Comparison of Phenotypic Methods and Polymerase Chain Reaction for the Detection of Carbapenemase Production in Clinical Klebsiella pneumoniae Isolates

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dc.contributor.authorTekintas, Yamac
dc.contributor.authorCilli, Feriha
dc.contributor.authorErac, Bayri
dc.contributor.authorYasar, Melike
dc.contributor.authorAydemir, Sabire Sohret
dc.contributor.authorHosgor Limoncu, Mine
dc.date.accessioned2019-10-27T11:06:56Z
dc.date.available2019-10-27T11:06:56Z
dc.date.issued2017
dc.departmentEge Üniversitesien_US
dc.description.abstractBeing a member of the Enterobacteriaceae family, Klebsiella pneumoniae is an opportunistic pathogen that inhabits normal human microbiota and causes predominantly hospital-acquired infections. The emergence of K.pneumoniae isolates which are resistant particularly to the carbapenem group of antibiotics has led to an increase in hospitalization period, mortality and morbidity. Although different rates of resistance are observed between countries, regions and even healthcare facilities, there has been a rapid increase in the prevalence of carbapenem-resistant strains in the last 10 years. Fast and correct identification of carbapenem-resistant strains is important for the successful treatment of infections caused by these resistant bacteria. The objective of this study was to investigate the presence and the types of carbapenemases in carbapenem-resistant K.pneumoniae strains using "MASTDISCS (TM) ID carbapenemase detection disc set", a commercial product that can be used for this purpose, and "Carbapenem Inactivation Method (CIM)", a relatively new method, and compare the results of these methods by polymerase chain reaction (PCR). For this purpose, we used 54 K.pneumoniae strains isolated in 2015-2016, that were resistant to any of the ertapenem, meropenem or imipenem antibiotics. The identification of the strains was performed using VITEK MS and their antibiotic susceptibility tests were carried out using the VITEK 2 Compact (R) automated system. For the strains that were found resistant to carbapenems in the automated system, the minimum inhibitor concentration (MIC) values were determined by the gradient testing method according to the recommendations of " The European Committee on Antimicrobial Susceptibility Testing (EUCAST)". The bla(OXA-48), bla(IMP), bla(NDM), bla(VIM), and bla(SIM) genes were investigated with PCR among these isolates. Phenotypic enzyme typing was performed in the carbapenem-resistant strains using the " MASTDISCS (TM) ID carbapenemase detection disc set" and " Carbapenem Inactivation Method (CIM)". REP-PCR was used to reveal clonal relationship of the isolates. The 54 K.pneumoniae isolates were found as resistant to carbapenem and the MIC50 and MIC90 values of imipenem, meropenem and ertapenem were 32 mu g/ml. Only 33 of the strains had bla(OXA-48) and two of them had only bla(NDM), the remaining 19 strains had both of these two genes. The bla(IMP), bla(VIM) and bla(SIM) genes were not encountered in any of the isolates. When the isolates were assessed by the REP-PCR method, six main clones were detected. The " MASTDISCS (TM) ID carbapenemase detection disc set" was able to detect all the carbapenemase producing strains and it remained incapable of distinguishing OXA-48 in the strains which had both OXA-48 and metallo beta lactamase (MBL) enzymes. The CIM method showed a low rate of positivity (46.15%) in the strains containing bla(OXA-48), but was found much more successful in the strains containing bla(NDM) with a detection rate of 85.71%. In this study, it was concluded that the Mastdiscs-ID method could be successfully used to detect the presence of bla(OXA-48) which has a high prevalence in our country.en_US
dc.identifier.doi10.5578/mb.57333en_US
dc.identifier.endpage276en_US
dc.identifier.issn0374-9096
dc.identifier.issue3en_US
dc.identifier.pmid28929963en_US
dc.identifier.startpage269en_US
dc.identifier.urihttps://doi.org/10.5578/mb.57333
dc.identifier.urihttps://hdl.handle.net/11454/31951
dc.identifier.volume51en_US
dc.identifier.wosWOS:000408311400007en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isotren_US
dc.publisherAnkara Microbiology Socen_US
dc.relation.ispartofMikrobiyoloji Bultenien_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectKlebsiella pneumoniaeen_US
dc.subjectPCRen_US
dc.subjectphenotypic methodsen_US
dc.subjectcarbapenemaseen_US
dc.titleComparison of Phenotypic Methods and Polymerase Chain Reaction for the Detection of Carbapenemase Production in Clinical Klebsiella pneumoniae Isolatesen_US
dc.typeArticleen_US

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