Karbapenem dirençli acinetobacter baumannii izolatlarında karbapenemaz üretiminin fenotipik ve genotipik yöntemlerle araştırılması

The nosocomial infection carbapenem-resistant Acinetobacter baumannii has attracted worldwide attention as a serious threat. Especially pneumonia and bloodstream infections, both of which have a high mortality risk, are the most common symptoms among the most vulnerable individuals. There has been not enough improvement the new antibiotic agent despite the constant attempts to improve medical treatment techniques. There are just a few antibiotics that can be used to treat carbapenem-resistant A. baumannii infections because of a significant resistance profile. The study included 80 carbapenem-resistant A. baumannii isolated from (pus, wound swab, catheter, sputum, and urine) samples taken from different clinics in Tokat Gaziosmanopasa Hospital. Identification and antibiotic susceptibility test of the isolates were done by the Vitek-2 (bioMerieux, France) automated system . The disk diffusion method was used to determine resistance to carbapenems too. The carbapenem-inactivation method was used to illustrate carbapenemase enzyme and polymerase chain reaction to identify carbapenem resistant genes. The highest percentage of carbapenems-resistant strains have been found in sputum specimens and neurosurgery clinics. The carbapenemase production in isolates, (n = 50, 63%) of the isolates were found to be positive by the carbapenem-inactivation method . In this investigation, carbapenem-resistant genes were 14/38 (27%) of the isolates were determined to be positive for IMP, 11(14%) isolates were detected positive for blaOXA-48, for NDM, 9(11%) isolates were determined as positive, and 8(10%) isolates were positive for NDM+KPC and KPC weren't detected without NDM. In contrast to the phenotypic detection of carbapenemase production in isolates, 50/80 (63%) of the isolates were positive by PCR. In this study, despite all isolates being resistant to meropenem and imipenem, carbapenemase production was not seen in all isolates in both PCR and CIM tests. These results indicate that carbapenem resistance was mediated by different carbapenemase genes or mechanisms. The evaluation of carbapenem resistance is critical for the prevention of healthcare-associated infection.