Karbapeneme duyarlı ve dirençli klebsiella pneumoniae suşlarındaki biyofilm üretiminin fenotipik ve genotipik olarak karşılaştırılması
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Karbapenem dirençli ve karbapenem duyarlı K. pneumoniae suşlarındaki biyofilm üretiminin karşılaştırılması ve biyofilm üretiminde görev aldığı düşünülen virülans faktörlerine ait genlerin varlığını araştırarak karbapenem direnci ile bir ilişkisi olup olmadığını tespit edilmesi amaçlandı. Çalışmaya 37 karbapenem dirençli ve aynı dönemde izole edilen 63 tane karbapnem duyarlı K. pneumoniae dahil edildi. Antibiyotik duyarlılıkları otomatize sistem kullanılarak saptandı. Biyofilm üretiminde rol aldığı düşünülen virülans faktörlerine ait genlerin (mrkA, wbbm, wzm, luxS) varlığı polimeraz zincir reaksiyonu yöntemiyle, suşların biyofilm oluşumu spektrofotometrik mikropleyt yöntemi kullanılarak araştırıldı. Suşların izole edildiği klinik örnekler sırasıyla idrar 62 (%62), trekeal aspirat 13 (%13), yara 12 (%12), kan 11 (%11) ve balgam 2 (%2) şeklinde olmuştur. Klinik örneklerin %30'u yoğun bakım ünitelerinden, %70'inin diğer kliniklerden gönderildiği tespit edildi. Suşların 65 (%65)'i MDR olarak belirlendi. Karbapenem direnç oranı %37 idi. Karbapeneme dirençli suşlar amoksisilin/klavulanik asit, piperasillin/tazobaktam, sefoksitin, seftazidim, seftriakson, sefuroksim, sefuroksim aksetil, amikasin, siprofloksasin ve trimetoprim/sülfametaksazole karşı karbapeneme duyarlı olanlardan daha dirençli olduğu saptandı. Suşların biyofilm üretiminde, 1'i (%1) güçlü, 30'u (%30) orta, 45'i (%45) zayıf olmak üzere 76'sında biyofilm üretimi görülürken 24 tane suşta biyofilm üretimi görülmedi. Karbapenem dirençli suşların tamamında biyofilm üretimi görülürken karbapenem duyarlı suşların %61,9'unun biyofilm ürettiği saptandı (p<0,001). Suşlarda en çok (%73) tespit edilen gen mrkA geni idi. Bunu sırasıyla wzm (%68), wbbM (%57) ve luxS (%52) genleri takip etti. Ayrıca karbapenem dirençli olan 37 suşun %70,2'sinde mrkA, %54'ünde wbbM, %51,3'ünde luxS ve %21,6'sında wzm geni tespit edildi Sonuç olarak karbapenem dirençli olan suşların diğer antibiyotiklere daha dirençli olduğu, MDR oranının karbapenem duyarlı olan suşlardan daha fazla olduğu bulundu. Karbapenem dirençli olanların hepsinin biyofilm ürettiği bulundu. Biyofilm üretimi olan suşlardaki MDR oranının daha fazla olduğu belirlendi. Biyofilm üreten suşlarda ertapenem, meropenem, amikasin, piperasilin/tazobaktam, sefoksitin, seftazidim, seftriakson direncinin daha fazla olduğu saptandı. Bu antibiyotiklerin MİK değerleri biyofilm üreten suşlarda daha fazla bulundu.
