Investigation of the existence of extended spectrum beta-lactamases (ESBL) enzyme in the K.pneunomia, K.oxytoca and E.coli strains isolated from clinical specimens

Extended Spectrum Beta-Lactamases (ESBL) have been existed due tofrequent usage of the ?extended spectrum? cephalosporins at theinfections caused by gram negative bacteria, count and types of ESBLincreased all over the world and became an important problem.The existence of the ESBL has been investigated in 100 E.coli and 100Klebsiella strains isolated from different clinical specimens sent toHospital of Gazi University from various clinics and policlinics. Theexistence of the ESBL has been investigated by double disk synergytest. 70 of the 100 Klebsiella strains were identified as Klebsiellapneumoniae and 30 were identified as Klebsiella oxytoca.The existence of ESBL has been observed at 19 (%19) of the E.colistrains. The existence of ESBL has been observed at 34 (%34) of theKlebsiella strains. ESBL has been detected in the 30 (43%) of the 70 K.pneumoniae strains and 4 (13%) of the 30 K. oxytoca strains.viThe antibiotics which GSBL positive Klebsiella strains are moresensitive were found as İmipenem (%94,1), Piperacillin/Tazobactam(%61,8), Amikacin (%58,8), Gentamicin (%41,2), Cefepime (%23,5),Ciprofloxacin (%17,6). Klebsiella strains found to be most resistant toAmoxycillin/Clavulanate, Trimethoprim/Sulfamethoxazole, (%94,1),Sulbactam/Ampicillin, Ceftazidime, Aztreonam, Ceftriaxone (%88,2). Theantibiotics which GSBL positive E.coli strains are more sensitive werefound as Imipenem (%100), Piperacillin/Tazobactam (%94,7), Amikacin(%78,9), Gentamicin (%36,8) ve Cefepime (%31,5). E.coli strains foundto be most resistant to Amoxycillin/Clavulanate (%100),Trimethoprim/Sulfamethoxazole (%94,7), Ceftazidime, Ciprofloxacin(%84,2), Sulbactam/Ampicillin, Ceftriaxone (%78,9), Aztreonam (%73,6).As a result, the analysis and report of the microorganism whichproduces ESBL by the routine laboratory is important for the successof the treatment of the infections due to these microorganisms.The double disk synergy method which is simple, quick andinexpensive may be used by any simple laboratory for this purpose. Inthe measure of the Hospital Diseases the most important is theinvestigation of the frequency of ESBL and guiding clinicians to thecorrect antibiotics.Science Code : 401.03.04Key Words : Double disk sinergy test, ESBL, K.pneumoniae,K.oxytoca, E.coliPage Number : 94Adviser : Prof. Dr. Güven URAZ