No abstract
Being a member of the Enterobacteriaceae family, Klebsiella pneumoniae is an opportunistic pathogen that inhabits normal human microbiota and causes predominantly hospital-acquired infections. The emergence of K.pneumoniae isolates which are resistant particularly to the carbapenem group of antibiotics has led to an increase in hospitalization period, mortality and morbidity. Although different rates of resistance are observed between countries, regions and even healthcare facilities, there has been a rapid increase in the prevalence of carbapenem-resistant strains in the last 10 years. Fast and correct identification of carbapenem-resistant strains is important for the successful treatment of infections caused by these resistant bacteria. The objective of this study was to investigate the presence and the types of carbapenemases in carbapenem-resistant K.pneumoniae strains using "MASTDISCS™ ID carbapenemase detection disc set", a commercial product that can be used for this purpose, and "Carbapenem Inactivation Method (CIM)", a relatively new method, and compare the results of these methods by polymerase chain reaction (PCR). For this purpose, we used 54 K.pneumoniae strains isolated in 2015-2016, that were resistant to any of the ertapenem, meropenem or imipenem antibiotics. The identification of the strains was performed using VITEK MS and their antibiotic susceptibility tests were carried out using the VITEK 2 Compact® automated system. For the strains that were found resistant to carbapenems in the automated system, the minimum inhibitor concentration (MIC) values were determined by the gradient testing method according to the recommendations of "The European Committee on Antimicrobial Susceptibility Testing (EUCAST)". The blaOXA-48, blaIMP, blaNDM, blaVIM, and blaSIM genes were investigated with PCR among these isolates. Phenotypic enzyme typing was performed in the carbapenem-resistant strains using the "MASTDISCS™ ID carbapenemase detection disc set" and "Carbapenem Inactivation Method (CIM)". REP-PCR was used to reveal clonal relationship of the isolates. The 54 K.pneumoniae isolates were found as resistant to carbapenem and the MIC50 and MIC90 values of imipenem, meropenem and ertapenem were 32 µg/ml. Only 33 of the strains had blaOXA-48 and two of them had only blaNDM, the remaining 19 strains had both of these two genes. The blaIMP, blaVIM and blaSIM genes were not encountered in any of the isolates. When the isolates were assessed by the REP-PCR method, six main clones were detected. The "MASTDISCS™ ID carbapenemase detection disc set" was able to detect all the carbapenemase producing strains and it remained incapable of distinguishing OXA-48 in the strains which had both OXA-48 and metallo beta lactamase (MBL) enzymes. The CIM method showed a low rate of positivity (46.15%) in the strains containing blaOXA-48, but was found much more successful in the strains containing blaNDM with a detection rate of 85.71%. In this study, it was concluded that the Mastdiscs-ID method could be successfully used to...
Giriş:Hastane kökenli ya da sağlık bakımı ile ilişkili enfeksiyonların (HE) görülme sıklığı ülkeden ülkeye, hatta aynı hastanenin farklı birimlerine göre değişebilmektedir. Prevalans çalışmaları ile hastanelerdeki enfeksiyon sorunu daha geniş bir perspektifte tüm hastaneyi kapsayacak şekilde ortaya konulabilir ve kontrol önlemleri bu kapsamda değerlendirilebilir. Bu çalışmada bir üçüncü basamqk eğitim hastanesi olan hastanemizde 23 Aralık 2013 tarihinde yatan hastalardaki HE prevalansı irdelenmiştir. Gereç ve Yöntem: Bin sekiz yüz elli yatak kapasiteli hastanemizde (1,516'sı erişkin, 334'ü pediatrik ve toplam 328'i yoğun bakım yatağı), 23 Aralık 2013'de yatmakta olan hastalardan, ilgili bölüm enfeksiyon hastalıkları ve klinik mikrobiyoloji konsültan hekimleri tarafından HE tanısı konulan hastalar altta yatan hastalıklar, risk faktörleri, uygulanan tıbbi girişimler, enfeksiyon odakları ve etken mikroorganizmalar açısından değerlendirilmiştir. Bulgular: Prevalans çalışmasının yapıldığı 23 Aralık 2013'de yatan hasta sayısı 1,470, HE prevalansı %7,21 olarak saptanmıştır. Hastalarda en sık görülen HE tipi pnömoni olup, diğer HE odakları sırasıyla idrar yolu enfeksiyonu, bakteriyemi, cerrahi alan enfeksiyonları ve intraabdominal enfeksiyonlar şeklinde sıralanmıştır. Sonuç: Hastanemiz gibi büyük hastanelerde tüm kliniklerde hastaya dayalı, aktif sürveyans yapılamadığı durumlarda, uygun aralıklarla tekrarlanan nokta prevalans çalışmalarının HE izleminde ve etkili enfeksiyon kontrol önlemleri alınmasında yararlı olacağını düşünüyoruz. Anahtar Kelimeler: Hastane enfeksiyonu, nokta prevelans, sürveyans, sağlık bakımı ilişkili enfeksiyonlar, nozokomiyal enfeksiyon Introduction: The prevalence of hospital-acquired or healthcare-associated infections (HAI) varies from country to country even between different units of the same hospital. By the help of prevalence studies, HAI rates can be demonstrated in a wider perspective and, based on these data; infection control measures may be reevaluated. In this study, we investigated the HAI prevalence in hospitalized patients on 23 December 2013 at our tertiary-care educational hospital. Materials and Methods: On 23 December 2013, patients diagnosed with HAI (by using Centers for Disease Control and Prevention criteria) by infectious diseases and clinical microbiology specialists in our 1850-bedded (including 1.516 adult, 334 pediatric and a total of 328 intensive care unit beds) tertiary-care hospital, were evaluated in terms of underlying disease, risk factors, implementation initiatives, focus of infection and causative microorganisms. Results: The number of patients hospitalized on 23 December 2014 was 1.470, the prevalence of HAI was found to be 7.21%. The most common type of HAI was pneumonia followed by urinary tract infection, bacteremia, surgical site infections and intra-abdominal infections. Conclusion: We conclude that repeated HAI prevalence studies at appropriate intervals are very useful for taking effective infection control measures and follow-up of HAI in large hospi...
