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    ANTIMICROBIAL RESISTANCE PROFILE OF ESCHERICHIA COLI CAUSING BACTEREMIA IN PATIENTS IN INTENSIVE CARE UNITS
    (Carbone Editore, 2015) Durmaz, Suleyman; Kiraz, Asli; Percin, Duygu; Doganay, Mehmet
    Aims: A crucial mechanism of antibiotic resistance of Escherichia coli (E.coli), a member of gram-negative bacteria that cause infections in intensive care units (ICUs), is beta-lactamase production. This study aims to determine extended-spectrum beta-lactamase (ESBL) production frequency and antibiotic resistance profile of E.coli strains isolated from blood cultures of adult patients in different intensive ICUs at Erciyes University-Kayseri, Turkey. Materials and methods: This study includes only one E.coli strain per patient. Antibiotic susceptibility test of 81 E.coli strains were performed using Kirby-Bauer disk diffusion method. ESBL-production was determined using double-disk synergy test. Results: A total of 58 (72%) strains were isolated from patients in internal ICUs while 23 (28%) strains were isolated from patients in surgical ICUs. A total of 44 (54.3%) strains were found to produce ESBL with ESBL-production rate of 55.2% in internal ICUs and 52.2% in surgical ICUs. Difference between the presence of ESBL-producing E.coli in male and female patients in ICUs is not statistically significant. 8 (9.8%), 46(56.8%), 69 (85.2%), 22 (27.2%), and 44 (543%) and zero strains were resistant to amikacine, ciprofloxacine, ampicillin, piperacillin-tazobactam, cefotaxime, and imipenem, respectively, and no strains were resistant to imipenenm. Resistance to amikacin, ciprofloxacin, ampicillin and cefotaxime in ESBL producing strains were significantly higher than ESBL non-producing strains (p<0.05). Piperacillin-tazobactam resistance ratio for E.coli strains isolated from surgical ICUs was found to be significantly greater than those isolated from internal ICUs (p<0.05). Despite higher ratios of ESBL-production of E.coli strains, carbapenem resistance was not gratifyingly determined in the ICUs. Conclusion: Early diagnosis and immediate treatment of nosocomial bacteremia are important for patients' survival. Therefore, monitoring antibiotic susceptibility profiles of isolated microorganisms will guide clinicians for controlling infections.
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    Antimicrobial resistance profile of Escherichia coli causing bacteremia in patients in intensive care units
    (Acta Medica Mediterranea, 2015) Durmaz, Suleyman; Kiraz, Asli; Percin, Duygu; Doganay, Mehmet
    Aims: A crucial mechanism of antibiotic resistance of Escherichia coli (E.coli), a member of gram-negative bacteria that cause infections in intensive care units (ICUs), is beta-lactamase production. This study aims to determine extended-spectrum betalactamase (ESBL) production frequency and antibiotic resistance profile of E.coli strains isolated from blood cultures of adult patients in different intensive ICUs at Erciyes University-Kayseri, Turkey. Materials and methods: This study includes only one E.coli strain per patient. Antibiotic susceptibility test of 81 E.coli strains were performed using Kirby-Bauer disk diffusion method. ESBL-production was determined using double-disk synergy test. Results: A total of 58 (72%) strains were isolated from patients in internal ICUs while 23 (28%) strains were isolated from patients in surgical ICUs. A total of 44 (54.3%) strains were found to produce ESBL with ESBL-production rate of 55.2% in internal ICUs and 52.2% in surgical ICUs. Difference between the presence of ESBL-producing E.coli in male and female patients in ICUs is not statistically significant. 8 (9.8%), 46 (56.8%), 69 (85.2%), 22 (27.2%), and 44 (54.3%) and zero strains were resistant to amikacine, ciprofloxacine, ampicillin, piperacillin-tazobactam, cefotaxime, and imipenem, respectively, and no strains were resistant to imipenenm. Resistance to amikacin, ciprofloxacin, ampicillin and cefotaxime in ESBL producing strains were significantly higher than ESBL non-producing strains (p<0.05). Piperacillin-tazobactam resistance ratio for E.coli strains isolated from surgical ICUs was found to be significantly greater than those isolated from internal ICUs (p<0.05). Despite higher ratios of ESBL-production of E.coli strains, carbapenem resistance was not gratifyingly determined in the ICUs. Conclusion: Early diagnosis and immediate treatment of nosocomial bacteremia are important for patients' survival. Therefore, monitoring antibiotic susceptibility profiles of isolated microorganisms will guide clinicians for controlling infections.
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    Öğe
    Macrolide-Lincosamide-Streptogramin B Resistance Phenotypes in Staphylococcus Aureus
    (Modestum Ltd, 2014) Durmaz, Suleyman; Kiraz, Asli; Ozer, Turkan Toka; Percin, Duygu
    Staphylococcus aureus is one of the most frequently isolated pathogens in community and hospital-acquired infections. Macrolidelincosamide- streptogramin B (MLSB) group antibiotics have frequently been preferred. In this study, it was aimed to determine MLSB group antibiotics resistance phenotypes observed in S. aureus strains. A total of 182 S. aureus strains were included in the study. Methicillin resistance was assessed using the cefoxitin (30 mu g) disc, MLSB resistance phenotypes were assessed using D zone test with erythromycin (15 mu g mu) and clindamycin (2 mu g) discs according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Of the strains included in the study, 38 (20.9%) methicillin-resistant S. aureus (MRSA) and 144 (79.1%) methicillin-susceptible S. aureus (MSSA) were identified. MLSB resistance phenotype was found in 65 (35.7%) strains. MLSB resistance was found 84% in MRSA strains and 23% in MSSA strains: There was statistically significant between MRSA and MSSA strains. Constitutional MLSB resistance was found higher in MRSA strains (71%) and however, in MSSA strains was higher inducibleMLSB resistance (16.5%). It is suggested that, using the D test method in routine antibiotic susceptibility testing and determining resistance phenotypes in microbiology laboratories is the right approach and may play an important role in the prevention of treatment failure according to the substantial proportion of inducible resistance MLSB resistance observed.