Karbapenem dirençli Pseudomonas ve Acinetobacter türlerinde metallo-beta-laktamaz üretiminin saptanması ve risk faktörlerinin değerlendirilmesi

Öz

Amaç: Pseudomonas ve Acinetobacter türlerinde, E-test ile MBL sıklığının araştırılması, risk faktörlerinin belirlenmesi ve enfekte hastaların demografik ve klinik özelliklerini değerlendirilmesi.
Materyal ve metod: Çeşitli klinik örneklerden konvansiyonel yöntemlerle izole edilen Pseudomonas ve Acinetobacter türlerinin imipenem veya meropenem direnci imipenem EDTA E-test ile değerlendirildilerek, Metallo-beta-laktamaz (MBL) varlığı incelendi. MBL varlığı saptanan izolatlardan örnekler alınarak, PCR testi ile VIM-1, VIM-2, IMP-1 ve IMP-2 taraması yapıldı.
Bulgular: 46 karbapenem dirençli Acinetobacter spp. izolatından 41'i (%89) ve 19 karbapenem dirençli Pseudomonas spp. izolatından 5'inde (%26) imipenem-EDTA E-testi ile MBL- pozitifliği saptandı. Yoğun bakımda yatış öyküsü, mekanik ventilasyon ve sefalosporin kullanımı MBL üretimi açısından önemli risk faktörleri olarak bulundu.
Sonuç: Özellikle yoğun bakım üniteleri hastalarından izole edilen Acinetobacter ve Pseudomonas türlerinde MBL üretiminin pratik yöntemlerle kısa sürede saptanması, enfeksiyonların hızlı ve etkin bir şekilde kontrol altına alınmasını kolaylaştırarak, salgınların önlenmesinde büyük önem taşımaktadır. 

Anahtar Kelimeler

• Metallo-beta-laktamazlar
• Acinetobacter spp
• Pseudomonas spp

Evaluation of risk factors and detection of metallo-beta-lactamase enzyme production in carbapenem-resistant Pseudomonas and Acinetobacter species

Abstract

Purpose: To investigate the frequency of MBLs in Pseudomonas and Acinetobacter species with E-test, to determine the risk factors and to evaluate the demographic and clinical features of infected patients.
Materials and methods: Imipenem or meropenem resistance of Pseudomonas and Acinetobacter isolated from several clinical samples with conventional methods were evaluated with imipenem EDTA E-test and the presence of Metallo-β-lactameses MBL was examined. Several isolates were screened for VIM-1, VIM-2, IMP-1, and IMP-2 with a PCR test.
Results: Of 46 carbapenem resistant Acinetobacter isolates, 41 (89%), as well as of 19 carbapenem resistant Pseudomonas isolates, 5 (26%) had MBL positivity with imipenem-EDTA E-test. A history of Intensive Care Unit stay, mechanical ventilation and cephalosporin use were found to be significant risk factors with respect to MBL production.
Conclusion: Detection of MBL production in Acinetobacter and Pseudomonas species especially in ICU patients is of prime importance to control infection rapidly and effectively, which contribute to prevention of outbreaks. 

Keywords

• Metallo-beta-lactameses
• Acinetobacter spp
• Pseudomonas spp

Kaynakça

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