Araştırma Makalesi
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Enterobacterales Üyelerinde Nadir Bir Plazmid Aracılı A Sınıfı Beta Laktamaz Olan IBC-1'in Araştırılması

Yıl 2021, , 81 - 87, 25.08.2021
https://doi.org/10.26650/experimed.2021.928330

Öz

Amaç: Bu çalışmanın amacı, tüm dünyada sıklıkla gözlemlenen geniş spektrumlu beta laktamazları (GSBL) TEM, SHV ve CTX-M ve nadir görülen IBC-1 beta laktamaz enziminin varlığını araştırmaktır.

Gereç ve Yöntem: Marmara Üniversitesi Hastanesinde yatan has-taların klinik örneklerinden izole edilen, fenotipik olarak GSBL üre-ten ve IBC-1 fenotipi gösteren 30 köken çalışmaya dahil edilmiştir. Antibiyotik duyarlılık testleri disk difüzyon ve agarda dilüsyon yön-temi ile gerçekleştirilmiştir. GSBL enzimlerinin fenotipik olarak sap-tanmasında E-test ve çift disk sinerji yöntemi kullanılmıştır. GSBL üretiminden sorumlu olan genlerinin varlığını saptamak amacıyla polimeraz zincir reaksiyonu (PZR) yapılmıştır.

Bulgular: Kökenlerin tamamı, imipeneme duyarlı bulunurken, am-pisilin, amoksisilin klavulanik asit, piperasilin, seftazidim ve trime-toprim sülfametaksazole dirençli olarak; saptanmıştır. E-test yön-temiyle 4 köken tanımsız, 26 köken ise GSBL pozitif saptanmıştır. Çift disk sinerji yöntemi ile 2 köken fenotipik olarak IBC-1 pozitif iken, 5 köken şüpheli pozitif olarak belirlenmiştir. Kökenlerimizin blaTEM, blaSHV ve blaCTX-M genlerini taşıma oranı sırasıyla %73,3, %60 ve %56,6 olarak belirlenmiştir. blaIBC geni ise hiçbir kökende sap-tanmamıştır.

Sonuç: İlk olarak Yunanistan’da saptanan IBC-1 enzimi ülkemiz için henüz bir tehlike oluşturmazken GSBL pozitif kökenlerde TEM, SHV ve CTX-M enzimlerinin oranı oldukça yüksek olarak tespit edilmiş-tir.

