Karbapenem Dirençli Enterobactericeae Türlerinin Antibiyotik Duyarlılıklarının İki Farklı Panelle (Phoenix BD) Karşılaştırılması
Öz
Amaç: Bu çalışmanın amacı; hastanemiz mikrobiyoloji laboratuvarında izole edilen karbapenem dirençli Enterobactericeae türlerinin antibiyotik duyarlılıklarının iki farklı panelle karşılaştırılması ve CPO testinin perfomansının değerlendirilmesidir.
Gereç ve Yöntemler: 01.01.2020-31.12.2020 tarihleri arasında hastanemiz mikrobiyoloji laboratuvarına gönderilen örnekler değerlendirilmiştir. Üremesi olan örnekler BD Phoenix 100 otomatize sistem BD Phoenix NMIC 433 paneline yüklenmiş olup, karbapenem dirençli olarak sonuçlanan 50 Enterobacteriaceae izolatı BD Phoenix NMIC 505 CPO paneliyle çalışılmıştır. Karbapenem dirençli 50 Enterobacteriaceae izolatı CPO paneliyle Ambler sınıfına göre
A, B ve D’ye göre sınıflandırılmıştır.
Bulgular: İzolatların 28’i (%56) erkek hastalardan, 22’si (%44) kadın hastalardan izole edilmiştir. Karbapenem dirençli Enterobacteriaceae izolatlarının 43’ü (%86) Klebsiella pneumoniae, 4’ü (%8) Escherichia coli olarak saptanmıştır. Karbapenem dirençli Enterobacteriaceae izolatlarının CPO paneli ve NMIC 433 panelinin antibiyotik duyarlılık oranlarının değerlendirmesi incelendiğinde; iki panelde de çalışılan 50 Enterobacteriaceae izolatının antibiyotik
duyarlılık sonuçlarının aynı olduğu saptanmıştır. CPO panelinde çalışılabilen antibiyotikler incelendiğinde en etkili antibiyotiğin seftazidim-avibaktam olduğu gözlenmiştir. Sonuçlar incelendiğinde seftazidim-avibaktama 46 (%92) izolatın duyarlı olduğu gözlemlenmiştir. Sınıf B karbapenemaz üreten bakteri sayısı 4 (%8), sınıf D karbapenemaz üreten bakteri sayısı 42 (%84) olarak belirlenmiştir.
Sonuçlar: Seftazidim-avibaktamın karbapenem dirençli türlerde tedavi seçeneği olarak kullanılabileceği unutulmamalıdır. CPO paneli ile ilgili daha fazla çalışma yapılması, CPO panelinin rutin iş akışına katkısının belirlenmesine fayda sağlayacaktır.
Anahtar Kelimeler
Antimikrobiyal duyarlılık testi CPO panel Enterobactericeae karbapenemaz seftazidim avibaktam.
Destekleyen Kurum
DESTEKLEYEN KURUM BULUNMAMAKTADIR.
Teşekkür
İlgilendiğiniz için teşekkür ederim.
Kaynakça
- Taşova Y. Gram negatif enterik bakteri infeksiyonlarının yönetimi. Ankem Derg. 2011;25(2):33-44.
- Nordmann P, Naas T, Poirel L. Global spread of Carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis. 2011;17(10):1791-1798.
- Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clinical microbiology reviews. 2001;14(4):933-951.
- Castanheira M, Farrell SE, Krause KM, Jones RN, Sader HS. Contemporary diversity of β-lactamases among Enterobacteriaceae in the nine US census regions and ceftazidime-avibactam activity tested against isolates producing the most prevalent β-lactamase groups. Antimicrobial agents and chemotherapy. 2014;58(2):833-838.
- Ehmann DE, Jahić H, Ross PL, Gu R-F, Hu J, Kern G et al. Avibactam is a covalent, reversible, non–β-lactam β-lactamase inhibitor. Proceedings of the National Academy of Sciences. 2012;109(29):11663-11668.
- Shirley M. Ceftazidime-avibactam: A review in the treatment of serious gram-negative bacterial infections. Drugs. 2018;78(6):675-692.
- Simon M, Gatermann S, Pfeifer Y, Reischl U, Gessner A, Jantsch J. Evaluation of the automated BD Phoenix CPO Detect panel in combination with the β-CARBA assay for detection and classification of carbapenemase-producing Enterobacterales. Journal of microbiological methods. 2019;156:29-33.
