Determination of phenotypic susceptibility to ertapenem, meropenem, imipenem, colistin, fosfomycin and temocillin in which producing extended spectrum beta-lactamase isolates of eschericha coli and klebsiella spp. and investigation of resistance genes by in house pcr method

Aim: Antibiotic resistance continues to be a serious problem all over the world its importance is increasingly understood. Escherichia coli and Klebsiella spp. one of the common causes of resistance in Enterobacteria, where resistance development is high, is the production of expanded spectrum beta-lactamase (ESBL). The discovery of new antibiotics is difficult and costly, and the rapid development of resistance to newly developed antibiotics has turned attention to antibiotics such as ertapenem, meropenem, imipenem, colistin and temocillin, where resistance is not detected or resistance is seen more slowly. The aim of this study was to determine the in vitro susceptibility of the isolates to ertapenem, meropenem, imipenem, colistin, fosfomycin and temosilin and to identify resistance genes by in house PCR method of ESBL positive E. coli and Klebsiella spp. isolated in Adıyaman. Material and Methods: In this study, 82 E. coli and 37 Klebsiella spp. isolated from clinical samples taken from various outpatient and inpatients between 10/2018-01/2019 in Adıyaman University Training and Research Hospital Microbiology Laboratory was evaluated. The susceptibility of these isolates to ertapenem, meropenem, imipenem, colistin and fosfomycin was determined with the BD Phoenix® automated system. Temocillin susceptibility test was performed by disk diffusion method in all ESBL positive isolates. The presence of OXA-48 and mcr-1 genes in isolates with carbapenem derivatives and colistin resistance were investigated by in house PCR method. Results: In our study, the resistance rates of ertapenem and meropenem, imipenem and colistin of 119 ESBL positive E. coli and Klebsiella spp. were found as 28.5 % and 9.2 %, respectively. Temocillin resistance was found as 26.8% in these isolates. 3 (2.9 %) of 101 ESBL strains examined in the study were found resistant to fosfomycin. According to the results of the PCR test, no mcr-1 gene was found in colistin resistant strains. While the OXA-48 gene was found in 23.5 % of carbapenem resistant ESBL positive E. coli isolates and 47 % of K. pneumoniae isolates, OXA-48 gene was not detected in K. oxytoca isolates. Conclusions: The ertapenem resistance in the isolates included in our study was higher than other carbapenems. Although temocillin is not used in our country, high resistance to temocillin has been found. Although the frequency of mcr-1 gene is rarely seen in the world, the mcr-1 gene was not found in our study. The OXA-48 gene was less detected in imipenem resistant strains compared to ertapenem and meropenem resistant strains.