Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates
Yıl: 2021 Cilt: 46 Sayı: 3 Sayfa Aralığı: 289 - 298 Metin Dili: İngilizce İndeks Tarihi: 02-06-2022
Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates
Öz: Carbapenem-Resistant Klebsiella pneumoniae (CRKp) infections are
worrying health problems due to decreasing treatment options. This study
investigates the carbapenemase (OXA-23,24, 48, 51, 55, 58, KPC,
NDM-1, VIM, IMP) and mcr-1 genes of the CRKps isolates A total
of 33 CRKp isolates isolated from patient blood samples from the Dicle
University Medical Faculty Hospital, intensive care units (ICUs) between
February 2020 and June 2020, were included in the study. The presence of
carbapenemase encoding genes -including all CRKp isolates, bla OXA-23,
24, 48, 58, bla KPC, blaNDM-1, bla VIM, bla IMP- were investigated
by multiplex Polymerase Chain Reaction (PCR). CRKp isolates were
tested for mcr-1 gene and bla OXA-51, bla OXA-55 genes by monoplex
PCR. All CRKp isolates studied with Kirby Bauer Disc Diffusion Method
(DDM) (100%) were resistant to ertapenem, 9 (27.27%) resistant to
imipenem, and 23 (69.70%) were resistant to meropenem. 20 (60.61%)
of the isolates were found resistant to colistin. bla OXA-48, bla NDM-1
and bla OXA-24 genes were found in 75.76% (n = 25), 6.06% (n =
2) and 3.03% (n = 1) isolates, respectively. Both bla OXA-48 and bla
NDM-1 genes were detected in two (6.06%) isolates and mcr-1 gene in
16 (48.48%) isolates. While the mean hospitalization was 20.3 days in
13 patients with a colistin minimum inhibitory concentration (MIC) of 2
μg/ml, it was 33.9 days in 20 patients with a colistin MIC of > 2 μg/ml.
The average length of stay in the hospital was 21.8 days in mcr-1 negative
patients and 35.7 days in mcr-1 positive patients. Carbapenemase and
mcr-1 positivities were found at dramatically high rates in Diyarbakır,
Turkey. It was indicated that plasmid-mediated antimicrobial resistance
in Kp isolates was problematic. Each hospital should monitor the colistin
and carbapenem resistance mechanisms by molecular methods. Colistin
resistance should be confirmed by the broth microdilution method (BMD).
Anahtar Kelime: Klebsiella Pneumoniae Kan İzolatlarında Karbapenem ve Kolistin Direnç Mekanizmalarının Moleküler Olarak İncelenmesi
Öz: Karbapenem Dirençli Klebsiella pneumoniae (KDKp) enfeksiyonları
azalan tedavi seçenekleri nedeniyle endişe verici sağlık sorunları
oluşturmaktadır. Bu çalışmada, KDKp izolatlarının karbapenemaz
(OXA-23,24, 48, 51, 55, 58, KPC, NDM-1, VIM, IMP) ve mcr-1
genleri araştırılmaktadır. Dicle Üniversitesi Tıp Fakültesi Hastanesi
yoğun bakım ünitelerinden (YBÜ) Şubat 2020 ile Haziran 2020
tarihleri arasında alınan hasta kan örneklerinden izole edilen toplam 33
KDKp izolatı çalışmaya dahil edildi. Tüm KDKp izolatları, bla OXA-23,
24, 48, 58, bla KPC, blaNDM-1, bla VIM, bla IMP dahil olmak üzere
karbapenemaz kodlayan genlerin varlığı multipleks Polimeraz Zincir
Reaksiyonu (PZR) ile araştırıldı. KDKp izolatları monoplex PZR ile mcr-
1 geni ve bla OXA-51, bla OXA-55 genleri için test edildi. Kirby Bauer
Disk Difüzyon Test (DDT) (%100) ile çalışılan tüm KDKp izolatları
ertapenem’e dirençliydi; 9’u (%2.27) imipeneme, 23’ü (%69.70)
meropeneme dirençliydi. İzolatların 20’si (%60,61) kolistine dirençli
bulundu. bla OXA-48, bla NDM-1 ve bla OXA-24 genleri sırasıyla
%75.76 (n=25), %6.06 (n=2) ve %3.03 (n=1) izolatında bulundu.
