Kırıkkale Yüksek İhtisas Hastanesine on aylık süreçte başvuran hastaların gaita örneklerinden izole edilen mikrobiyota elemanı Escherichia coli izolatlarının antibiyotik duyarlılıkları

Öz

Amaç: Antibiyotik direnci, tüm dünyada global bir halk sağlığı sorunu haline dönüşmüştür. Bağırsak florası bakterileri, insan sağlığı adına birçok önemli görevi yerine getirirler. Mikrobiyota üyesi olarak Escherichia coli birçok enfeksiyona neden olmaktadır. Bu çalışmada mikrobiyota üyesi E. coli izolatlarının tedavide kullanılan antibiyotiklere karşı antibiyotik duyarlılıklarını belirlemeyi amaçladık. Yöntemler: Kırıkkale Yüksek İhtisas Hastanesi, Mikrobiyoloji Laboratuvarına Mart-Aralık 2013 tarihleri arasında gaitada gizli kan araştırılması için gönderilen ve “negatif” sonuç çıkan 150 gaita örneği değerlendirmeye alındı. E. coli izolatlarının antibiyotik duyarlılık testi Kirby Bauer disk diffüzyon yöntemiyle yapıldı ve sonuçlar Clinical Laboratory Standards Institute CLSI standardlarına göre değerlendirildi. Bulgular: Yüz elli E. coli izolatının 70 tanesi çalışılan tüm antibiyotiklere duyarlı bulundu. İzolatların 24 %16 ’ünde genişlemiş spektrumlu betalaktamaz saptandı. İzolatların tümü karbapenemlere duyarlı bulundu. Sonuç: Mikrobiyota elemanı E. coli izolatlarının direnç profillerinin özellikle spesifik hasta gruplarında izlenmesinin ve enfeksiyon ajanlarına karşı ampirik tedavinin belirlenmesinde önemli olacağı kanısına varılmıştır

Anahtar Kelimeler

• Antimikrobiyal duyarlılık, E. coli, mikrobiyota

Antibiotic susceptibility of microbiota members Escherichia coli strains isolated from stool samples of patients attended Kırıkkale Yüksek İhtisas Hospital in ten months

Öz

Objective: Antibiotic resistance has turned into a global public health problem in all over the world. Intestinal flora bacteria perform many important functions for human health. As a member of microbiota Escherichia coli cause many infections. This study was aimed to determine antibiotic susceptibility of microbiota member E. coli isolates against to the antibiotics that used in treatment.Methods: One hundred and fifty stool samples, which were sent to Kırıkkale Yüksek İhtisas Hospital microbiology laboratory in a period of between March to December 2013 to study fecal occult blood test and were determined as “negative”, were included in this study. E. coli isolates were performed antibiotic susceptibility test by the Kirby Bauer disk diffusion method according to the recommendations of the Clinical Laboratory Standards Institute CLSI .Results: A total of 70 out of 150 E. coli isolates were sensitive to all antibiotics that used in the study. Twenty four 16% isolates were found to be ESBL producers. All isolates were found sensitive to carbapenems. Conclusion: It was reached the conclusion that monitoring to resistance profiles of microbiota member E. coli isolates, especially in specific group patients in addition to infection agents, is important for giving direction to empirical therapy