Objective:Pseudomonas aeruginosa is an opportunistic pathogen that can cause serious infections, especially in health care settings where host defense is impaired. In addition to resistance problem, the different virulence characteristics of these bacteria can change the course of infection and cure. In this study, it was aimed to determine antibiotic susceptibilities, epidemiological relations and virulence factors of clinical P. aeruginosa isolates. Methods:This study was performed, a total of 83 P. aeruginosa isolated from different clinical samples of
A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : In this study, it was ai med to in ves ti ga te in vit ro ac ti vi ti es of li ne zo lid combi ned with van comy cin, te i cop la nin, fu si dic acid, and cip rof lo xa cin aga inst Gram-po si ti ve pat hogens. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : This study was con duc ted at Ege Uni ver sity, Fa culty of Phar macy, De part ment of Phar ma ce u ti cal Mic ro bi o logy. Cli ni cal iso la tes used in this study we re ob ta i ned retros pec ti vely from the col lec ti on of Ege Uni ver sity Me di cal Fa culty, De part ment of Mic ro bi o logy and Cli ni cal Mic ro bi o logy, Bac te ri o logy La bo ra tory. Mi ni mal in hi bi tor con cen tra ti ons (MICs) of test stra ins_met hi cil lin-sus cep tib le Staph ylo coc cus au re us (MSSA), met hi cil lin-re sis tant S. au re us (MRSA), van comy cin in ter me di a te S. au re us (VI SA), Mu50 (van comy cin in ter me di a te S. au re us stra in), met hi cil lin-sus cep tib le Staph ylo coc cus epi der mi dis (MSSE), met hi cil lin-re sis tant S. epider mi dis (MRSE), van comy cin-sus cep tib le En te ro coc cus fa e ca lis (VSE) and van comy cin-re sis tant E. fa e ca lis (VRE)) we re de ter mi ned by mic ro di lu ti on met hod. Ti me-kill stu di es we re per for med over 24 h using an ino cu lum of 5 x 10 6 and 1 x 10 7 CFU/mL. An ti bi o tics we re tes ted at con cen trati ons 1x and 4 x MIC (minimum inhibitory concentration). R Re e s su ul lt ts s: : Synergy was de tec ted bet ween li ne zo lid plus te i cop la nin and fu si dic acid at 1 x MIC con cen tra ti ons in MSSA stra in. In MRSE stra in, li ne zo lid sho wed the sa me ef fect with fu si dic acid at 1xMIC. An ta go nis tic ef fect was fo und li ne zo lid plus van comy cin and te i cop la nin (4 x MIC) in VSE and li ne zo lid plus cip rof lo xa cin (4 x MIC) in MRSE stra in. C Co on nc c l lu u s si i o on n: : In this study, li ne zo lid plus fu si dic acid ap pe a red to be the most ac ti ve com bi na ti on aga inst Gram-po si ti ve pat ho gens.K Ke ey y W Wo or rd ds s: : Drug com bi na ti ons; li ne zo lid; drug syner gism Ö ÖZ ZE ET T A Am ma aç ç: : Bu ça lış ma da, li ne zo li din van ko mi sin, te i kop la nin, fu si dik asit ve sip rof lok sa sin ile kom bi nas yon la rı nın Gram-po zi tif pa to jen ler üze ri ne in vit ro et kin li ği nin araş tı rıl ma sı amaç lan dı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Bu ça lış ma, Ege Üni ver si te si Ec za cı lık Fa kül te si, Far ma sö tik Mik ro bi yo lo ji Anabi lim Da lı'n da ger çek leş ti ril di. Ça lış ma da kul la nı lan kli nik izo lat lar, Ege Üni ver si te si Tıp Fa kül te si, Mik ro bi yo lo ji ve Kli nik Mik ro bi yo lo ji Ana bi lim Da lı, Bak te ri yo lo ji La bo ra tu va rı'n dan ret ros pek tif ola rak sağ lan dı. Ça lış ma kö ken le ri nin (me ti si lin-du yar lı Staph ylo coc cus au re us (MSSA), me ti si lindi renç li S. au re us (MRSA), van ko mi sin or ta dü zey de di renç li S. au re us (VI SA), Mu50 (van ko mi sin or ta dü zey de di...
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