Kaynakça

  • 1. Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev 2005; 18(4): 657-86. [CrossRef] google scholar
  • 2. Akova M. Dikkat Genişlemiş Spektrumlu Beta Laktamaz (GSBL) Var! ANKEM Dergisi 2004; 18(2): 98-103. google scholar
  • 3. Stürenburg E, Mack D. Extended Spectrum Beta Lactamases Imp-lications for The Clinical Microbiology Laboratory, Therapy and Infection Control. J Infect 2003; 47: 273-95. [CrossRef] google scholar
  • 4. Giakkoupi P, Tzouvelekis SL, Tsakris A, Loukova V, Sofianou D, Tze-lepi E. IBC-1 a Novel Integron Associated Class A Beta Lactamases with Extended Spectrum Properties Produced by an Enterobacter cloacae Clinical Strain. Antimicrob Agents Chemother 2000; 44(9): 2247-53. [CrossRef] google scholar
  • 5. Vourli S, Tzouvelekis SL, Tzelepi E, Lebessi NJ, Miriagou V. Chara-cterization of in In111 a Class 1 Integron That Carries the Exten-ded-Spectrum Beta-Lactamase Gene bla IBC-1. FEMS Microbiol Lett 2003; 225: 149-53. [CrossRef] google scholar
  • 6. Vourli S, Tzouvelekis SL, Tzelepi E. Characterization of Klebsiella pneumoniae Clinical Strain Producing a Rare Extended Spectrum Beta Lactamase (IBC-1). Int J Antimicrob Agents 2003; 21(5): 4957. [CrossRef] google scholar
  • 7. Tzelepi E, Managa C, Platsouka E, Sofianou D, Paniara O, Legakis NJ, et al. Extended Spectrum Beta Lactamase Types in Klebsiella pneumoniae and E. coli in Two Greek Hospitals. Int J Antimicrob Agents 2003; 21: 285-8. google scholar
  • 8. Lebessi E, Stamos G, Foustoukou M, Vourli S, Legakis NJ, Tzouvele-kis LS. Performance of Methods for Detection Of Extended- Spe-ctrum Beta-Lactamases Applied to Clinical Enterobacterial Strains Producing IBC-Type of Beta-Lactamases. J Clin Microbiol 2003; 41(2): 912. [CrossRef] google scholar
  • 9. Clinical and Laboratory Standards Institute. Performance Standar-ds for Antimicrobial Susceptibility Testing. 22th ed. CLSI Supple-ment M100. Wayne, PA: CLSI, 2004. google scholar
  • 10. Öksüz L, Gürler N. Escherichia coli ve Klebsiella spp. Suşlarında Genişlemiş Spektrumlu Beta Laktamazların Tiplendirilmesi ve Plaz-mid Profil Analizi. Mikrobiyoloji Bülteni 2009; 43: 183-94. google scholar
  • 11. Bradford PA. Extended Spectrum Beta Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat. Clin Microbiol Rev 2001; 14(4): 93351. [CrossRef] google scholar
  • 12. Shaikh S, Fatima J, Shakil S, Rizvi SM, Kamal MA. Antibiotic resis-tance and extended spectrum beta-lactamases: Types, epidemio-logy and treatment. Saudi J Biol Sci 2015; 22(1): 90-101. [CrossRef] google scholar
  • 13. Naas T, Poirel L, Nordmann P. Minor extended-spectrum beta-lac-tamases. Clin Microbiol Infect 2008; Suppl 1: 42-52. google scholar
  • 14. Kartali G, Tzelepi E, Pournaras S, Kontopoulou C, Kontos F, Sofia-nou D, et al. Outbreak of Infections Caused by Enterobacter cloa-cae Producing the Integron-Associated Beta Lactamase IBC-1 in a Neonatal Intensive Care Unit of a Greek Hospital. Antimicrob Agents Chemother 2002; 46(5): 1577-80. [CrossRef] google scholar
  • 15. Bonnin RA, Jousset AB, Emeraud C, Oueslati S, Dortet L, Naas T. Genetic Diversity, Biochemical Properties, and Detection Methods of Minor Carbapenemases in Enterobacterales. Front Med (Lau-sanne) 2021; 20(7): 616490. [CrossRef] google scholar
  • 16. Cicek AC, Saral A, Iraz M, Ceylan A, Duzgun AO, Peleg AY, et al. OXA-and GES-type-lactamases predominate in extensively drug-resis-tant Acinetobacter baumannii isolates from a Turkish University Hospital. Clin Microbiol Infect 2014; 20: 410-5. [CrossRef] google scholar
  • 17. Naas T, Dortet L, Iorga BI. Structural and Functional Aspects of Class A Carbapenemases. Curr Drug Targets 2016; 17(9): 1006-28. [CrossRef] google scholar
  • 18. Bektaş A, Güdücüoğlu H, Gürsoy NC, Berktaş M, Gültepe BS, Parlak M, et al. Genişlemiş Spektrumlu Beta-Laktamaz (GSBL) Üreten Esc-herichia coli ve Klebsiella pneumoniae Suşlarının GSBL Genlerinin Araştırılması. FLORA Dergisi 2018; 23(3): 116-23. [CrossRef] google scholar
  • 19. Copur Cicek A, Saral A, Ozad Duzgun A, Yasar E, Cizmeci Z, Ozlem Balci P,et al. Nationwide study of Escherichia coli producing extended-spectrum β-lactamases TEM, SHV and CTX-M in Turkey. J Antibiot (Tokyo) 2013; 66(11): 647-50. [CrossRef] google scholar
  • 20. Dağlar D, Ongüt G, Oğünç D, Ozhak Baysan B, Demirbakan H, et al. Toplum kaynaklı üriner sistem enfeksiyonu etkeni Escherichia coli suşlarında GSBL enzim tiplerinin izoelektrik odaklama ve poli-meraz zincir reaksiyonu yöntemleri ile araştırılması. Mikrobiyol Bul 2010; 44(3): 367-74. google scholar

Investigation of IBC-1, a Rare Plasmid-Mediated Class A Beta-lactamase in Members of Enterobacterales

Yıl 2021, , 81 - 87, 25.08.2021
https://doi.org/10.26650/experimed.2021.928330

Öz

Objective: The aim of the study was to investigate the presence of extended -spectrum beta-lactamases (ESBL) TEM, SHV, and CTX-M which are frequently observed all over the world, and the rare IBC-1 betalactamase enzyme.

