Uğur KOSTAKOGLU, Ayse ERTÜRK, İlknur Esen YILDIZ, Songül ÖZYURT, Ayşegül ÇOPUR ÇİÇEK, Mevlüt KARATAŞ, Emine SÖNMEZ

Yoğun Bakım Ünitesinden Alınan Alt Solunum Yolu Örneklerinde Üretilen Acinetobacter baumannii İzolatlarında Antibiyotik Direnci ve İntegron Gen Kasetleri

Amaç: Antibiyotik direnç genlerinin bakteriler arasındaki yayılımı, enfeksiyon hastalıklarının tedavisinde ciddi sorunlara yol açmaktadır. Son zamanlarda bu direnç genlerin integronlarda da bulunduğu gösterilmiştir. Bu çalışmada alt solunum yollarından alınan kültürlerde üretilen infeksiyon etkeni olan Acinetobacter baumannii suşlarında sınıf 1, sınıf 2 integron varlığı ve antibiyotik direnç genleri araştırıldı.

Anahtar Kelimeler:

Acinetobacter baumannii, Antibiyotik direnç genleri, alt solunum yolu örnekleri, integron

ANTIBIOTIC RESISTANCE AND INTEGRON GENE CASSETTES IN ACINETOBACTER BAUMANNII ISOLATES PRODUCED IN LOWER RESPIRATORY TRACT SAMPLES TAKEN FROM THE INTENSIVE CARE UNIT

Objective: The spread of antibiotic resistance genes among bacteria causes serious problems in the treatment of infectious diseases. Recently, it has been shown that these resistance genes are also found in integrons. This study investigated the class 1, 2 integrons and the antibiotic-resistant genes in the infection agent Acinetobacter baumannii produced in respiratory tract samples.

Keywords:

Acinetobacter baumannii, Lower respiratory tract specimens, Integron, Antibiotic-resistant genes,