- Güran M. Karbapenemaz enzimleri: Türkiye'deki durum üzerine bir derleme. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2016;36(2):98-105.
- Oteo J, Saez D, Bautista V, Fernandez-Romero S, Hernandez-Molina JM, Perez-Vazquez M et al. Carbapenemase-producing enterobacteriaceae in Spain in 2012. Antimicrob Agents Chemother. 2013;57(12):6344-6347.
- Zhang Y, Wang Q, Yin Y, Chen H, Jin L, Gu B et al. Epidemiology of Carbapenem-Resistant Enterobacteriaceae infections: Report from the China CRE network. Antimicrob Agents Chemother. 2018;62(2):e01882-17.
- Glasner C, Albiger B, Buist G, Andrašević AT, Canton R, Carmeli Y et al. Carbapenemase-producing Enterobacteriaceae in Europe: A survey among national experts from 39 countries, February 2013. Eurosurveillance. 2013;18(28):20525.
- Pollett S, Miller S, Hindler J, Uslan D, Carvalho M, Humphries R. Phenotypic and molecular characteristics of carbapenem-resistant Enterobacteriaceae in a health care system in Los Angeles, California, from 2011 to 2013. Journal of clinical microbiology. 2014;52(11):4003-9.
- Balkan II, Aygün G, Aydın S, Mutcalı SI, Kara Z, Kuşkucu M, et al. Blood stream infections due to OXA-48-like carbapenemase-producing Enterobacteriaceae: treatment and survival. International Journal of Infectious Diseases. 2014;26:51-56.
- Karlowsky JA, Biedenbach DJ, Kazmierczak KM, Stone GG, Sahm DF. Activity of ceftazidime-avibactam against extended-spectrum-and AmpC β-lactamase-producing Enterobacteriaceae collected in the INFORM global surveillance study from 2012 to 2014. Antimicrobial agents and chemotherapy. 2016;60(5):2849-2857.
- Kazmierczak KM, Biedenbach DJ, Hackel M, Rabine S, de Jonge BL, Bouchillon SK et al. Global dissemination of blaKPC into bacterial species beyond Klebsiella pneumoniae and in vitro susceptibility to ceftazidime-avibactam and aztreonam-avibactam. Antimicrobial agents and chemotherapy. 2016;60(8):4490-4500.
- de Jonge BL, Karlowsky JA, Kazmierczak KM, Biedenbach DJ, Sahm DF, Nichols WW. In vitro susceptibility to Ceftazidime-Avibactam of Carbapenem-Nonsusceptible Enterobacteriaceae isolates collected during the INFORM global surveillance study (2012 to 2014). Antimicrob Agents Chemother. 2016;60(5):3163-3169.
- Nichols WW, de Jonge BL, Kazmierczak KM, Karlowsky JA, Sahm DF. In vitro susceptibility of global surveillance isolates of Pseudomonas aeruginosa to Ceftazidime-Avibactam (INFORM 2012 to 2014). Antimicrob Agents Chemother. 2016;60(8):4743-4749.
- Aydemir O, Terzi HA, Koroglu M, Altindis M. In vitro activity of Ceftolozane/tazobactam and Ceftazidime/avibactam against carbapenemase-producing Pseudomonas aeruginosa. Mediterr J Infect M. 2019;8(5).
- van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence. 2017;8(4):460-469.
- Karakullukçu A, Borsa BA, Kuşkucu MA, Bakır E, Taner Z, Özalp VC et al. Karbapeneme dirençli enterik bakterilerde isepamisin, kloramfenikol ve minosiklin duyarlılığının araştırılması. Klimik Journal/Klimik Dergisi. 2018;31(1):50-55.
- Cakar A, Akyon Y, Gur D, Karatuna O, Ogunc D, Baysan BO et al. Investigation of carbapenemases in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae strains isolated in 2014 in Turkey. Mikrobiyoloji Bulteni. 2016;50(1):21-33.
- Yapıcı O, Yapıcı H, Pekintürk NS, Akgüneş A, Akgül S, Ekinci B. Karbapenemaz üreten Enterobacteriaceae izolatlarının immünokromatografik kart test RESIST-3 OKN K-SET ile değerlendirilmesi. Ege Tıp Dergisi. 2019;58(4):370-374.
