Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients

ÇAVUŞLU, Şaban; AKSOY, M. Duygu; TUĞRUL, H. Murat

Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients

M. Duygu AKSOY, (Halk Sağlığı Laboratuvarı, Yozgat, Türkiye)

Şaban ÇAVUŞLU, (Trakya Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Edirne, Türkiye)

H. Murat TUĞRUL (Trakya Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Edirne, Türkiye)

Balkan Medical Journal

0 0

Yıl: 2015 Cilt: 32 Sayı: 1 Sayfa Aralığı: 79 - 83 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients

Öz:

Background: Resistance to beta-lactam antibiotics is widespread among Acinetobacter strains. Plasmid-mediated metallo beta lactamases (MBL) are responsible for carbapenem resistance, as are oxacillinases (OXA). In recent years, MBL producing carbapenem-resistant strains have been reported in the world and in Turkey in increasing rates. In our country, besides the OXA 51- like enzyme which is inherent in A. baumannii strains, OXA 58-like and OXA 23-like carbapenemases producing strains have also been widely detected. In addition, Verona Imipenemase (VIM) and (IMP)-type MBL have been reported in some centers. Aims: The aim of our study was to investigate the presence of carbapenemases in Acinetobacter strains isolated from hospitalized patients in Edirne. Study Design: Cross-sectional study. Methods: A total of 52 imipenem-resistant A. baumannii strains isolated between January and March 2013 were investigated. The presence of MBL was described phenotypically by the combined disk diffusion test (CDDT), double disk synergy test (DDST), MBL E- test (only performed in 28 strains) and modified Hodge test. blaIMP , blaVIM, blaGIM, blaSIM, blaSPM genes and blaOXA-23, blaOXA-51, blaOXA-40, blaOXA-58 genes were inves- tigated by multiplex polymerase chain reaction (PCR). The blaNDM-1 gene was determined by PCR. Results: By modified Hodge test, 50 strains (96%) were found to be MBL positive. Positivity of MBL was 21% by both CDDT (0.1 M EDTA) and DDST. Twen- ty-four of 28 strains (85.7%) were positive by MBL E-test. OXA 23-like and OXA 51-like carbapenemases were detected in all strains, but OXA 58-like and OXA 40-like carbapenemases-producing A. baumannii were not detected. Also, MBL genes were not detected by genotypic methods. Conclusion: Only OXA 23-like carbapenemase was responsible for carbapenem resistance in carbapenem- resistant Acinetobacter strains in Edirne. The MBL- producing Acinetobacter strain is not yet a problem in our hospital. MBL resistance was found by phenotyp- ing tests, which must be confirmed by genotypic meth- ods; multiplex PCR tests can be easily used for screen- ing MBL.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Giamarellou H, Antoniadou A, Kanellakopoulou K. Acineto- bacter baumannii: a universal threat to public health? Int J Anti- microb Agents 2008;32:106-19. [CrossRef]
2. Cornaglia G, Giamarellou H, Rossolini GM. Metallo-β- lactamases: a last frontier for β-lactams? Lancet Infect Dis 2011;11:381-93. [CrossRef]
3. Gur D, Korten V, Unal S, Deshpande LM, Castanheira M. In- creasing carbapenem resistance due to the clonal dissemination of oxacillinase (OXA-23 and OXA-58)-producing Acineto- bacter baumannii: report from the Turkish SENTRY Program sites. J Med Microbiol 2008;57:1529-32. [CrossRef]
4. Vahaboglu H, Budak F, Kasap M, Gacar G, Torol S, Karad- enizli A, et al. High prevalence of OXA-51-type class D beta- lactamases among ceftazidime-resistant clinical isolates of Aci- netobacter spp.: co-existence with OXA-58 in multiple centres. J Antimicrob Chemother 2006;58:537-42. [CrossRef]
5. Sarı AN, Biçmen M, Gülay Z. The First Report on the Outbreak of OXA-24/40-Like Carbapenemase-Producing Acinetobacter baumannii in Turkey. Jpn J Infect Dis 2013;66:439-42.
6. Zarrilli R, Pournaras S, Giannouli M, Tsakris A. Global evolu- tion of multidrug resistant Acinetobacter baumannii clonal lin- eages. Int J Antimicrob Agents 2013;41:11-9. [CrossRef]
7. Bahar G, Mazzariol R, Koncan R, Mert A, Fontana R, Rossolini GM, et al. Detection of VIM-5 metallo-betalactamase in a Pseu- domonas aeruginosa clinical isolate from Turkey. J Antimicrob Chemother 2004;54:282-3. [CrossRef]
8. Ozgumus OB, Caylan R, Tosun I, Sandalli C, Aydin K, Koksal I. Molecular epidemiology of clinical Pseudomonas aeruginosa isolates carrying IMP-1 metallo-beta-lactamase gene in a Uni- versity Hospital in Turkey. Microb Drug Resist 2007;13:191-8. [CrossRef]
9. Yakupogullari Y, Poirel L, Bernabeu S, Kizirgil A, Nordmann P. Mul- tidrug-resistant Pseudomonas aeruginosa isolate co-expressing extend- ed- spectrum beta-lactamase PER-1 and metallo-beta-lactamase VIM- 2 from Turkey. J Antimicrob Chemother 2008;61:221-2. [CrossRef]
