfektan direnç genlerinin belirlenmesi için qacG (275 bp), qacJ (306 bp), qacE (350 bp), acrA (567 bp) genleri birinci grupta, qacC/D (249 bp), qacH (295 bp), qacΔE (335 bp) ve qacA/B (629 bp) genleri ise ikinci grupta olmak üzere multipleks PCR yapılarak araştırıldı. Çalışmada direnç genleri pozitif bulunan izolatlar için benzalkonyum klorür ve klorhekzidin glukonat etken maddelerini içeren ve ticari temin edilen preparatlar kullanılarak MİK değerleri belirlendi. Antibiyotik duyarlılıkları araştırılan 22 E. coli izolatının ikisi 5, üçü 6, dördü 7, biri 8, biri 9, sekizi 10, ikisi 11 ve biri 13 farklı antibiyotiğe dirençli bulundu. Toplam 6 adet P. aeruginosa izolatının biri 3, ikisi 4, ikisi 7 ve biri 8 antibiyotiğe, 3 adet K. pneumoniae izolatından ikisi 7, biri 12 antibiyotiğe dirençli olarak değerlendirildi. S. Kentucky 5, S. Typhimurium ve S. Infantis ise 7’şer antibiyotiğe direnç gösterdi. Test edilen S. aureus izolatlarından biri 5, biri 6, altısı 7 ve ikisi ise 12 antibiyotiğe dirençli bulundu. Test edilen 14 antibiyotik için %0-100 arasında dirençlilik oranları belirlendi. Yapılan multipleks PCR sonucunda qacG (275 bp), qacJ (306 bp), qacE (350 bp), acrA (567 bp), qacC/D (249 bp) ve qacH (295 bp) genleri çalışılan izolatların tamamında negatif olarak değerlendirildi. Sadece E. coli suşlarında qacΔE (335 bp) geni 7 izolatta pozitif olarak saptanırken qacA/B (629 bp) geni ise 13 izolatta pozitif olarak değerlendirildi. qacΔE (335 bp) geni pozitif bulunan 7 örneğin tamamı qacA/B (629 bp) geni ile birlikte görüldü. Geriye kalan 6 örnekte ise qacA/B (629 bp) geni tek olarak belirlendi. Direnç genleri pozitif bulunan suşlarda MİK değerleri benzalkonyum klorür için 32-128 (mg/L), klorhekzidin glukonat için 2-32 (mg/L) olarak belirlendi. Sonuç olarak, Tek Sağlık kapsamında büyük öneme sahip olan biyosit/dezenfektan dirençliliğinin ve beraberinde çapraz antibiyotik direncinin daha detaylı araştırılmasının, antibiyotik direnci için farkındalık oluşturulmaya çalışılırken dezenfektan direncinin göz ardı edilmemesinin önemli olacağı kanısına varıldı.

Anahtar Kelimeler

• Tek Sağlık
• Dezenfektan direnci
• MDR bakteri
• MİK
• PCR

Disinfectant Resistance in Multiple Antibiotic Resistant Bacteria Isolated from Clinical Cases in Animals

Öz

The aim of this study was to investigate the presence of disinfectant resistance genes, including qacA/B, qacC/D, qacE, qacΔE1, qacG, qacH, qacJ, and acrA, in bacteria exhibiting multiple drug resistance (MDR) isolated from clinical cases using the PCR method. For this purpose, a total of 44 bacterial isolates were examined, comprising 10 Staphylococcus aureus, 22 Escherichia coli, 6 Pseudomonas aeruginosa, 3 Klebsiella pneumoniae, and one isolate each of Salmonella Kentucky, Salmonella Typhimurium, and Salmonella Infantis. For the detection of disinfectant resistance genes, two multiplex PCR assays were conducted. The first group targeted qacG (275 bp), qacJ (306 bp), qacE (350 bp), and acrA (567 bp), while the second group focused on qacC/D (249 bp), qacH (295 bp), qacΔE (335 bp), and qacA/B (629 bp). Minimum inhibitory concentration (MIC) values were determined for isolates harboring resistance genes using commercially available preparations containing benzalkonium chloride and chlorhexidine gluconate. Among the 22 E. coli isolates, two exhibited resistance to 5 antibiotics, three to 6, four to 7, one to 8, one to 9, eight to 10, two to 11, and one to 13 different antibiotics. Of the 6 P. aeruginosa isolates, one was resistant to 3 antibiotics, two to 4, two to 7, and one to 8. Among the 3 K. pneumoniae isolates, two were resistant to 7 antibiotics and one to 12. S. Kentucky exhibited resistance to 5 antibiotics, while S. Typhimurium and S. Infantis were each resistant to 7 antibiotics. Among the S. aureus isolates, one exhibited resistance to 5 antibiotics, one to 6, six to 7, and two to 12 antibiotics. Overall, resistance rates between 0-100% were determined for the 14 antibiotics tested. Multiplex PCR results showed that qacG (275 bp), qacJ (306 bp), qacE (350 bp), acrA (567 bp), qacC/D (249 bp), and qacH (295 bp) genes were negative in all isolates. However, in E. coli strains, the qacΔE (335 bp) gene was detected in 7 isolates, while the qacA/B (629 bp) gene was present in 13 isolates. All 7 isolates positive for qacΔE (335 bp) also harbored the qacA/B (629 bp) gene, whereas the remaining 6 isolates contained only the qacA/B (629 bp) gene. MIC values for isolates harboring resistance genes ranged from 32 to 128 mg/L for benzalkonium chloride and from 2 to 32 mg/L for chlorhexidine gluconate. In conclusion, investigating biocide/disinfectant resistance and its potential association with cross-antibiotic resistance is crucial within the One Health framework. Therefore, while raising awareness about antibiotic resistance, the importance of disinfectant resistance should not be overlooked.

Anahtar Kelimeler

• One Health
• Disinfectant resistance
• MDR bacteria
• MIC
• PCR

Kaynakça

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