Yıl 2020, Cilt 22 , Sayı 3, Sayfalar 450 - 460 2020-12-31

Yoğun Bakım Ünitesinden Alınan Alt Solunum Yolu Örneklerinde Üretilen Acinetobacter baumannii İzolatlarında Antibiyotik Direnci ve İntegron Gen Kasetleri
ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT

Uğur KOSTAKOĞLU [1] , Ayşe ERTÜRK [2] , İlknur Esen YILDIZ [3] , Songül ÖZYURT [4] , Ayşegül ÇOPUR ÇİÇEK [5] , Mevlüt KARATAŞ [6] , Emine SÖNMEZ [7]


Amaç: Antibiyotik direnç genlerinin bakteriler arasındaki yayılımı, enfeksiyon hastalıklarının tedavisinde ciddi sorunlara yol açmaktadır. Son zamanlarda bu direnç genlerin integronlarda da bulunduğu gösterilmiştir. Bu çalışmada alt solunum yollarından alınan kültürlerde üretilen infeksiyon etkeni olan Acinetobacter baumannii suşlarında sınıf 1, sınıf 2 integron varlığı ve antibiyotik direnç genleri araştırıldı. 
Gereç ve Yöntemler: Çalışmaya, Mart 2014- Mart 2015 tarihleri arasında alt solunum yolu örneklerinden izole edilen toplam 86 A. baumannii suşu dahil edildi. İzolatların tanımlanması ve antibiyogramları konvansiyonel metodlar ve Vitek 2 Compact sistemleriyle yapıldı. Suşlarda integron varlığı, sınıf 1 (intI1) ve sınıf 2 (intI2) integraz bölgeleri için özgül primer çiftleri kullanılarak PCR yöntemiyle araştırıldı. İntegron amplifikasyonunun gerçekleştirildiği tüm örnekler hem klonlanarak hem de PCR ürünü olarak DNA dizi analizine tabi tutuldu. Direnç genleri polimeraz zincir reaksiyonu ile tarandı. 
Bulgular: İzolatlar trakeal aspiratlar (%33.7), bronkoalveoler lavaj (%29,1), balgam (%22.1), bronşiyal yıkama sıvısı / bronşiyal fırçalama (%4.7), transbronşiyal biyopsi (%4.7), plevral sıvı (%3.4) ve akciğer aspirasyonları / apse (%2.3) örneklerinden elde edildi. Tüm izolatlarda imipenem, meropenem, seftazidim, piperasillin-tazobaktam, ampisilin-sulbaktama karşı direnç saptanırken, siprofloksasin, levofloksasin, gentamisin, amikasin ve tigesikline karşı direnç sırasıyla %97.7, %93.0, %60.5, %53.5 ve %9.3 olarak tespit edildi. Kolistin, tüm suşlara karşı tek etkin antibiyotikti. Integraz I ve II gen pozitiflik oranı sırasıyla %45.4 ve %9.3 iken, sınıf 1 ve 2 integron pozitiflik oranı tüm izolatlarda sırasıyla %31.4 ve %8.1 olarak bulundu. blaTEM, blaSHV, blaCTX-M1, blaCTX-M2, blaOXA23, blaOXA40, blaOXA58 sırasıyla %70.9, %2.3, %4.7, %7.0, %95.3, %5.8 ve %3.5 bulundu.
Sonuç: A. baumannii infeksiyonlarında çoklu ilaç direnci olan suşların ve integron direnç genlerinin birlikte artışı, antibiyotik tedavi stratejilerinin başarısızlığına yol açacaktır.
Objective: The spread of antibiotic resistance genes among bacteria causes serious problems in the treatment of infectious diseases. Recently, it has been shown that these resistance genes are also found in integrons. This study investigated the class 1, 2 integrons and the antibiotic-resistant genes in the infection agent Acinetobacter baumannii produced in respiratory tract samples.
Material and Methods: The study involved 86 A. baumannii strains isolated from lower respiratory tract samples collected between March 2014 and March 2015 in the Intensive Care Units. Identification and antibiograms of the isolates were made using conventional methods and Vitek 2 Compact systems. The presence of integrons in strains was investigated by polymerase chain reaction method using specific primer pairs for class 1and class 2 integrase regions. All samples in which integron amplification was carried out were subjected to DNA sequence analysis both by cloning and as a PCR product. The resistance genes were screened by polymerase chain reaction. 
Results: Isolates were obtained from specimens including tracheal aspirates (33.7%), bronchoalveolar lavage (29.1%), sputum (22.1%), bronchial washing fluid/bronchial brushing (4.7%), transbronchial biopsy (4.7%), pleural fluid (3.4%) and lung aspirates/abscess (2.3%). While resistance to imipenem, meropenem, ampicillin-sulbactam, ceftazidime, and piperacillin-tazobactam was determined in all isolates, resistance rates to ciprofloxacin, levofloxacin, gentamicin, amikacin and tigecycline were 97.7%, 93.0%, 60.5%, 53.5%and 9.3%, respectively. Colistin was the only antibiotic to which all strains were susceptible. The positivity rates of integrase I and II genes were 45.4%and 9.3%, respectively. Class 1 and 2 integron positivity rates in all isolates were 31.4%and 8.1%, respectively. blaTEM, blaSHV, blaCTX-M1, blaCTX-M2, blaOXA23, blaOXA40, blaOXA58 were 70.9%, 2.3%, 4.7%, 7.0%, 95.3%, 5.8%and 3.5%, respectively. 
Conclusion: Increasing association of multi drug resistant strains and integron resistant genes in A. baumannii infections will lead to the failure of antibiotic treatment strategies.
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Birincil Dil en
Konular Sağlık Bilimleri ve Hizmetleri
Yayınlanma Tarihi 2020/3
Bölüm Makaleler
Yazarlar