Anahtar Kelimeler

• Antimicrobial susceptibility, E. coli, microbiota

Kaynakça

1. 1. Shakya P, Barrett P, Diwan V, Marothi Y, Shah H, Chhari N, et al. Antibiotic resistance among Escherichia coli isolates from stool samples of children aged 3 to 14 years from Ujjain, India. BMC Inf Dis, 2013; 13: 477-82.
2. 2. Lynch JP, Clark NM, Zhanel GG. Evolution of antimicrobial resistance among Enterobacteriaceae (focus on extended spectrum β-lactamases and carbapenemases). Expert Opin Pharmacother, 2013; 14(2): 199-210.
3. 3. Salyers AA, Gupta A, Wang Y. Human intestinal bacteria as reservoirs for antibiotic resistance genes. Trend Microbiol, 2004; 12(9): 412-6.
4. 4. Nys S, Okeke IN, Kariuki S, Dinant GJ, Driessen C, Stobberingh EE. Antibiotic resistance of faecal Escherichia coli from healthy volunteers from eight developing countries. J Antimicrob Chemother, 2004; 54(5): 952-5.
5. 5. Moreno E, Andreu A, Pigrau C, Kuskowski MA, Johnson JR and Prats G. Relationship between Escherichia coli strains causing acute cystitis in women and the fecal E. coli population of the host. J Clin Microbiol, 2008; 46(8): 2529-34.
6. 6. Yang CM, Lin MF, Lin CH, Huang YT, Hsu CT, Liou ML. Characterization of antimicrobial resistance patterns and integrons in human fecal Escherichia coli in Taiwan. Jpn J Infect Dis, 2009; 62(3): 177-81.
7. 7. Medeiros AA. Evolution and dissemination of betalactamases accelerated by generations of betalactam antibiotics. Clin Infect Dis, 1997; 24(1): 19-45.
8. 8. Jacoby GA. Extended-spectrum beta-lactamases and other enzymes providing resistance to oxyimino-beta-lactams. Infect Dis Clin North Am, 1997; 11(4): 875-87.

