PSEUDOMONAS AERUGINOSA VE ACINETOBACTER BAUMANII SUŞLARINDA MCR-1 GENİNİN MOLEKÜLER ANALİZİ

Öz

Amaç: Pseudomonas aeruginosa ve Acinetobacter baumanii izolatları içerisinde birçok antibiyotiğe direnç meydana gelmesiyle birlikte halk sağlığı açısından ciddi riskler ortaya çıkmıştır. Çalışmamızın amacı bu suşlar içerisinde kolistin direnci varlığı ile mcr-1 geni pozitifliğinin araştırılmasını hedeflemektedir. Gereç ve Yöntem: P. aeruginosa ve A. baumanii suşlarının izolasyonu ve identifikasyonu amacıyla farklı yöntemler kullanılmıştır. Bunlar sırasıyla kültür, biyokimyasal testler, antibiyotik duyarlılık testleri ve moleküler testlerdir. Sonuç ve Tartışma: Türkiye’nin Van kentindeki en büyük hastaneden bir yılda toplanan 550 klinik örnekten tam olarak 156 klinik P. aeruginosa (n = 89) ve A. baumannii (n = 67) izolatı elde edildi. Yapılan antibiyotik duyarlılık testleri araştırma sonuçlarına göre yaklaşık %82.8 P. aeruginosa ve %94.6 A. baumannii suşlarının MDR olduğu görüldü. Agar dilüsyon ve mikro dilüsyon yöntemleri kullanılarak P. aeruginosa izolatlarının %11.23'sinde (10/89) ve A. baumannii izolatlarının %11.94'unda (8/67) kolistin direnci keşfedildi. Kolistine dirençli 18 izolat arasında mcr-1 geni, üç P. aeruginosa ve iki A. baumannii suşunda tespit edildi. P. aeruginosa ve A. baumannii'da plazmit aracılı kolistin direncinin meydana gelmesi, kolistin direncinin klinik alanlarda yayılma eğiliminin yüksek oranda olması nedeniyle oldukça önemlidir. Küresel kolistin direncinin özel durumunun anlaşılması için kolistin direnç profillerinin tespitine yönelik hızlı prosedürlerin geliştirilmesi ve bu prosedürlerin hastane laboratuvarlarında uygulanması teşvik edilmelidir. Kolistin ve karbapenemin kombinasyonu ile oluşturulacak terapinin uygulanması, direnç gelişimi sürecinin hızının azaltılmasına ve ortaya çıkan bu dirençli süper mikropların tedavisinde yardımcı olabilir.

Anahtar Kelimeler

• Acinetobacter baumannii
• antibiyotik direnci
• mcr-1
• Pseudomonas aeruginosa

MOLECULAR ANALYSIS OF THE MCR-1 GENE IN PSEUDOMONAS AERUGINOSA AND ACINETOBACTER BAUMANII STRAINS

Öz

Objective: The emergence of antibiotic resistance in Pseudomonas aeruginosa and Acinetobacter baumanii isolates poses serious risks to public health. Our study aimed to investigate the presence of colistin resistance and mcr-1 gene positivity in these isolates. Material and Method: Culture, biochemical tests, antibiotic susceptibility tests, and molecular tests were used to isolate and identify P. aeruginosa and A. baumanii strains. Result and Discussion: A sum of 156 clinical isolates of Pseudomonas aeruginosa (n = 89) and Acinetobacter baumannii (n = 67) were obtained using the 550 clinical samples collected in one year from the largest hospital in Van, Turkey. The results of antibiotic susceptibility tests showed that approximately 82.8% of P. aeruginosa and 94.6% of A. baumannii strains were multidrug-resistant (MDR). Colistin resistance was detected in 11.23% (10/89) of P. aeruginosa isolates and 11.94% (8/67) of A. baumannii isolates using agar dilution and microdilution methods. Out of the 18 colistin-resistant isolates, the mcr-1 gene was detected in three P. aeruginosa and two A. baumannii strains. The detection of plasmid-mediated colistin resistance in P. aeruginosa and A. baumannii is of great concern due to the high potential for colistin resistance to spread in clinical settings. Understanding the unique circumstances of worldwide colistin resistance can be facilitated by promoting the creation of quick processes for identifying colistin resistance profiles and putting them into practice in hospital laboratories. Colistin and carbapenem treatment are two effective ways to treat emerging resistant super-microbes and slow down the emergence of resistance.

Anahtar Kelimeler

• Acinetobacter baumannii
• antibiotic resistance
• mcr-1
• Pseudomonas aeruginosa

Destekleyen Kurum

IT WAS NOT SUPPORTED BY ANY INSTITUTION.

Etik Beyan

Our study was authorized by the Van Training and Research Hospital's clinical research ethics committee (decision dated 25/01/2018 and numbered 2018/02) to evaluate the accuracy of blood collection in patients.

Teşekkür

I would like to thank Van Yüzüncü Yıl University, Faculty of Pharmacy, Department of Pharmaceutical Microbiology.

Kaynakça

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