10. Alp E, Perçin D, Colakoğlu S, Durmaz S, Kürkcü CA, Ekincioğlu P, et al. Moleculacharacterization of carbapenem-resistant Kleb- siella pneumoniae in a tertiary university hospital in Turkey. J Hosp Infect 2013;84:178-80. [CrossRef]
11. Aktaş Z, Kayacan CB. Investigation of metallo-beta-lactamase producing strains of Pseudomonas aeruginosa and Acinetobacter baumannii by E-test, disk synergy and PCR. Scand J Infect Dis 2008;40:320-5. [CrossRef]
12. Lee K, Chong Y, Shin HB, Kim YA, Yong D, Yum JH. Modi- fied Hodge and EDTA-disk synergy tests to screenmetallo-β- lactamase-producing strains of Pseudomonas and Acinetobacter species. Clin Microbiol Infect 2001;7:88-91. [CrossRef]
13. Franco MR, Caiaffa-Filho HH, Burattini MN, Rossi F. Metallo- betalactamases among imipenem-resistant Pseudomonas aeru- ginosa in a Brazilian university hospital. Clinics (Sao Paulo) 2010;65:825-9. [CrossRef]
14. Ellington MJ, Kistler J, Livermore DM, Woodford N. Multiplex PCR for rapid detection of genes encoding acquired metallo-beta- lactamases. J Antimicrob Chemother 2007;59:321-2. [CrossRef]
15. Woodford N. Rapid Characterization of β lactamases by Multi- plex PCR. In: Gillespie SH. and McHugh TD, editors. Antibi- otic Resistance Protocols. 2th ed. London: Humana Press; 2010. p.181-92. [CrossRef]
16. Zarfel G, Hoenigl M, Leitner E, Salzer HJ, Feierl G, Masoud L, et al. Emergence of New Delhi metallo-β-lactamase, Austria. Emerg Infect Dis 2011;17:129-30. [CrossRef]
17. Esen S, Leblebicioglu H. Prevalence of nosocomial infections at intensive care units in Turkey: a multicentre 1-day point preva- lence study. Scand J Infect Dis 2004;36:144-8. [CrossRef]
18. Ayres HM, Furr JR, Russell AD. Effect of permeabilizers on an- tibiotic sensitivity of Pseudomonas aeruginosa. Lett Appl Micro- biol 1999;28:13-6. [CrossRef]
19. Denny B, West P, Panigrahi D. Effects of permeabilizers on an- timicrobial susceptibility of Stenotrophomonas maltophilia and Acinetobacter spp. J Microbiol Immunol Infect 2003;36:72-6.
20. Ulusoy Al M, Mumcuoğlu İ, Aksu N, Dolapçı İ, Karahan ZC, Baran I, ve ark. İmipenem dirençli Acinetobacter İzolatlarında metallo-beta-laktamaz üretiminin fenotipik ve genotipik yöntem- lerle araştırılması. Türk Mikrobiyol Cem Derg 2011;41:29-36.
21. Eser ÖK, Ergin A, Hasçelik G. Erişkin hastalardan izole edilen Acinetobacter türlerinde antimikrobiyal direnç ve metallo-beta- laktamaz varlığı. Mikrobiyol Bul 2009;43:383-90.
22. Türk Dağı H, Kuş H, Keyik Ş, Arslan U, Tuncer İ, Fındık D. Karbapenemlere Dirençli Acinetobacter baumannii Suşlarında Metallo-Beta-Laktamaz Varlığının Araştırılması. ANKEM Derg 2012;26:187-92.
23. Rodrigues AC, Chang MR, Nóbrega GD, Rodrigues MS, Carval- ho NC, Gomes BG, et al. Metallo-β-lactamase and genetic diver- sity of Pseudomonas aeruginosa in intensive care units in Campo Grande, MS, Brazil. Braz J Infect Dis 2011;15:195-9. [CrossRef]
24. Ratkai C, Quinteira S, Grosso F, Monteiro N, Nagy E, Peixe L. Controlling for false positives: interpreting MBL Etest and MBL combined disc test for the detection of metallo-beta-lactamases. J Antimicrob Chemother 2009;64:657-8. [CrossRef]
25. Chu YW, Cheung TK, Ngan JY, Kam KM. EDTA susceptibility leading to false detection of metallo-b-lactamase in Pseudomo- nas aeruginosa by E-test and an imipenem-EDTA disk method. Int J Antimicrob Agents 2005;26:340-1. [CrossRef]
26. Kulah C, Mooij MJ, Comert F, Aktas E, Celebi G, Ozlu N, et al. Characterisation of carbapenem-resistant Acinetobacter bau- mannii outbreak strains producing OXA-58 in Turkey. Int J An- timicrob Agents 2010;36:114-8. [CrossRef]
27. Ozen N, Ergani A, Naas T, Ogunc D, Gultekin M, Colak D, et al. Outbreak of carbapenem-resistant Acinetobacter baumannii pro- ducing the carbapenemase OXA-58 in Turkey. Open Antimicrob Agents J 2009;1:1-8. [CrossRef]
28. Pournaras S, Markogiannakis A, Ikonomidis A, Kondyli L, Bethimouti K, Maniatis A, et al. Outbreak of multiple clones of imipenem-resistant Acinetobacter baumannii isolates express- ing OXA-58 carbapenemase in an intensive care unit. J Antimi- crob Chemother 2006;57:557-61. [CrossRef]
29. Liakopoulos A, Miriagou V, Katsifas EA, Karagouni AD, Dai- kos GL, Tzouvelekis LS, et al. Identification of OXA-23-pro- ducing Acinetobacter baumannii in Greece, 2010 to 2011. Euro Surveill 2012;17.
30. Strateva T, Markova B, Marteva-Proevska Y, Ivanova D, Mi- tov I. Widespread dissemination of multidrug-resistant Acineto- bacter baumannii producing OXA-23 carbapenemase and ArmA 16S ribosomal RNA methylase in a Bulgarian university hospi- tal. Braz J Infect Dis 2012;16:307-10. [CrossRef]

