Carbapenem resistance in ESBL positive Enterobacteriaceae isolates causing invasive infections

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dc.contributor.authorEser, O.
dc.contributor.authorAltun Uludagc, Hatice
dc.contributor.authorErgin, Alper
dc.contributor.authorBoral, Bariş
dc.contributor.authorŞener, Burçin
dc.contributor.authorHasçelik, G?u?lsen
dc.date.accessioned2025-10-24T18:06:51Z
dc.date.available2025-10-24T18:06:51Z
dc.date.issued2014
dc.departmentMalatya Turgut Özal Üniversitesi
dc.description.abstractThe aim of this study was to investigate the presence of carbapenem resistance in Enterobacteriaeceae isolates recovered from invasive infections, in Hacettepe University Hospital, Ankara, Turkey, between 2005-2009, by phenotypic and genotypic methods. A total of 210 non-duplicated Escherichia coil (n= 153), Klebsiella pneumoniae (n= 47) and Klebsiella oxytoca (n= 10) isolates which were all determined to be extended-spectrum beta-lactamase (ESBL) positive with the BD Phoenix automated identification and antibiotic susceptibility system (Sparks, USA), were included in the study. The isolates were recovered from patients with bloodstream infections. Susceptibility of the isolates to imipenem, meropenem and ertapenem was detected with microdilution method according to the standards of Clinical and Laboratory Standards Institute (CLSI) minimal inhibitory concentration MIC breakpoints. Doripenem susceptibility was detected by the E-test (bioMerieux, Hazelwood, USA). All isolates which were found to be non-susceptible to any of the carbapenem antibiotics tested, were characterized by the phenotypic confirmatory tests and the presence of the resistance genes; bla<inf>Ampc</inf> bla<inf>CTX-M</inf>, bla<inf>KPC</inf> bla<inf>NDM</inf>, bla<inf>OXA</inf>, bla<inf>lMP</inf> ve bla<inf>VIM</inf> were screened by polymerase chain reaction (PCR). Among the 210 ESBL-producing Enterobacteriaceae blood isolates, 23 (11%) were identified as non-susceptible to any of the carbapenems tested. Resistance rates for imipenem, meropenem and ertapenem were 5.7% (n= 12), 1.9% (n= 4) and 2.4% (n= 5), respectively. Doripenem was more active than the other carbapenems, with a resistance rate of 1.0%. Seven of 23 isolates were ESBL negative with cefotaxime/clavulanic acid CTX CLA) and ceftazidime/clavulanic acid (CAZ/CLA) combined disk diffusion test, however, six of them were ESBL positive with the addition of boronic acid (BA) to CTX/CLA. Among the three isolates positive for Modifiye Hodge test MHT and/or ertapenem-BA tests, bla<inf>QXA-48</inf> was detected in one and bla<inf>AmpC</inf> in the other. Phenotypic pAmpC activity was present in three K.pneumoniae isolates of which one was positive for bla<inf>AmpC</inf> gene. One K.pneumoniae isolate resistant to all carbapenems with MICs > 256 ?g/ ml and positive for phenotypic meropenem-BA, MHT, imipenem-EDTA, ceftazidime-CAZ/CLA, cefoxitin-BA production, was found to inhabit bla<inf>OXA-48</inf> gene. Five isolates were positive for bla <inf>OXA-1</inf> and one for bla<inf>OXA-10</inf>. Two isolates were positive for bla<inf>CTX-M</inf>, however bla<inf>IMP</inf> ,bla<inf>VIM</inf> and bla<inf>NDM-1</inf> genes were not detected among the isolates. In conclusion, carbapenem non-susceptibility which was low among the Enterobacteriaceae strains isolated in our center, was mostly attributed to the presence of bla <inf>OXA</inf> type carbapenemases and no accumulation of bla<inf>KPC</inf> and bla<inf>NDM</inf> were detected. © 2024 Elsevier B.V., All rights reserved.
dc.identifier.doi10.5578/mb.7181
dc.identifier.endpage69
dc.identifier.issn0374-9096
dc.identifier.issue1
dc.identifier.pmid24506716
dc.identifier.scopus2-s2.0-84897609295
dc.identifier.scopusqualityQ3
dc.identifier.startpage59
dc.identifier.urihttps://doi.rog/10.5578/mb.7181
dc.identifier.urihttps://hdl.handle.net/20.500.12899/3223
dc.identifier.volume48
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isotr
dc.publisherAnkara Microbiology Society
dc.relation.ispartofMikrobiyoloji Bulteni
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzScopus_20251023
dc.subjectCarbapenem resistance
dc.subjectCarbapenemase
dc.subjectEnterobacteriaceae
dc.subjectESBL
dc.titleCarbapenem resistance in ESBL positive Enterobacteriaceae isolates causing invasive infections
dc.title.alternativeInvazif enfeksiyonlara neden olan gsbl pozitif enterobacteriaceae izolatlarinda karbapenem direnci
dc.typeArticle

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