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[Resistance to newer beta-lactams and related ESBL types in gram-negative nosocomial isolates in Turkish hospitals: results of the multicentre HITIT study].
Mikrobiyol Bul. 2008 Oct; 42(4):537-44.MB

Abstract

Increasing resistance due to extended-spectrum beta-lactamases (ESBLs) and multiple resistance mechanisms in gram-negative hospital isolates restrict the role of beta-lactam antibiotics in empirical treatment of serious infections. As the prevalence of ESBL producing strains and resistance rates to antimicrobial agents can vary in each center, local surveillance studies are required to guide therapy. In this study, in vitro rates of resistance to ceftriaxone, ceftazidime, cefepime, imipenem, cefoperazone/sulbactam and piperacillin/tazobactam were evaluated in 1196 gram-negative hospital isolates in a multicenter in vitro study with the participation of six different centers in Turkey between the period of June 2004-January 2005. The isolates included Escherichia coli (n= 457), Klebsiella pneumoniae (n= 390), Pseudomonas aeruginosa (n= 194) and Acinetobacter boumannii (n= 155). In addition, frequency of ESBL production and types of enzymes were determined in blood isolates of E. coli and K. pneumoniae. MICs and ESBL production were investigated by E-test (AB Biodisk, Solna) and the results were evaluated by using CLSI breakpoints. PCR analysis was used for typing of the ESBLs. In E. coli, 26% and in K. pneumoniae 32% of the isolates were ESBL producers. Among the blood isolates of E. coli and K. pneumoniae, 31.7% and 33.3% produced ESBLs, respectively. CTX-M (71.4%) was the most prevalent enzyme, followed by TEM (49.4%) and SHV (46.7%) derived enzymes. CTX-M-15 (69.4%) was the most frequent CTX-M type in blood isolates followed by CTX-M-3 (28.6%) and CTX-M-1 (2%). Resistance to imipenem was not observed in E. coli isolates, however it was 1.3% in K. pneumoniae, 28.9% in P. aeruginosa and 52.2% in A. baumannii strains. Resistance to cefoperazone/sulbactam was found as 6%, 17.7%, 27.9% and 41.3% in E. coli, K. pneumoniae, P. aeruginosa and A. baumannii isolates, respectively, whereas resistance rates to piperacillin/tazobactam were 10.2%, 22.3%, 22.7% and 78.7%, respectively. These results indicate that ESBL production and rates of resistance to beta-lactam antibiotics are high in hospital isolates of gram-negative bacteria in Turkey, however, they show variations in different hospitals and CTX-M enzymes are prevalent in these isolates.

Authors+Show Affiliations

Hacettepe Universitesi Tip Fakültesi, Ihsan Doğramaci Cocuk Hastanesi, Klinik Mikrobiyoloji Laboratuvari, Ankara. dgur@hacettepe.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Multicenter Study

