Hacettepe Üniversitesi Erişkin Hastanesinde 2004-2012 Yılları Arasında Kan Kültürlerinde Üreyen Enterobacteriaceae Üyelerinin Genişletilmiş Spektrumlu Betalaktamaz ve Karbapenemaz Pozitifliklerinin Değerlendirilmesi

Abstract

Aim: The aim of this study was to determine ESBL and carbapenemase positivity of Enterobacteriaceae that grew in blood cultures and define the clinical properties of patients infected with carbapenemase positive strains. . Material and method: E.coli, K. pneumoniae, Enterobacter spp. and other Enterobacteriaceae in blood cultures between years 2004-2012 in Hacettepe Üniversity Faculty of Medicine were evaluated for ESBL and carbapenemase positivity. ESBL was defined with standart phenotypic method and carbapenemase with PCR for "VIM, IMP, KPC, NDM, OXA" carbapenemases.. Findings: 382 of 1138 E. coli bacteremias (%31.8), 175 of 703 Klebsiella spp. bacteremias (%24.8) and 46 of 237 Enterobacter spp. bacteremias (%24.8) were ESBL positive. PCR was performed on 11 E. coli strains and 36 Klebsiella spp. strains. 7 of E. coli strains (%63.6) and 28 of Klebsiella spp.strains (%77) were carbapenemase positive. Klebsiella spp. subgroup analysis showed that 22 strains were OXA, 3 were VIM, 2 were IMP and one strain was OXA+VIM pozitive. For E.coli strains; 5 were OXA, 2 were OXA+VIM pozitive. NDM and KPC subtypes were detected. Results: Our hospitals ESBL and/or carbapenemase positive Enterobacteriaceae frequency is similar with Europe and Turkey. In some years, there were sharp rises in ESBL producing bacteria rates , probably due to local epidemias Resistance to antibiotics, increased mortality can be caused by these species. Since treatment options are limited, every precaution necessary should be taken to avoid spreading of resistant Enterobacteriaceae.