İnvestigation of carbapenem resistant klebsiella pneumoniae and esherichia coli strains i̇solated from rectal swap samples of i̇ntensive care unit patients

Hospital infections are major health problems due to high morbidity and mortality, long hospitalisation and high treatment costs. Carbapenem-resistant Enterobacteriaceae (CRE), especially Klebsiella pneumoniae has been frequently isolated in hospital infections in last decades. Minimum inhibitory concentration (MİC) values should be carefully monitored in CRE infections, especially during prolonged treatments. A total of 462 rectal swab samples sent to Culture Laboratory of Dicle University Hospital from intensive care unit patients between March 2014 and March 2015 were included in this study. Lactose-positive bacteria growing in Eosin Metylen Blue agar containing ertapenem (Ertapenem EMB agar) were identified and antiMİKrobial susceptibility testing were carried out by BD Phoenix (Becton Dickinson, USA) automated system. Extended spectrum beta-lactamase (GSBL) of isolates and carbapenem susceptibility was tested by Kirby-Bauer disk diffusion method. MİC values of ertapenem, meropenem, imipenem and doripenem were studied with gradient test. Lactose-positive bacteria growing in Ertapenem EMB agar were isolated from 107 (23.2%) of samples. Among 107 isolates, 100 of them were found as resistant to ertapenem and 35 to meropenem by automated system. Ertapenem and meropenem resistant isolates were 106 and 83 by disc diffusion method, respectively. A total of 91 isolates were resistant to ertapenem while 49 to meropenem by the gradient test which was considered as the reference method. Perianal cultures surveillance is an important infection control method in monitoring CRE infection and colonization incidence. Further research is needed for establishing the risk factors and molecular epidemiology of carbapenem resistance.