Material and Method: Thirty strains that isolated from various clinical samples from inpatient at Marmara University Hospital, which were phenotypically positive for ESBL, and IBC-1were included in the study. Antimicrobial susceptibility tests were per-formed both by disk diffusion and agar dilution tests. E-test and double-disc synergy method (DDS) were used for phenotypic detection of ESBLs. The presence of ESBL genes was detected by polymerase chain reaction (PCR).

Results: All strains were susceptible to imipenem while ampicil-lin, amoxicillin-clavulanic acid, piperacillin, ceftazidime, and trimethoprim-sulfamethoxazole were resistant. While 4 strains were unidentified, 26 strains were detected as ESBL positive by E-test. Two strains were phenotypically positive for IBC-1 with DDS, while 5 strains were identified as doubtful. The rate of carrying the blaTEM, blaSHV, and blaCTX-M genes of strains was 73.3%, 60%, and 56.6%, respectively. The blaIBC gene was not detected in any of the strains.

Conclusion: While the IBC-1 enzyme, which was first detected in Greece, have not caused a threat to our country yet, the rate of TEM, SHV, and CTX-M enzymes were found to be quite high.

Kaynakça

  • 1. Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev 2005; 18(4): 657-86. [CrossRef] google scholar
  • 2. Akova M. Dikkat Genişlemiş Spektrumlu Beta Laktamaz (GSBL) Var! ANKEM Dergisi 2004; 18(2): 98-103. google scholar
  • 3. Stürenburg E, Mack D. Extended Spectrum Beta Lactamases Imp-lications for The Clinical Microbiology Laboratory, Therapy and Infection Control. J Infect 2003; 47: 273-95. [CrossRef] google scholar
  • 4. Giakkoupi P, Tzouvelekis SL, Tsakris A, Loukova V, Sofianou D, Tze-lepi E. IBC-1 a Novel Integron Associated Class A Beta Lactamases with Extended Spectrum Properties Produced by an Enterobacter cloacae Clinical Strain. Antimicrob Agents Chemother 2000; 44(9): 2247-53. [CrossRef] google scholar
  • 5. Vourli S, Tzouvelekis SL, Tzelepi E, Lebessi NJ, Miriagou V. Chara-cterization of in In111 a Class 1 Integron That Carries the Exten-ded-Spectrum Beta-Lactamase Gene bla IBC-1. FEMS Microbiol Lett 2003; 225: 149-53. [CrossRef] google scholar
  • 6. Vourli S, Tzouvelekis SL, Tzelepi E. Characterization of Klebsiella pneumoniae Clinical Strain Producing a Rare Extended Spectrum Beta Lactamase (IBC-1). Int J Antimicrob Agents 2003; 21(5): 4957. [CrossRef] google scholar
  • 7. Tzelepi E, Managa C, Platsouka E, Sofianou D, Paniara O, Legakis NJ, et al. Extended Spectrum Beta Lactamase Types in Klebsiella pneumoniae and E. coli in Two Greek Hospitals. Int J Antimicrob Agents 2003; 21: 285-8. google scholar
  • 8. Lebessi E, Stamos G, Foustoukou M, Vourli S, Legakis NJ, Tzouvele-kis LS. Performance of Methods for Detection Of Extended- Spe-ctrum Beta-Lactamases Applied to Clinical Enterobacterial Strains Producing IBC-Type of Beta-Lactamases. J Clin Microbiol 2003; 41(2): 912. [CrossRef] google scholar
  • 9. Clinical and Laboratory Standards Institute. Performance Standar-ds for Antimicrobial Susceptibility Testing. 22th ed. CLSI Supple-ment M100. Wayne, PA: CLSI, 2004. google scholar
