Karbapenem dirençli pseudomonas aeruginosa ızolatlarında karbapenemaz üretiminin araştırılması

Introduction: P. aeruginosa is an opportunistic pathogen that causes life-threatening nosocomial infections, especially in immunocompromised patients. It is highly resistant to most current antibiotics, including carbapenems. Production of the carbapenemase enzyme is the main mechanism of carbapenem resistance and has become a serious health concern worldwide as these enzymes are highly transferable and limit therapeutic options. In this study, it was aimed to investigate carbapenemase production in carbapenem-resistant P. aeruginosa isolates by phenotypic methods. Material and Methods: A total of 172 P. aeruginosa isolates were obtained from different samples sent from various clinics to Tokat-Gaziosmanpaşa University Research and Application Hospital Microbiology Laboratory between 2016-2019 and were evaluated retrospectively. Of the 172 isolates, 51 (29.7%) were found to be carbapenem-resistant and included in the study. Identification and antibiotic susceptibility tests of the isolates were performed with the Vitek 2 (Biomerieux, France) automated system. Carbapenem sensitivities were also determined by the disc diffusion method. Carbapenemase production in isolates was investigated by simplified and modified carbapenem inactivation methods. Results: Of the 51 carbapenem-resistant isolates, 38 (74.5%) were found to be resistant to both imipenem and meropenem. Eight (15.7%) isolates were found resistant to imipenem only, and five (9.8%) isolates were found to be resistant to meropenem. Carbapenemase production was detected in 31 (60.8%) of all isolates by the modified carbapenem inactivation method. However, no carbapenemase production was detected in the isolates in the simplified carbapenem inactivation method. Conclusion: Rapid identification of carbapenemase enzymes among carbapenem-resistant P. aeruginosa isolates using phenotypic and genotypic approaches is important to control the transmission of infection caused by carbapenem-resistant isolates and to control the morbidity and mortality associated with them. In this study, the modified carbapenem inactivation test was seen as a method that can be preferred in the laboratory in terms of its easy and fast application in the detection of carbapenemase production.