- Uyanık Parlak A, Güdücüoğlu H, Parlak M, Bayram Y, Otlu B. Klebsiella pneumoniae suşlarında OXA-48 ve alt türevlerinin araştırılması ve fenotipik yansıma. ANKEM Derg. 2021;35(1):1-8.
Comparison of Antibiotic Susceptibility of Carbapanem-Resistant Enterobactericeae Species with Two Different Panels (Phoenix BD)
Öz
Objective: The aim of this study is to compare the antibiotic susceptibility of carbapanem-resistant Enterobactericeae strains isolated in the microbiology laboratory of our hospital with two different panels and to evaluate the performance of the CPO test.
Material and Methods: The samples sent to the microbiology laboratory of our hospital between 01.01.2020-31.12.2020 were evaluated. Specimens with growth were loaded into the BD Phoenix 100 automated system BD Phoenix NMIC 433 panel, and 50 isolates of Enterobacteriaceae that resulted in carbapenem resistant were studied with the BD Phoenix NMIC 505 CPO panel. 50 carbapenem-resistant Enterobacteriaceae isolates were classified according to Ambler class A, B, and D by the CPO panel.
Results: Of the isolates, 28 (56%) were isolated from male patients and 22 (44%) from female patients. Of the carbapenem-resistant Enterobacteriaceae isolates, 43 (86%) were identified as Klebsiella pneumoniae and 4 (8%) were Escherichia coli. When the evaluation of antibiotic susceptibility rates of the CPO panel and NMIC 433 panel of carbapenem-resistant Enterobacteriaceae isolates were examined; Antibiotic susceptibility results of 50 Enterobacte-
riaceae isolates studied in both panels were found to be the same. When the antibiotics that can be studied in the CPO panel were examined, it was observed that the most effective antibiotic was ceftazidime-avibactam. When the results were examined, it was observed that 46 (92%) isolates were susceptible to ceftazidime-avibactam. The number of bacteria producing class B carbapenemase was 4 (8%) and the number of bacteria producing class D carbapenemase was 42 (84%).
Conclusions: It should be noted that ceftazidime-avibactam can be used as a treatment option in carbapenem-resistant species. Further work on the CPO panel will help identify the contribution of the CPO panel to the routine workflow.
Anahtar Kelimeler
Antimicrobial susceptibility test carbapenemase ceftazidime avibactam CPO panel Enterobactericeae.
Kaynakça
- Taşova Y. Gram negatif enterik bakteri infeksiyonlarının yönetimi. Ankem Derg. 2011;25(2):33-44.
- Nordmann P, Naas T, Poirel L. Global spread of Carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis. 2011;17(10):1791-1798.
- Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clinical microbiology reviews. 2001;14(4):933-951.
- Castanheira M, Farrell SE, Krause KM, Jones RN, Sader HS. Contemporary diversity of β-lactamases among Enterobacteriaceae in the nine US census regions and ceftazidime-avibactam activity tested against isolates producing the most prevalent β-lactamase groups. Antimicrobial agents and chemotherapy. 2014;58(2):833-838.
- Ehmann DE, Jahić H, Ross PL, Gu R-F, Hu J, Kern G et al. Avibactam is a covalent, reversible, non–β-lactam β-lactamase inhibitor. Proceedings of the National Academy of Sciences. 2012;109(29):11663-11668.
- Shirley M. Ceftazidime-avibactam: A review in the treatment of serious gram-negative bacterial infections. Drugs. 2018;78(6):675-692.
- Simon M, Gatermann S, Pfeifer Y, Reischl U, Gessner A, Jantsch J. Evaluation of the automated BD Phoenix CPO Detect panel in combination with the β-CARBA assay for detection and classification of carbapenemase-producing Enterobacterales. Journal of microbiological methods. 2019;156:29-33.
- Güran M. Karbapenemaz enzimleri: Türkiye'deki durum üzerine bir derleme. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2016;36(2):98-105.
- Oteo J, Saez D, Bautista V, Fernandez-Romero S, Hernandez-Molina JM, Perez-Vazquez M et al. Carbapenemase-producing enterobacteriaceae in Spain in 2012. Antimicrob Agents Chemother. 2013;57(12):6344-6347.
