Molecular analysis of carbapenem resistance in carbapenem resistant gram negative bacilli isolated from clinical samples

Carbapenem resistance in Gram-negative bacilli seen all over the World and in our country is the last step of the long standing problem of bacterial resistance. The only way to achieve success in the long run in treatment of Gram-negative bacilli infections which clinicians often remain helpless is is to make studies with microbiological methods to illuminate the mechanisms and epidemiology. In our country, research done on this subject is very limited and a surveillance study of wide range is not available. In this study, it is aimed to determine the susceptibilities to various antibiotics with phenotypical methods and to present epidemiological data by determining the enzymes associated with resistance by using genotypical methods in carbapenem-resistant gram-negative bacteria isolated from a variety of clinical infections. At the end of the study; it was seen that the only reliable antibiotic in infections caused by carbapenem resistant gram negative bacilli is colistin. After analysing the carbapenem resistance genotypically it is determined that, the most dominant carbapenemase genes among entire species are OXA-48 and OXA-58, GES and PER in non-fermenter species also IMP, VIM and NDM type genes are found to be responsible from carbapenem resistance in Enterobacteriaceae. In 26.7% of the isolates it is determined that the resistance arises from E.S.B.L.`s out of carbapenemases.