Çopur Çiçek Ayşegül, Ertürk Ayşe, Ejder Nebahat, Rakici Erva, Kostakoğlu Uğur, Esen Yıldız İlknur, Özyurt Songül, Sönmez Emine
Recep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Microbiology, Rize, Turkey.
Recep Tayyip Erdogan University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Rize, Turkey.
Infect Drug Resist. 2021 Apr 20;14:1517-1526. doi: 10.2147/IDR.S299742. eCollection 2021.
Researching carbapenem-resistant isolates enables the identification of carbapenemase-producing bacteria and prevents their spread.
isolates were recovered from Medicine Faculty of Recep Tayyip Erdoğan University and identified by conventional methods and the automated Vitek 2 Compact system. Antimicrobial susceptibility experiments were performed in accordance with CLSI criteria and the automated Vitek 2 Compact system. The PCR method was investigated for the presence of β-lactamase resistance genes. PFGE typing was performed to show clonal relation among samples.
Seventy isolates were isolated from seventy patients. Of the patients, 67.1% had contact with the health service in the last 90 days and 75.7% of the patients had received antimicrobial therapy in the previous 90 days. Twenty-four isolates were carbapenem resistant, 2 isolates were multidrug-resistant except colistin, and none of the samples had colistin resistance. The gene encoding β-lactamase or metallo-β-lactamase was found in a total of 36 isolates. The and genes were identified in 1 and 5 isolates alone or 17 and 13 isolates in combination with other resistance genes, respectively. The was the most detected metallo-β-lactamase encoding gene (n=18), followed by (n=12). and were detected in 5 and 1 isolates, respectively. Also, the association of - and - - was found to be very high. Much more resistance genes and co-occurrence were detected in hospital-acquired samples than community-acquired samples. No difference was found between the community and hospital-associated isolates according to PFGE results. Simultaneously from 6 patients, other microorganisms were also isolated and 5 of them died.
The average length of stay (days) was found to be significantly higher in HAI group than CAI group. The death of 5 patients with fewer or no resistance genes showed that the co-existence of other microorganisms in addition to resistance genes was important on death.
对耐碳青霉烯类分离株进行研究有助于识别产碳青霉烯酶的细菌并防止其传播。
从雷杰普·塔伊普·埃尔多安大学医学院采集分离株，采用传统方法及Vitek 2 Compact自动系统进行鉴定。按照CLSI标准及Vitek 2 Compact自动系统进行药敏试验。采用PCR方法检测β-内酰胺酶耐药基因的存在情况。进行PFGE分型以显示样本间的克隆关系。
从70例患者中分离出70株分离株。这些患者中，67.1%在过去90天内曾接触过医疗服务，75.7%的患者在之前90天内接受过抗菌治疗。24株分离株对碳青霉烯类耐药，2株除对黏菌素外呈多重耐药，且所有样本均无黏菌素耐药。共在36株分离株中发现编码β-内酰胺酶或金属β-内酰胺酶的基因。blaKPC和blaNDM基因分别仅在1株和5株分离株中鉴定出，或分别与其他耐药基因一起在17株和13株分离株中鉴定出。blaVIM是检测到的最常见的金属β-内酰胺酶编码基因（n = 18），其次是blaIMP（n = 12）。blaOXA-48和blaOXA-23分别在5株和1株分离株中检测到。此外，发现blaKPC- blaNDM和blaNDM- blaVIM的关联度非常高。与社区获得性样本相比，医院获得性样本中检测到的耐药基因及共现情况更多。根据PFGE结果，社区相关分离株和医院相关分离株之间未发现差异。同时从6例患者中还分离出其他微生物，其中5例死亡。
发现医院获得性感染组的平均住院天数显著高于社区获得性感染组。5例耐药基因较少或无耐药基因的患者死亡表明，除耐药基因外，其他微生物的共存对死亡情况很重要。
