Sadece gsbl üreten, sadece ampc beta-laktamaz üreten ve gsbl+ampc beta-laktamaz üreten sefoksitin dirençli escherıchıa colı ve klebsıella pneumonıae izolatlarındaki antibiyotik direnç profillerinin karşılaştırılması

Mart-Kasım 2009 tarihleri arasında Ankara Numune Eğitim ve Araştırma Hastanesi ile Yüksek İhtisas Hastanesinden sefoksitine dirençli 96 Escherichia coli ve Klebsiella pneumoniae izolatı toplanmıştır. Bu izolatlarda genişlemiş spektrumlu beta-laktamaz (GSBL) ile plazmid aracılı AmpC beta-laktamaz varlığı sefalosporin+boronik asit (BA)+klavulanik (CA) kom bine disk yöntemi ile araştırılmıştır. AmpC beta-laktamazlar multipleks polimeraz zincir reaksiyonu (PCR) ile doğrulanmış tır. Sefoksitine dirençli 96 izolatta GSBL ve plazmid aracılı AmpC beta-laktamaz üretimi sırasıyla % 54 ve % 45 olarak bulunmuştur. AmpC beta-laktamaz, GSBL+AmpC beta-laktamaz ve GSBL üreten üç grubun antibiyotik direnç profilleri karşılaştırılmıştır. Sadece AmpC beta-laktamaz, GSBL+AmpC beta-laktamaz ve sadece GSBL üreten izolatlarda sırasıyla piperasilin tazobaktam direnci % 33, % 40, % 26, siprofloksasin direnci % 44, % 56, % 93, trimetoprim-sulfametoksazol direnci % 22, % 64, % 78 ve gentamisin direnci % 17, % 44, % 63 olarak bulunmuştur.

Comparison of antibiotic resistance patterns between ampc producers, esbl producers, ampc and esbl coproducers of cefoxitin-insusceptible clinical ısolates of escherichia coli and klebsiella pneumoniae

A total of 96 cefoxitin-resistant Escherichia coli and Klebsiella pneumoniae strains collected in Ankara Numune Education and Research Hospital and Yüksek İhtisas Hospital between March and November 2009 were examined for extended-spectrum beta-lactamases (ESBL) and plasmid mediated AmpC beta-lactamases. The presence of ESBL and plasmid mediated AmpC beta-lactamases were examined by cephalosporin+boronic acid+clavulanic disk combination test. AmpC beta-lactamases were confirmed by multiplex PCR. The rates of ESBL and AmpC beta-lactamase production in 96 cefoxitin-resistant isolates were 54 % and 45 %, respec tively. The antibiotics resistance patterns were compared among the three groups of AmpC producers, AmpC and ESBL cop roducers and ESBL producers. Piperacillin-tazobactam resistance were found to be 33 %, 40 %, 26 %; ciprofloxacin resistance were 44 %, 56 %, 93 %; trimethoprim-sulfamethoxazole resistance were 22 %, 64 %, 78 %; and gentamicin resistance were 17 %, 44 % 63 % in AmpC beta-lactamase producers, ESBL and AmpC beta-lactamase coproducers and ESBL producers respectively.

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