Evaluation of Antibiotic Resistance Profiles and Extended Spectrum of Beta Lactamase (ESBL) Properties of Uropathogenic Escherichia coli Strains

Year 2020, Volume: 46 Issue: 2, 41 - 65, 31.10.2020

Mehmet Akif Bozkır Ahmet Uysal , Emine Arslan

Abstract

In this study; 135 Escherichia coli strains, isolated and identified from urinary tract infections, were evaluated for their sensitivity to twenty different antibiotics and for their production of extended spectrum of beta lactamase enzyme (ESBL). Disc diffusion method was used to determine antibiotic susceptibilities. It was determined that 65.1% of the strains were resistant to at least one or more antibiotics and there were 69 different resistance profiles among the strains. It was seen that the highest resistance rate among strains was 50.4% against ampicillin, followed by 40.7% tetracycline, 40% nalidixic acid, 31.1% ofloxacin and moxifloxacin, 28.9% amoxicillin / clavulanic acid and ciprofloxacin. Strains were observed to be 100% sensitive to meropenem, followed by imipenem with a rate of 1.48% and amikacin with a rate of 2.2%. Double disk synergy method was used to determine the production of ESBL. It was determined that phenotypically, the number of ESBL positive strains was 16 (11.8%). Multiplex PCR method was used to detect the ESBL genes genotypically in ESBL positive strains. With this method, blaCTX-M, blaTEM, blaSHV, blaOXA beta lactamase genes were investigated. It was revealed that the most common gene in ESBL positive strains was the blaTEM gene with a rate of 93.7%. Uropathogenic Escherichia coli infections have become a serious problem worldwide. Strains that are increasingly resistant to both synthetic and natural antibiotics cause the infection to recur and become chronic with the emergence of new and more serious diseases. For this reason, surveillance studies on the antibiotic resistance properties of uropathogenic E. coli strains should be conducted and new therapeutic solutions should be developed.

Keywords

Antibiotic resistance, blaTEM, ESBL, Urinary tract infection, UPEC

Üropatojenik Escherichia coli Suşlarının Antibiyotik Direnç Profilleri ve Genişlemiş Spektrumlu Beta Laktamaz (GSBL) Özelliklerinin Değerlendirilmesi

Abstract

Bu çalışmada; idrar yolu enfeksiyonlarından izole ve identifiye edilen 135 Escherichia coli suşu; yirmi farklı antibiyotiğe duyarlılıkları ve genişlemiş spektrumlu beta laktamaz enzimi (GSBL) üretimleri açısından değerlendirildi. Antibiyotik duyarlılıklarının belirlenmesi için, disk difüzyon yöntemi kullanıldı. Suşların % 65.1’nin en az bir veya daha fazla antibiyotiğe dirençli olduğu ve suşlar arasında 69 farklı direnç profili olduğu belirlendi. Suşlar arasındaki en yüksek direnç oranı % 50.4 ile ampisiline karşı olduğu, bunu % 40.7 tetrasiklin, % 40 nalidiksik asid, % 31.1 ofloksasin ve moksifloksasin, % 28.9 ile amoksisilin/klavulanik asit ve siprofloksasin’in takip ettiği görüldü. Suşlar meropeneme karşı % 100 duyarlı olarak gözlemlendi, bunu % 1.48 oranı ile imipenem ve % 2.2 oranı ile amikasinin takip ettiği görüldü. GSBL üretiminin belirlenmesi için çift disk sinerji yöntemi kullanıldı. Fenotipik olarak GSBL pozitif suş sayısı 16 (% 11.8) olarak tespit edildi. GSBL pozitif suşların genotipik olarak GSBL genlerinin tespiti amacı ile multipleks PZR yöntemi kullanıldı. Bu yöntem ile blaCTX-M, blaTEM, blaSHV, blaOXA beta laktamaz genleri araştırıldı. GSBL pozitif suşlarda en yaygın genin % 93.7 oranı ile blaTEM geni olduğu ortaya koyuldu. Üropatojenik Escherichia coli enfeksiyonları dünya çapında ciddi bir sorun haline gelmiştir. Hem sentetik hem de doğal antibiyotiklere karşı artan dirençli suşlar, yeni ve daha ciddi hastalıkların ortaya çıkmasıyla enfeksiyonun tekrarlamasına ve kronikleşmesine neden olmaktadır. Bu sebeple üropatojenik E. coli suşlarının antibiyotik direnç özellikleri ile ilgili sürveyans çalışmaları yapılmalı ve yeni terapötik çözümlerin geliştirilmesine olanak sağlanmalıdır.

Keywords

Antibiyotik direnci, BlaTEM, GSBL, İdrar yolu enfeksiyonu, UPEC

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