Selma Ay, Ayfer Serindağ, Fikret Karademir, Barış Otlu, Mehmet Sait Tekerekoğlu, Ahmet Mansur

MBL E Test Araştırmasında 5 Farklı Marka Müller-Hinton Agar Besiyerlerinden Elde Edilen Sonuçların Değerlendirilmesi

Amaç: Karbapenem dirençli Pseudomonas aeruginosa izolatlarında MBL taraması için MBL E test; hızlı ve güvenilir fenotipik test olarak önerilmektedir. Ancak antibiyotik duyarlılık testlerinde MBL E testinde kullanılan farklı marka Müeller- Hinton Agar (MHA) besiyerlerinde karbapenem MİK değerleri ve MBL E test sonuçlarının etkilenebileceğini gösteren çalışmalar mevcuttur. Bu nedenle çalışmamızda 5 farklı marka MHA besiyeri kullanarak, rutin mikrobiyoloji laboratuarlarında MBL E test araştırılmasında kullanılabilecek en uygun marka MHA besiyerini belirlemeyi amaçladık. Gereçler ve Yöntemler: Çalışmada yatan hastalardan izole edilen, karbapenemlere dirençli 29 Pseudomonas aeruginosa izolatları konvansiyonel yöntemler ile tanımlanmıştır. Karbapenem direncini doğrulamak için imipenem ve meropenem E test (AB BIODISK, Solna, İsveç) kullanılmıştır. MBL üretimini belirlemek için MBL E test (AB BIODISK, Solna, İsveç) beş farklı marka (Oxoid, BBL, Merck, Himedia, Plasmatec) Müller Hinton agar (MHA) besiyerinde test edilmiş ve elde edilen sonuçlar Polimeraz Zincir Reaksiyonu sonuçları ile karşılaştırılmıştır. Bulgular: Karbapenemlere dirençli 29 izolatta Polimeraz Zincir Reaksiyonu ile IMP, VIM, GIM, SIM ve SPM tipi metallo beta-laktamaz geni saptanmamıştır. MBL E test ile BBL marka MHA besiyerinde bir izolat (1/29), Oxoid marka MHA besiyerinde iki izolat (2/29), Himedia marka MHA besiyerinde 19 izolat (19/29) Merck marka MHA besiyerinde 21 izolat (21/29), Plasmatec marka MHA besiyerinde 27 izolat (27/29) pozitif sonuç vermiştir. Sonuç: Moleküler tanı yapma olanağı olmayan laboratuvarlarda MBL E test araştırmalarında BBL ve Oxoid marka besiyerlerinin, diğer besiyerlerine oranla daha güvenilir bir şekilde kullanılabileceği sonucuna varılmıştır.

Evaluation of Metallo Beta Lactamase E test Results from Different Brands of Mueller Hinton Agar Plates

Aim: MBL E test for MBL screening in carbapenem resistant Pseudomonas aeruginosa isolatesis recommended as a fast and reliable phenotypic screening test. However, as it has been putforward by some reserachers, because of variations in antibiotic susceptibility tests or MBL Etest with different brands of Müeller- Hinton Agar (MHA) media, the possibility thatcarbapenem MIK values and MBL E test results can, therefore, be influenced by these media.To this end, we aim to determine the most suitable MHA media to be used in search for MBLE test in routine microbiology laboratories by employing five different brands of MHA media.Materials and Methods: 29 carbapenem resistant Pseudomonas aeruginosa strains isolatedfrom hospitalised patients have been used in this study. P.aeruginosa isolates were identifiedby conventional methods. Imipenem and meropenem E test were used for verification ofcarbapenem resistance. MBL E test was used for detecting MBL production by five differentbrands of Mueller Hinton agar plates and the results of these tests were compared withpolymerase chain reaction (PCR) results.Results: IMP, VIM, GIM, SIM and SPM type genes were found to be negative with polymerasechain reaction for 29 isolates that were resistant to carbapenem. One isolate with BBL brandMHA, two isolates with Oxoid brand MHA, 19 isolates with Himedia brand MHA, 21 isolateswith Merck brand MHA, and 27 isolates with Plasmatec brand MHA gave positive results.Conclusion: The present results indicate that use of BBL or Oxoid brand MHA media,especially in laboratories without any fascilities for molecular diagnosis, can be more reliablecompared to other brands.

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