Orcid: 0000-0002-4589-0962
Yazar: Uğur KOSTAKOĞLU (Sorumlu Yazar)
Kurum: RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0002-2222-5580
Yazar: Ayşe ERTÜRK
Kurum: Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi
Ülke: Turkey


Orcid: 0000-0003-2987-0483
Yazar: İlknur Esen YILDIZ
Kurum: Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi
Ülke: Turkey


Orcid: 0000-0002-9768-1425
Yazar: Songül ÖZYURT
Kurum: Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi
Ülke: Turkey


Orcid: 0000-0002-3673-9670
Yazar: Ayşegül ÇOPUR ÇİÇEK
Kurum: Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi
Ülke: Turkey


Orcid: 0000-0003-2524-9964
Yazar: Mevlüt KARATAŞ
Kurum: Ataturk Eğitim Araştırma Hastanesi
Ülke: Turkey


Orcid: 0000-0003-4418-5599
Yazar: Emine SÖNMEZ
Kurum: Bekent Tıp fakültesi
Ülke: Turkey


Destekleyen Kurum Recep Tayyip Erdogan University-Scientific Research Projects Coordination Unit
Proje Numarası Project number: TSA-2017-541
Tarihler

Başvuru Tarihi : 3 Kasım 2020
Yayımlanma Tarihi : 31 Aralık 2020

Bibtex @araştırma makalesi { kutfd789547, journal = {Kırıkkale Üniversitesi Tıp Fakültesi Dergisi}, issn = {1302-3314}, eissn = {2148-9645}, address = {}, publisher = {Kırıkkale Üniversitesi}, year = {2020}, volume = {22}, pages = {450 - 460}, doi = {10.24938/kutfd.789547}, title = {ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT}, key = {cite}, author = {Kostakoğlu, Uğur and Ertürk, Ayşe and Yıldız, İlknur Esen and Özyurt, Songül and Çopur Çiçek, Ayşegül and Karataş, Mevlüt and Sönmez, Emine} }
APA Kostakoğlu, U , Ertürk, A , Yıldız, İ , Özyurt, S , Çopur Çiçek, A , Karataş, M , Sönmez, E . (2020). ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT . Kırıkkale Üniversitesi Tıp Fakültesi Dergisi , 22 (3) , 450-460 . DOI: 10.24938/kutfd.789547
MLA Kostakoğlu, U , Ertürk, A , Yıldız, İ , Özyurt, S , Çopur Çiçek, A , Karataş, M , Sönmez, E . "ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT" . Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 (2020 ): 450-460 <https://dergipark.org.tr/tr/pub/kutfd/issue/58988/789547>
Chicago Kostakoğlu, U , Ertürk, A , Yıldız, İ , Özyurt, S , Çopur Çiçek, A , Karataş, M , Sönmez, E . "ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 (2020 ): 450-460
RIS TY - JOUR T1 - ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT AU - Uğur Kostakoğlu , Ayşe Ertürk , İlknur Esen Yıldız , Songül Özyurt , Ayşegül Çopur Çiçek , Mevlüt Karataş , Emine Sönmez Y1 - 2020 PY - 2020 N1 - doi: 10.24938/kutfd.789547 DO - 10.24938/kutfd.789547 T2 - Kırıkkale Üniversitesi Tıp Fakültesi Dergisi JF - Journal JO - JOR SP - 450 EP - 460 VL - 22 IS - 3 SN - 1302-3314-2148-9645 M3 - doi: 10.24938/kutfd.789547 UR - https://doi.org/10.24938/kutfd.789547 Y2 - 2020 ER -
EndNote %0 Kırıkkale Üniversitesi Tıp Fakültesi Dergisi ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT %A Uğur Kostakoğlu , Ayşe Ertürk , İlknur Esen Yıldız , Songül Özyurt , Ayşegül Çopur Çiçek , Mevlüt Karataş , Emine Sönmez %T ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT %D 2020 %J Kırıkkale Üniversitesi Tıp Fakültesi Dergisi %P 1302-3314-2148-9645 %V 22 %N 3 %R doi: 10.24938/kutfd.789547 %U 10.24938/kutfd.789547
ISNAD Kostakoğlu, Uğur , Ertürk, Ayşe , Yıldız, İlknur Esen , Özyurt, Songül , Çopur Çiçek, Ayşegül , Karataş, Mevlüt , Sönmez, Emine . "ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 / 3 (Aralık 2020): 450-460 . https://doi.org/10.24938/kutfd.789547
AMA Kostakoğlu U , Ertürk A , Yıldız İ , Özyurt S , Çopur Çiçek A , Karataş M , Sönmez E . ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT. Kirikkale Univ Tip Fak Derg. 2020; 22(3): 450-460.
Vancouver Kostakoğlu U , Ertürk A , Yıldız İ , Özyurt S , Çopur Çiçek A , Karataş M , Sönmez E . ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2020; 22(3): 450-460.
IEEE U. Kostakoğlu , A. Ertürk , İ. Yıldız , S. Özyurt , A. Çopur Çiçek , M. Karataş ve E. Sönmez , "ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT", Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, c. 22, sayı. 3, ss. 450-460, Ara. 2021, doi:10.24938/kutfd.789547