  • 10. Öksüz L, Gürler N. Escherichia coli ve Klebsiella spp. Suşlarında Genişlemiş Spektrumlu Beta Laktamazların Tiplendirilmesi ve Plaz-mid Profil Analizi. Mikrobiyoloji Bülteni 2009; 43: 183-94. google scholar
  • 11. Bradford PA. Extended Spectrum Beta Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat. Clin Microbiol Rev 2001; 14(4): 93351. [CrossRef] google scholar
  • 12. Shaikh S, Fatima J, Shakil S, Rizvi SM, Kamal MA. Antibiotic resis-tance and extended spectrum beta-lactamases: Types, epidemio-logy and treatment. Saudi J Biol Sci 2015; 22(1): 90-101. [CrossRef] google scholar
  • 13. Naas T, Poirel L, Nordmann P. Minor extended-spectrum beta-lac-tamases. Clin Microbiol Infect 2008; Suppl 1: 42-52. google scholar
  • 14. Kartali G, Tzelepi E, Pournaras S, Kontopoulou C, Kontos F, Sofia-nou D, et al. Outbreak of Infections Caused by Enterobacter cloa-cae Producing the Integron-Associated Beta Lactamase IBC-1 in a Neonatal Intensive Care Unit of a Greek Hospital. Antimicrob Agents Chemother 2002; 46(5): 1577-80. [CrossRef] google scholar
  • 15. Bonnin RA, Jousset AB, Emeraud C, Oueslati S, Dortet L, Naas T. Genetic Diversity, Biochemical Properties, and Detection Methods of Minor Carbapenemases in Enterobacterales. Front Med (Lau-sanne) 2021; 20(7): 616490. [CrossRef] google scholar
  • 16. Cicek AC, Saral A, Iraz M, Ceylan A, Duzgun AO, Peleg AY, et al. OXA-and GES-type-lactamases predominate in extensively drug-resis-tant Acinetobacter baumannii isolates from a Turkish University Hospital. Clin Microbiol Infect 2014; 20: 410-5. [CrossRef] google scholar
  • 17. Naas T, Dortet L, Iorga BI. Structural and Functional Aspects of Class A Carbapenemases. Curr Drug Targets 2016; 17(9): 1006-28. [CrossRef] google scholar
  • 18. Bektaş A, Güdücüoğlu H, Gürsoy NC, Berktaş M, Gültepe BS, Parlak M, et al. Genişlemiş Spektrumlu Beta-Laktamaz (GSBL) Üreten Esc-herichia coli ve Klebsiella pneumoniae Suşlarının GSBL Genlerinin Araştırılması. FLORA Dergisi 2018; 23(3): 116-23. [CrossRef] google scholar
  • 19. Copur Cicek A, Saral A, Ozad Duzgun A, Yasar E, Cizmeci Z, Ozlem Balci P,et al. Nationwide study of Escherichia coli producing extended-spectrum β-lactamases TEM, SHV and CTX-M in Turkey. J Antibiot (Tokyo) 2013; 66(11): 647-50. [CrossRef] google scholar
  • 20. Dağlar D, Ongüt G, Oğünç D, Ozhak Baysan B, Demirbakan H, et al. Toplum kaynaklı üriner sistem enfeksiyonu etkeni Escherichia coli suşlarında GSBL enzim tiplerinin izoelektrik odaklama ve poli-meraz zincir reaksiyonu yöntemleri ile araştırılması. Mikrobiyol Bul 2010; 44(3): 367-74. google scholar
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Gülşen Altınkanat Gelmez 0000-0003-0274-628X

Ufuk Hasdemir Bu kişi benim 0000-0002-1606-0804

Güner Söyletir 0000-0001-5695-731X

Yayımlanma Tarihi 25 Ağustos 2021
Gönderilme Tarihi 27 Nisan 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

Vancouver Altınkanat Gelmez G, Hasdemir U, Söyletir G. Enterobacterales Üyelerinde Nadir Bir Plazmid Aracılı A Sınıfı Beta Laktamaz Olan IBC-1’in Araştırılması. Experimed. 2021;11(2):81-7.