Language

tur

PubMed ID

19149074

Citation

Gür, Deniz, et al. "[Resistance to Newer Beta-lactams and Related ESBL Types in Gram-negative Nosocomial Isolates in Turkish Hospitals: Results of the Multicentre HITIT Study]." Mikrobiyoloji Bulteni, vol. 42, no. 4, 2008, pp. 537-44.
Gür D, Gülay Z, Akan OA, et al. [Resistance to newer beta-lactams and related ESBL types in gram-negative nosocomial isolates in Turkish hospitals: results of the multicentre HITIT study]. Mikrobiyol Bul. 2008;42(4):537-44.
Gür, D., Gülay, Z., Akan, O. A., Aktaş, Z., Kayacan, C. B., Cakici, O., Eraç, B., Gültekin, M., Oğünç, D., Söyletir, G., Unal, N., & Uysal, S. (2008). [Resistance to newer beta-lactams and related ESBL types in gram-negative nosocomial isolates in Turkish hospitals: results of the multicentre HITIT study]. Mikrobiyoloji Bulteni, 42(4), 537-44.
Gür D, et al. [Resistance to Newer Beta-lactams and Related ESBL Types in Gram-negative Nosocomial Isolates in Turkish Hospitals: Results of the Multicentre HITIT Study]. Mikrobiyol Bul. 2008;42(4):537-44. PubMed PMID: 19149074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Resistance to newer beta-lactams and related ESBL types in gram-negative nosocomial isolates in Turkish hospitals: results of the multicentre HITIT study]. AU - Gür,Deniz, AU - Gülay,Zeynep, AU - Akan,Ozay Arikan, AU - Aktaş,Zerrin, AU - Kayacan,Ciğdem Bal, AU - Cakici,Ozlem, AU - Eraç,Bayri, AU - Gültekin,Meral, AU - Oğünç,Dilara, AU - Söyletir,Güner, AU - Unal,Nilgün, AU - Uysal,Sevil, PY - 2009/1/20/entrez PY - 2009/1/20/pubmed PY - 2009/4/8/medline SP - 537 EP - 44 JF - Mikrobiyoloji bulteni JO - Mikrobiyol Bul VL - 42 IS - 4 N2 - Increasing resistance due to extended-spectrum beta-lactamases (ESBLs) and multiple resistance mechanisms in gram-negative hospital isolates restrict the role of beta-lactam antibiotics in empirical treatment of serious infections. As the prevalence of ESBL producing strains and resistance rates to antimicrobial agents can vary in each center, local surveillance studies are required to guide therapy. In this study, in vitro rates of resistance to ceftriaxone, ceftazidime, cefepime, imipenem, cefoperazone/sulbactam and piperacillin/tazobactam were evaluated in 1196 gram-negative hospital isolates in a multicenter in vitro study with the participation of six different centers in Turkey between the period of June 2004-January 2005. The isolates included Escherichia coli (n= 457), Klebsiella pneumoniae (n= 390), Pseudomonas aeruginosa (n= 194) and Acinetobacter boumannii (n= 155). In addition, frequency of ESBL production and types of enzymes were determined in blood isolates of E. coli and K. pneumoniae. MICs and ESBL production were investigated by E-test (AB Biodisk, Solna) and the results were evaluated by using CLSI breakpoints. PCR analysis was used for typing of the ESBLs. In E. coli, 26% and in K. pneumoniae 32% of the isolates were ESBL producers. Among the blood isolates of E. coli and K. pneumoniae, 31.7% and 33.3% produced ESBLs, respectively. CTX-M (71.4%) was the most prevalent enzyme, followed by TEM (49.4%) and SHV (46.7%) derived enzymes. CTX-M-15 (69.4%) was the most frequent CTX-M type in blood isolates followed by CTX-M-3 (28.6%) and CTX-M-1 (2%). Resistance to imipenem was not observed in E. coli isolates, however it was 1.3% in K. pneumoniae, 28.9% in P. aeruginosa and 52.2% in A. baumannii strains. Resistance to cefoperazone/sulbactam was found as 6%, 17.7%, 27.9% and 41.3% in E. coli, K. pneumoniae, P. aeruginosa and A. baumannii isolates, respectively, whereas resistance rates to piperacillin/tazobactam were 10.2%, 22.3%, 22.7% and 78.7%, respectively. These results indicate that ESBL production and rates of resistance to beta-lactam antibiotics are high in hospital isolates of gram-negative bacteria in Turkey, however, they show variations in different hospitals and CTX-M enzymes are prevalent in these isolates. SN - 0374-9096 UR - https://www.unboundmedicine.com/medline/citation/19149074/[Resistance_to_newer_beta_lactams_and_related_ESBL_types_in_gram_negative_nosocomial_isolates_in_Turkish_hospitals:_results_of_the_multicentre_HITIT_study]_ L2 - https://medlineplus.gov/antibiotics.html DB - PRIME DP - Unbound Medicine ER -