- Zhang Y, Wang Q, Yin Y, Chen H, Jin L, Gu B et al. Epidemiology of Carbapenem-Resistant Enterobacteriaceae infections: Report from the China CRE network. Antimicrob Agents Chemother. 2018;62(2):e01882-17.
- Glasner C, Albiger B, Buist G, Andrašević AT, Canton R, Carmeli Y et al. Carbapenemase-producing Enterobacteriaceae in Europe: A survey among national experts from 39 countries, February 2013. Eurosurveillance. 2013;18(28):20525.
- Pollett S, Miller S, Hindler J, Uslan D, Carvalho M, Humphries R. Phenotypic and molecular characteristics of carbapenem-resistant Enterobacteriaceae in a health care system in Los Angeles, California, from 2011 to 2013. Journal of clinical microbiology. 2014;52(11):4003-9.
- Balkan II, Aygün G, Aydın S, Mutcalı SI, Kara Z, Kuşkucu M, et al. Blood stream infections due to OXA-48-like carbapenemase-producing Enterobacteriaceae: treatment and survival. International Journal of Infectious Diseases. 2014;26:51-56.
- Karlowsky JA, Biedenbach DJ, Kazmierczak KM, Stone GG, Sahm DF. Activity of ceftazidime-avibactam against extended-spectrum-and AmpC β-lactamase-producing Enterobacteriaceae collected in the INFORM global surveillance study from 2012 to 2014. Antimicrobial agents and chemotherapy. 2016;60(5):2849-2857.
- Kazmierczak KM, Biedenbach DJ, Hackel M, Rabine S, de Jonge BL, Bouchillon SK et al. Global dissemination of blaKPC into bacterial species beyond Klebsiella pneumoniae and in vitro susceptibility to ceftazidime-avibactam and aztreonam-avibactam. Antimicrobial agents and chemotherapy. 2016;60(8):4490-4500.
- de Jonge BL, Karlowsky JA, Kazmierczak KM, Biedenbach DJ, Sahm DF, Nichols WW. In vitro susceptibility to Ceftazidime-Avibactam of Carbapenem-Nonsusceptible Enterobacteriaceae isolates collected during the INFORM global surveillance study (2012 to 2014). Antimicrob Agents Chemother. 2016;60(5):3163-3169.
- Nichols WW, de Jonge BL, Kazmierczak KM, Karlowsky JA, Sahm DF. In vitro susceptibility of global surveillance isolates of Pseudomonas aeruginosa to Ceftazidime-Avibactam (INFORM 2012 to 2014). Antimicrob Agents Chemother. 2016;60(8):4743-4749.
- Aydemir O, Terzi HA, Koroglu M, Altindis M. In vitro activity of Ceftolozane/tazobactam and Ceftazidime/avibactam against carbapenemase-producing Pseudomonas aeruginosa. Mediterr J Infect M. 2019;8(5).
- van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence. 2017;8(4):460-469.
- Karakullukçu A, Borsa BA, Kuşkucu MA, Bakır E, Taner Z, Özalp VC et al. Karbapeneme dirençli enterik bakterilerde isepamisin, kloramfenikol ve minosiklin duyarlılığının araştırılması. Klimik Journal/Klimik Dergisi. 2018;31(1):50-55.
- Cakar A, Akyon Y, Gur D, Karatuna O, Ogunc D, Baysan BO et al. Investigation of carbapenemases in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae strains isolated in 2014 in Turkey. Mikrobiyoloji Bulteni. 2016;50(1):21-33.
- Yapıcı O, Yapıcı H, Pekintürk NS, Akgüneş A, Akgül S, Ekinci B. Karbapenemaz üreten Enterobacteriaceae izolatlarının immünokromatografik kart test RESIST-3 OKN K-SET ile değerlendirilmesi. Ege Tıp Dergisi. 2019;58(4):370-374.
- Uyanık Parlak A, Güdücüoğlu H, Parlak M, Bayram Y, Otlu B. Klebsiella pneumoniae suşlarında OXA-48 ve alt türevlerinin araştırılması ve fenotipik yansıma. ANKEM Derg. 2021;35(1):1-8.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Mart 2023 |
| Gönderilme Tarihi | 17 Aralık 2021 |
| Kabul Tarihi | 30 Mart 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 18 Sayı: 1 |