9. 9. Czaja CA, Stamm WE, Stapleton AE, Roberts PL, Hawn TR, Scholes D, et al. Prospective cohort study of microbial and inflammatory events immediately preceding Escherichia coli recurrent urinary tract infection in women. J Infect Dis, 2009; 200(4): 528- 36.
10. 10. Bingen E, Picard B, Brahimi N, Mathy S, Desjardins P, Elion J, Denamur E. Phylogenetic analysis of Escherichia coli strains causing neonatal meningitis suggests horizontal gene transfer from a predominant pool of highly virulent B2 group strains. J Infect Dis, 1998; 177(3): 642-50.
11. 11. Vollmerhausen TL, Ramos NL, Gündoğdu A, Robinson W, Brauner A, Katouli M. Population structure and uropathogenic virulence-associated genes of faecal Escherichia coli from healthy young and elderly adults. J Med Microbiol, 2011; 60(5): 574-81.
12. 12. Moreno E, Johnson JR, Pérez T, Prats G, Kuskowski MA, Andreu A. Structure and urovirulence characteristics of the fecal Escherichia coli population among healthy women. Microbes Infect, 2009; 11(2): 274-80.
13. 13. Navidinia M, Peerayeh SN, Fallah F, Bakhshi B, Sajadinia RS. Phylogenetic grouping and pathotypic comparison of urine and fecal Escherichia coli isolates from children with urinary tract infection. Braz J Microbiol, 2014; 45(2): 509-14.
14. 14. Hilbert DW, Paulish TE, Mordechai E, Adelson ME, Gygax SE, Trama JP. Antimicrobial non-susceptibility of cervico-vaginal and rectal Escherichia coli isolates is associated with phylogeny and plasmid carriage. Eur J Clin Microbiol Infect Dis, 2009; 28(11): 1399-403.
15. 15. Stürmer T, Erb A, Marre R, Brenner H. Prevalence and determinants of antibiotic resistance in faecal Escherichia coli among unselected patients attending general practitioners in Southwest Germany. Pharmacoepidemiol Drug Saf, 2004; 13(5): 303-8.
16. 16. Plavsić T. Markers of antimicrobial drug resistance in the most common bacteria of normal facultative anaerobic intestinal flora. Med Pregl, 2011; 64(11- 12): 613-7.
17. 17. Kang HY, Jeong YS, Oh JY, Tae SH, Choi CH, Moon DC, et al. Characterization of antimicrobial resistance and class 1 integrons found in Escherichia coli isolates from humans and animals in Korea. J Antimicrob Chemother, 2005; 55(5): 639-44.
18. 18. Domínguez E, Zarazaga M, Sáenz Y, Briñas L, Torres C. Mechanisms of antibiotic resistance in Escherichia coli isolates obtained from healthy children in Spain. Microb Drug Resist, 2002; 8(4): 321-7.
19. 19. Calva JJ, Sifuentes-Osornio J, Cerón C. Antimicrobial resistance in fecal flora: longitudinal community-based surveillance of children from urban Mexico. Antimicrob Agents Chemother, 1996; 40(7): 1699-702.
20. 20. Coque TM, Novais A, Carattoli A, Poirel L, Pitout J, Peixe L, et al. Dissemination of clonally related Escherichia coli strains expressing extendedspectrum β-lactamase CTX-M-15. Emerg Infect Dis, 2008; 14: 195–200.
21. 21. Novais A, Cantón R, Valverde A, Machado E, Galán JC, Peixe L, et al. Dissemination and persistence of blaCTX-M-9 are linked to class 1 integrons containing CR1 associated with defective transposon derivatives from Tn402 located in early antibiotic resistance plasmids of IncHI2, IncP1-α, and IncFI groups. Antimicrob Agents Chemother, 2006; 50: 2741–50.
22. 22. Leflon-Guibout V, Blanco J, Amaqdouf K, Mora A, Guize L, Nicolas-Chanoine MH. Absence of CTX-M enzymes but high prevalence of clones, including clone ST131, among fecal Escherichia coli isolates from healthy subjects living in the area of Paris, France. J Clin Microbiol, 2008; 46: 3900–5.
23. 23. Valverde A, Coque TM, Sanchez-Moreno MP, Rollan A, Baquero F, Canton R. Dramatic increase in prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae during nonoutbreak situations in Spain. J Clin Microbiol, 2004; 42(10): 4769–75.
24. 24. Geser NSR, Korczak BM, Beutin L, Hachler H. Molecular identification of blaESBL genes from Enterobacteriaceae isolated from healthy human carriers in Switzerland. Antimicrob Agents Chemother, 2012; 56(3): 1609–12.
25. 25. Pons MJ, Mosquito S, Gomes C, Del Valle LJ, Ochoa TJ, Ruiz J. Analysis of quinolone-resistance in commensal and diarrheagenic Escherichia coli isolates from infants in Lima, Peru. Trans R Soc Trop Med Hyg, 2014; 108(1): 22-8.
26. 26. Balasar M, Doğan M, Kandemir A, Feyzioğlu B, Haşimov Z, Baykan M. İdrar kültürlerinde, enfeksiyon etkenleri ve antibiyotik direnç oranları. Selçuk Tıp Dergisi, 2014; 30(2): 54-7.
27. 27. Saraçoğlu KT, Fidan V, Pekel Ö, Saraçoğlu A, Kalkandelen S, Arpalı E. İdrar kültürlerinde izole edilen bakterilerin antibiyotik duyarlılıkları. J Clin Exp Invest, 2013; 4(3): 356-9.
28. 28. Terek EG, Başoğlu TM. Bir üniversite hastanesine gönderilen idrar kültürlerinde üreyen izolatların dağılımı ve antimikrobiyal duyarlılık profilinin incelenmesi. Ege J Med, 2013; 52(3): 136-40.
29. 29. Duman Y, Güçlüer N, Serindağ A, Tekerekoğlu MS. Escherichia coli Suşlarında Antimikrobiyal Duyarlılık ve Genişlemiş Spektrumlu-Βeta Laktamaz (GSBL) Varlığı. Fırat Tıp Derg, 2010; 15(4): 197-200.
30. 30. Çetinkol Y, Yıldırım AA, Çakır FÖ. Extendedspectrum beta-lactamase activity and in vitro efficiency of ertapenem among Escherichia coli strains isolated from urine samples. Mediterr J Infect Microb Antimicrob, 2014; 3: 8-13.
31. 31. Aksoy A, Göçmen SJ, KAçmaz B, Canver S. Antibiotic Resistance and Extended SpectrumBetalactamase Production in Fecal Escherichia coli Strains Isolated from Human and Cattle. ANKEM Derg, 2005; 19(3): 130-4.