İki (%6.06) izolatta hem bla OXA-48 hem de bla NDM-1 genleri, 16
(%48,48) izolatta mcr-1 geni saptandı. Kolistin minimum inhibitör
konsantrasyonu (MİK) değeri 2 μg/ml olan 13 hastada ortalama yatış
süresi 20.3 gün iken, kolistin MİK değeri > 2 μg/ml olan 20 hastada
33.9 gündü. Hastanede ortalama kalış süresi mcr-1 negatif hastalarda
21.8 gün, mcr-1 pozitif hastalarda 35.7 gündü. Karbapenemaz ve mcr-
1 pozitiflikleri Diyarbakır, Türkiye’de çarpıcı biçimde yüksek oranlarda
bulundu. Kp izolatlarında plazmit aracılı antimikrobiyal direncin
sorunlu olduğu belirtildi. Her hastane moleküler yöntemlerle kolistin ve
karbapenem direnç mekanizmalarını izlemelidir. Kolistin direnci sıvı
mikrodilüsyon yöntemi ile doğrulanmalıdır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA | Kulahlioglu N, Özcan N, Gül K, Akpolat N, Atmaca s, KENAR L, altanlar n (2021). Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. , 289 - 298. |
Chicago | Kulahlioglu Neslihan,Özcan Nida,Gül Kadri,Akpolat Nezahat,Atmaca selahattin,KENAR LEVENT,altanlar nurten Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. (2021): 289 - 298. |
MLA | Kulahlioglu Neslihan,Özcan Nida,Gül Kadri,Akpolat Nezahat,Atmaca selahattin,KENAR LEVENT,altanlar nurten Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. , 2021, ss.289 - 298. |
AMA | Kulahlioglu N,Özcan N,Gül K,Akpolat N,Atmaca s,KENAR L,altanlar n Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. . 2021; 289 - 298. |
Vancouver | Kulahlioglu N,Özcan N,Gül K,Akpolat N,Atmaca s,KENAR L,altanlar n Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. . 2021; 289 - 298. |
IEEE | Kulahlioglu N,Özcan N,Gül K,Akpolat N,Atmaca s,KENAR L,altanlar n "Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates." , ss.289 - 298, 2021. |
ISNAD | Kulahlioglu, Neslihan vd. "Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates". (2021), 289-298. |
APA | Kulahlioglu N, Özcan N, Gül K, Akpolat N, Atmaca s, KENAR L, altanlar n (2021). Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. FABAD Journal of Pharmaceutical Sciences, 46(3), 289 - 298. |
Chicago | Kulahlioglu Neslihan,Özcan Nida,Gül Kadri,Akpolat Nezahat,Atmaca selahattin,KENAR LEVENT,altanlar nurten Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. FABAD Journal of Pharmaceutical Sciences 46, no.3 (2021): 289 - 298. |
MLA | Kulahlioglu Neslihan,Özcan Nida,Gül Kadri,Akpolat Nezahat,Atmaca selahattin,KENAR LEVENT,altanlar nurten Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. FABAD Journal of Pharmaceutical Sciences, vol.46, no.3, 2021, ss.289 - 298. |
AMA | Kulahlioglu N,Özcan N,Gül K,Akpolat N,Atmaca s,KENAR L,altanlar n Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. FABAD Journal of Pharmaceutical Sciences. 2021; 46(3): 289 - 298. |
Vancouver | Kulahlioglu N,Özcan N,Gül K,Akpolat N,Atmaca s,KENAR L,altanlar n Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates. FABAD Journal of Pharmaceutical Sciences. 2021; 46(3): 289 - 298. |
IEEE | Kulahlioglu N,Özcan N,Gül K,Akpolat N,Atmaca s,KENAR L,altanlar n "Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates." FABAD Journal of Pharmaceutical Sciences, 46, ss.289 - 298, 2021. |
ISNAD | Kulahlioglu, Neslihan vd. "Molecular Investigation of Carbapenem and Colistin Resistance Mechanisms in Klebsiella pneumoniae Bloodstream Isolates". FABAD Journal of Pharmaceutical Sciences 46/3 (2021), 289-298. |