It was aimed to compare the biofilm production in carbapenem resistant and carbapenem susceptible K. pneumoniae strains and to determine whether there is a relationship with carbapenem resistance by investigating the presence of genes belonging to virulence factors thought to be involved in biofilm production. 37 carbapenem-resistant and 63 carbapenem-susceptible K. pneumoniae isolated in the same period were included in the study. Antibiotic sensitivities were determined using an automated system. The presence of genes (mrkA, wbbM, wzm, luxS) of virulence factors thought to play a role in biofilm production was investigated by polymerase chain reaction method. Biofilm formation of the strains was determined using the spectrophotometric microplate method. The clinical samples from which strains were isolated were urine 62 (62%), tracheal aspirate 13 (13%), wound 12 (12%), blood 11 (11%), and sputum 2 (2%). It was determined that 30% of the clinical samples were sent from intensive care units and 70% of them were sent from other clinics. 65 (65%) of the strains were determined as MDR. Carbapenem resistance rate was 37%. Carbapenem resistant strains were also found to be more resistant to amoxicillin/clavulanic acid, piperacillin/tazobactam, cefoxitin, ceftazidime, ceftriaxone, cefuroxime, cefuroxime axetil, amikacin, ciprofloxacin and trimethoprim/sulfamethoxazole. While biofilm production was observed in 76 (76%) of the strains, 1 (1%) was strong, 30 (30%) was medium, 45 (45%) was weak, biofilm production could not be detected in 24 strains. All carbapenem resistant strains produced biofilm, while 61.9% of carbapenem susceptible strains produced biofilm (p<0,001). The most (73%) detected gene in the isolates was mrkA. This was followed by wzm (68%), wbbM (57%) and luxS (52%) genes, respectively. In addition, mrkA gene was detected in 70.2% of 37 carbapenem resistant strains, wbbM in 54%, luxS in 51.3%, and wzm in 21.6%. As a result, it was found that the strains resistant to carbapenem were more resistant to other antibiotics, and the MDR rate was higher than the strains that were susceptible to carbapenems. It was determined that the MDR ratio was higher in the strains with biofilm production. It was determined that ertapenem, meropenem, amikacin, piperacillin/tazobactam, cefoxitin, ceftazidime and ceftriaxone resistance were higher in biofilm producing strains. MIC values of these antibiotics were higher in biofilm producing strains.
It was aimed to compare the biofilm production in carbapenem resistant and carbapenem susceptible K. pneumoniae strains and to determine whether there is a relationship with carbapenem resistance by investigating the presence of genes belonging to virulence factors thought to be involved in biofilm production. 37 carbapenem-resistant and 63 carbapenem-susceptible K. pneumoniae isolated in the same period were included in the study. Antibiotic sensitivities were determined using an automated system. The presence of genes (mrkA, wbbM, wzm, luxS) of virulence factors thought to play a role in biofilm production was investigated by polymerase chain reaction method. Biofilm formation of the strains was determined using the spectrophotometric microplate method. The clinical samples from which strains were isolated were urine 62 (62%), tracheal aspirate 13 (13%), wound 12 (12%), blood 11 (11%), and sputum 2 (2%). It was determined that 30% of the clinical samples were sent from intensive care units and 70% of them were sent from other clinics. 65 (65%) of the strains were determined as MDR. Carbapenem resistance rate was 37%. Carbapenem resistant strains were also found to be more resistant to amoxicillin/clavulanic acid, piperacillin/tazobactam, cefoxitin, ceftazidime, ceftriaxone, cefuroxime, cefuroxime axetil, amikacin, ciprofloxacin and trimethoprim/sulfamethoxazole. While biofilm production was observed in 76 (76%) of the strains, 1 (1%) was strong, 30 (30%) was medium, 45 (45%) was weak, biofilm production could not be detected in 24 strains. All carbapenem resistant strains produced biofilm, while 61.9% of carbapenem susceptible strains produced biofilm (p<0,001). The most (73%) detected gene in the isolates was mrkA. This was followed by wzm (68%), wbbM (57%) and luxS (52%) genes, respectively. In addition, mrkA gene was detected in 70.2% of 37 carbapenem resistant strains, wbbM in 54%, luxS in 51.3%, and wzm in 21.6%. As a result, it was found that the strains resistant to carbapenem were more resistant to other antibiotics, and the MDR rate was higher than the strains that were susceptible to carbapenems. It was determined that the MDR ratio was higher in the strains with biofilm production. It was determined that ertapenem, meropenem, amikacin, piperacillin/tazobactam, cefoxitin, ceftazidime and ceftriaxone resistance were higher in biofilm producing strains. MIC values of these antibiotics were higher in biofilm producing strains.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji, Microbiology