PDF

___

1. Ellis D, Cohen B, Liu J, Larson E. Risk factors for hospital-acquired antimicrobial-resistant infection caused by Acinetobacter baumannii. Antimicrobial Resistance and Infection Control. 2015;4(40):1-5. Doi:10.1186/s13756-015-0083-2.
2. Anwar M, Ejaz H, Zafar A, Hamid H. Phenotypic Detection of metallo-beta lactamases in carbapenem resistant Acinetobacter baumannii isolated from pediatric patients in Pakistan. J Pathog. 2016;8603964. Doi:10.1155/2016/8603964.
3. Hussein NH, Al-Mathkhury HJF, Sabbah MA. Identification of imipenem-resistant genes in Acinetobacter baumannii isolated from Baghdad Hospitals. J Med Microb Diagn. 2014;3(6):170. Doi:10.4172/2161-0703.1000170.
4. Gaur A, Prakash P, Anupurba S, Mohapatra TM. Possible role of integrase gene polymerase chain reaction as an epidemiological marker: study of multidrug resistant Acinetobacter baumannii isolated from nosocomial infections. Int J Antimicrob Agents. 2007;29(4):446-50. Doi:10.1016/j.ijantimicag.2006.11.014.
5. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev. 2008;21(3):538-82. Doi:10.1128/CMR.00058-07.
6. Poirel L, Naas T, Nordmann P. Diversity, epidemiology, andgenetics of class D beta-lactamases. Antimicrob Agents Chemother. 2010;54(1):24-38. Doi:10.1128/AAC.01512-08.
7. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. M100-S24. USA. Clinical Laboratory Standards Institute, Wayne, 2014.
8. Navon-Venezia S, Leavitt A, Carmeli Y. High tigecycline resistance in multidrug-resistant Acinetobacter baumannii. J Antimicrob Chemother. 2007;59(4):772-774. Doi:10.1093/jac/dkm018.
9. Çopur Çiçek A, Düzgün AO, Saral A, Kayman T, Çizmeci Z, Balcı PÖ et al. Detection of class1integron in Acinetobacter baumannii isolates collected from nine hospitals in Turkey. Asian Pac J Trop Biomed. 2013;3(9):743-47. Doi:10.1016/S2221-1691(13)60149-5.
10. Çopur Çicek A, Saral A, Iraz M, Ceylan A, Duzgun AO, Peleg AY et al. OXA- and GES-type β-lactamases predominate in extensively drug-resistant Acinetobacter baumannii isolates from a Turkish University Hospital. Clin Microbiol Infect. 2014;20(5):410-5. Doi:10.1111/1469-0691.12338.
11. Copur Cicek A, Saral A, Ozad Duzgun A, Yasar E, Cizmeci Z, Balci PO et al. Nationwide study of Escherichia coli producing extended-spectrum β-lactamases TEM, SHV and CTX-M in Turkey. J Antibiot. 2013;66:647-650. Doi:10.1038/ja.2013.72.
12. Iraz M, Özad Düzgün A, Sandallı C, Doymaz MZ, Akkoyunlu Y, Saral A et al. Distribution of β-lactamase genes among carbapenem-resistant Klebsiella pneumoniae strains isolated from patients in Turkey. Ann Lab Med. 2015;35(6):595-601. Doi:10.3343/alm.2015.35.6.595.
13. Keskin H, Tekeli A, Dolapçı İ, Öcal D. Molecular characterization of beta-lactamase-associated resistance in Acinetobacter baumannii strains isolated from clinical samples. Mikrobiyol Bul. 2014;48(3):365-376. Doi:10.5578/mb.7796.
14. Sarı B, Baran I, Alaçam S, Mumcuoğlu İ, Kurşun Ş, Aksu N. Investigation of oxacillinase genes in nosocomial multidrug-resistant Acinetobacter baumannii isolates by multiplex PCR and evaluation of their clonal relationship with rep-PCR. Mikrobiyol Bul. 2015;49(2):249-58. Doi:10.5578/mb.8884.
15. Al-Agamy MH, Khalaf NG, Tawfick MM, Shibl AM, El Kholy A. Molecular characterization of carbapenem-insensitive Acinetobacter baumannii in Egypt. Int J Infect Dis. 2014;22:49-54. Doi:10.1016/j.ijid.2013.12.004.
16. Beriş FŞ, Budak EE, Gülek D, Uzun A, Çizmeci Z, Mengeloğlu FZ et al. Investigation of the frequency and distribution of beta-lactamase genes in the clinical isolates of Acinetobacter baumannii collected from different regions of Turkey: a multicenter study. Mikrobiyol Bul. 2016;50(4):511-21. Doi:10.5578/mb.29176.
17. Sesli Cetin E, Durmaz R, Tetik T, Otlu B, Kaya S, Çalışkan A. Epidemiologic characterization of nosocomial Acinetobacter baumannii infections in a Turkish university hospital by pulsed-field gel electrophoresis. Am J Infect Control. 2009;37(1):56-64. Doi:10.1016/j.ajic.2008.01.010.
18. Leila V, Dashti K, Opazo-Capurro AF, Dashti AA, Obaid KA, Evans BA. Diversity of multi-drug resistant Acinetobacter baumannii population in a major hospital in Kuwait. Front Microbiol. 2015;6:743. Doi:10.3389/fmicb.2015.00743.
