Gülşen ALTINKANAT GELMEZ, Ufuk HASDEMİR, Güner SÖYLETİR

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

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.

Anahtar Kelimeler:

ESBL, IBC-1, E. coli, K. pneumoniae, E. cloacae

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

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.

Keywords:

GSBL, IBC-1, E. coli, K. pneumoniae, E. cloacae,

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