APA	AKSOY M, ÇAVUŞLU Ş, TUĞRUL H (2015). Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. , 79 - 83.
Chicago	AKSOY M. Duygu,ÇAVUŞLU Şaban,TUĞRUL H. Murat Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. (2015): 79 - 83.
MLA	AKSOY M. Duygu,ÇAVUŞLU Şaban,TUĞRUL H. Murat Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. , 2015, ss.79 - 83.
AMA	AKSOY M,ÇAVUŞLU Ş,TUĞRUL H Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. . 2015; 79 - 83.
Vancouver	AKSOY M,ÇAVUŞLU Ş,TUĞRUL H Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. . 2015; 79 - 83.
IEEE	AKSOY M,ÇAVUŞLU Ş,TUĞRUL H "Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients." , ss.79 - 83, 2015.
ISNAD	AKSOY, M. Duygu vd. "Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients". (2015), 79-83.

APA	AKSOY M, ÇAVUŞLU Ş, TUĞRUL H (2015). Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. Balkan Medical Journal, 32(1), 79 - 83.
Chicago	AKSOY M. Duygu,ÇAVUŞLU Şaban,TUĞRUL H. Murat Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. Balkan Medical Journal 32, no.1 (2015): 79 - 83.
MLA	AKSOY M. Duygu,ÇAVUŞLU Şaban,TUĞRUL H. Murat Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. Balkan Medical Journal, vol.32, no.1, 2015, ss.79 - 83.
AMA	AKSOY M,ÇAVUŞLU Ş,TUĞRUL H Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. Balkan Medical Journal. 2015; 32(1): 79 - 83.
Vancouver	AKSOY M,ÇAVUŞLU Ş,TUĞRUL H Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients. Balkan Medical Journal. 2015; 32(1): 79 - 83.
IEEE	AKSOY M,ÇAVUŞLU Ş,TUĞRUL H "Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients." Balkan Medical Journal, 32, ss.79 - 83, 2015.
ISNAD	AKSOY, M. Duygu vd. "Investigation of metallo beta lactamases and oxacilinases in carbapenem resistant acinetobacter baumannii strains isolated from inpatients". Balkan Medical Journal 32/1 (2015), 79-83.