19. Gao L, Lyu Y, Li Y. Trends in Drug Resistance of Acinetobacter baumannii over a 10year period: Nationwide data from the China surveillance of antimicrobial resistnace program. Chin Med J(Engl). 2017;130(6):659-64. Doi:10.4103/0366-6999.201601.
20. Li P, Wang X, Wang W, Zhao X. Comparision of the efficacies of three empirically selected antibiotics for treating Acinetobacter baumannii pulmonary infection: experience from a teaching hospital China. Int J Clin Pharmacol Ther. 2017;55(7):588-93. Doi:10.5414/CP202557.
21. Direkel Ş, Çopur Çiçek A, Karagöz A, Aydoğan Ejder N, Oktay E, Delialioğlu N et al. Antimicrobial susceptibility and molecular characterization of multidrug-resistant Acinetobacter baumannii isolated in a university hospital. Mikrobiyol Bul. 2016;50(4):522-34. Doi:10.5578/mb.34158.
22. Çıkman A, Parlak M, Gültepe B, Güdücüoğlu H, Berktaş M. Investigation of tigecycline sensitivity rates in nosocomial Acinetobacter baumannii isolates by E-Test. ANKEM Derg. 2011;25(2):79-83. Doi:10.5222/ankem.2011.079.
23. Deng Y, Bao X, Ji L, Chen L, Liu J, Miao J et al. Resistance integrons: class 1, 2 and 3 integrons. Ann Clin Microbiol Antimicrob. 2015;14:45. Doi:10.1186/s12941-015-0100-6. 24. Joshi PR, Acharya M, Kakshapati T, Leungtongkam U, Thummeepak R, Sitthisak S. Co-existence of blaOXA-23 and NDM-1 genes Acinetobacter baumannii isolated from Nepal: antimicrobial resistance and clinical significance. Antimicrob Resist Infect Control. 2017;6(21):1-7. Doi:10.1186/s13756-017-0180-5.
25. Khajuria A, Praharaj AK, Kumar M, Grover N. Molecular characterization of carbapenem resistant isolates of Acinetobacter baumannii in an intensive care unit of a tertiary care centre at Central India. J Clin Diagn Res. 2014;8(5):38-40. Doi:10.7860/JCDR/2014/7749. 4398.
26. Keyik S, Arslan U, Türk Dağı H, Seyhan T, Fındık D. Investigation of OXA type beta-lactamases and PFGE patterns in Acinetobacter baumannii strains resistant to carbapenems. Mikrobiyol Bul. 2014;48(4):556-65. Doi:10.5578/mb.8274.
27. Alyamani EJ, Khiyami MA, Booq RY, Alnafjan BM, Altammami MA, Bahwerth FS. Molecular characterization of extended spectrum-beta-lactamases (ESBLs) produced by clinical isolates of Acinetobacter baumannii in Saudi Arabia. Ann Clin Microbiol Antimicrob. 2015;14(38):1-9. Doi:10.1186/s12941-015-0098-9.
28. Safari M, Mozaffari Nejad AS, Bahador A, Jafari R, Alikhani MY. Prevalence of ESBL and MBL encoding genes in Acinetobacter baumannii strains isolated from patients of intensive care units (ICU). Saudi J Biol Sci. 2015;22(4):424-29. Doi:10.1016/j.sjbs.2015.01.004.
29. El-Shazly S, Dashti A, Vali L, Bolaris M, Ibrahim AS. Molecular epidemiology and characterization of multiple drug-resistant (MDR) clinical isolates of Acinetobacter baumannii. Int J Infect Dis. 2015;41:42–9. Doi:10.1016/j.ijid.2015.10.016.
30. Zeka AN, Poirel L, Sipahi OR, Bonnin RA, Arda B, Ozinel MA et al. GES-type and OXA-23 carbapenemase-producing Acinetobacter baumannii in Turkey. J Antimicrob Chemother. 2014;69(4):1145-6. Doi:10.1093/jac/dkt465.
31. Moubareck C, Brémont S, Conroy MC, Courvalin P, Lambert T. GES-11, a novel integron-associated GES variant in Acinetobacter baumannii. Antimicrob Agents Chemother. 2009;53(8):3579-81. Doi:10.1128/AAC.00072-09.
32. Aşık G, Özdemir M, Kurtoğlu MG, Yağcı S. Detection of the frequency of PER-1 type extended-spectrum β-lactamase–producing Acinetobacter baumannii clinical isolates in Turkey: a multicenter study. Turk J Med Sci. 2014;44(6):1041-6. Doi:10.3906/sag-1309-126.
33. Pritsch M, Zeynudin A, Messerer M, Baumer S, Liegl G, Schubert S et al. First report on bla NDM-1 producing Acinetobacter baumannii in three clinical isolates from Ethiopia. BMC Infect Dis. 2017;17(1):180. Doi:10.1186/s12879-017-2289-9.
34. Voulgari E, Politi L, Pitiriga V, Dendrinos J, Poulou A, Georgiadis G et al. First report of an NDM-1 metallo-β-lactamase-producing Acinetobacter baumannii clinical isolate in Greece. Int J Antimicrob Agents. 2016;48(6):761-62. Doi:10.1016/j.ijantimicag.2016.09.006.
35. Shoja S, Moosavian M, Roztami S, Abbasi F, Tabatabaiefer MA, Peymani A et al. Characterization of oxacillinase and metallo-β- lactames genes and moleculer typing of clinical isolates of Acinetobacter baumannii in Ahvaz, South-West of Iran. Jundishapur J Microbiol. 2016;9(5):e32388. Doi:10.5812/jjm.32388.