Molecular Epidemiology of Beta-Lactamases in Ceftazidime-Resistant Pseudomonas aeruginosa Isolates

Pseudomonas aureginosa, özellikle immün sistemin baskılandığı hastalarda, yaşlılarda ve ağır yanık durumlarında hastalık oluşturan ve daha çok hastane enfeksiyonlarına neden olabilen önemli bir fırsatçı patojendir. Bakterinin birçok antibiyotiğe karşı yüksek oranda direnç geliştirme özelliği, P.aeruginosa enfeksiyonlarının mortalite ve morbiditesini artırmaktadır. Bu çalışmada, yatan hastalardan izole edilen P.aeruginosa suşlarının antibiyotik duyarlılıklarının belirlenmesi ve PER, GES, KPC, VIM, IMP ve OXA gibi direnç enzimlerinin varlığının araştırılması amaçlanmıştır. Çalışmaya, 2010-2012 yılları arasında Afyon Kocatepe Üniversitesi Tıp Fakültesi Hastanesinde yatan 134ü erkek 61i kadın hastanın çeşitli klinik örneklerinden (29 balgam, 67 yara, 53 trakeal aspirat, 23 kan, 18 idrar, 3 beyin omurilik sıvısı, 2 plevral sıvı) izole edilen, 195 P.aeruginosa suşu dahil edilmiştir. İzolatların tanımlanmasında konvansiyonel ve otomatize sistemler (VITEK 2, BioMerieux, Fransa) kullanılmış; antibiyotik duyarlılıklarının belirlenmesi için disk difüzyon ve E-test yöntemleri uygulanmıştır. İzolatların indüklenebilir beta-laktamaz (İBL), genişlemiş spektrumlu beta-laktamaz (GSBL) ve metallo-beta-laktamaz (MBL) üretimleri, fenotipik olarak, sırasıyla çift disk indüksiyon yöntemi, çift disk sinerji testi ve E-test yöntemi ile saptanmıştır. İzolatlarda direnç enzimlerini (PER, GES, KPC, VIM, IMP ve OXA) kodlayan genlerin varlığı ise gerçek zamanlı polimeraz zincir reaksiyonu ile araştırılmış; pozitif örneklere dizi analizi uygulanmıştır. Çalışmamızda, 195 P.aeruginosa suşunun tümü (%100) seftazidime, %90.8i tazobaktam/piperasiline, %60.5i aztroenama, %50.2 si sefepime, %48.2 si imipeneme, %47.2 si meropeneme, %47.2 si ofl oksasine, %44.1 i pipe rasiline, %31.3 ü levofl oksasine, %26.2 si siprofl oksasine, %11.8 i gentamisine, %8.7 si amikasine ve %6.2 si tobramisine dirençli bulunmuştur. Fenotipik yöntemlerle, izolatların %89.2 sinde (174/195) İBL, %30.7 sinde (60/195) GSBL ve %26.7sinde (52/195) MBL pozitifl iği tespit edilmiştir. Moleküler çalış- malar sonucunda beş izolatta OXA-10, dört izolatta OXA-14, dört izolatta VIM-2, iki izolatta IMP-1, 26 izolotta GES-1 ve 87 izolatta ABC taşıyıcı permeaz (transporter permease) geni saptanmış; PER ve KPC genlerine rastlanmamıştır. Sonuç olarak, beta-laktamaz genlerini taşıyan kökenlerin saptanması ve betalaktamaz tiplerinin tanımlanmasının; antibiyotik seçiminde, tedavinin takibinde, direnç gelişiminin önlenmesinde ve enfeksiyon kontrol programlarının geliştirilmesinde yol gösterici olacağı düşünülmüştür.Pseudomonas aeruginosa is an important opportunistic pathogen that cause mainly nosocomial infections especially in the immunocompromised patients, the elderly and patients with severe burns. The bacterial feature of developing high degree of resistance against several antibiotics leads to increased morbidity and mortality of P.aeruginosa infections. The aims of this study were to investigate the antibiotic susceptibilities of P.aeruginosa strains isolated from hospitalized patients and to determine the presence of resistance enzymes namely PER, GES, KPC, VIM, IMP and OXA. A total of 195 P.aeruginosa strains isolated from different clinical samples (29 sputum, 67 wound, 53 tracheal aspirate, 23 blood, 18 urine, 3 cerebrospinal fl uid, 2 pleural fl uid) of inpatients (134 male, 61 female) in Afyon Kocatepe University School of Medicine Hospital between 2010-2012, were included in the study. The isolates were identifi ed by conventional methods and automated systems (VITEK 2, BioMerieux, France), and their antibiotic susceptibilities were detected by disk diffusion and E-test methods. Inducible beta-lactamase (IBL), extended-spectrum beta-lactamase (ESBL) and metallo-beta-lactamase (MBL) productions of the isolates were phenotypically investigated by double disk induction, double disk synergy and E-test methods, respectively. The presence of resistance genes encoding PER, GES, KPC, VIM, IMP and OXA enzymes were determined by real-time polymerase chain reaction, and sequence analysis was applied to positive samples. In our study, the antibiotic resistance rates of 195 P.aeruginosa strains were found as follows: ceftazidime 100%, tazobactam/piperacillin 90.8%, aztreonam 60.5%, cefepime 50.2%, imipenem 48.2%, meropenem 47.2%, ofl oxacin 47.2%, piperacillin 44.1%, levofl oxacin 31.3%, cipro- fl oxacin 26.2%, gentamicin 11.8%, amikacin 8.7% and tobramycin 6.2%. With the use of phenotypical methods, IBL, ESBL and MBL production rates in the isolates were detected as 89.2% (174/195), 30.7% (60/195) and 26.7% (52/195), respectively. Molecular studies showed that, fi ve strains harboured OXA- 10, four OXA-14, four VIM-2, two IMP-1, 26 GES-1 and 87 ABC transporter permease genes, while PER and KPC genes were not detected in any of the isolates. In conclusion, it was considered that the detection of beta-lactamase genes in bacteria and the identifi cation of beta-lactamase types may provide facilities in selection of antibiotics, monitorization of therapy, prevention of resistance development of infection control programs

A Diagnostic Algorithm for the Detection of Clostridium difficile-Associated Diarrhea

Background: Clostridium difficile is a common cause of hospital-acquired diarrhea, which is usually associated with previous antibiotic use. The clinical manifestations of C. difficile infection (CDI) may range from mild diarrhea to fulminant colitis. Clostridium difficile should be considered in diarrhea cases with a history of antibiotic use within the last 8 weeks (community-associated CDI) or with a hospital stay of at least 3 days, regardless of the duration of antibiotic use (hospital-acquired CDI). Aims: This study investigated the frequency of CDI in diarrheic patients and evaluated the efficacy of the triple diagnostic algorithm that is proposed here for C. difficile detection. Study Design: Cross-sectional study. Methods: In this study, we compared three methods currently employed for C. difficile detection using 95 patient stool samples: an enzyme immunoassay (EIA) for toxin A/B (C. diff Toxin A+B; Diagnostic Automation Inc.; Calabasas, CA, USA), an EIA for glutamate dehydrogenase (GDH) (C. DIFF CHEK-60TM, TechLab Inc.; Blacksburg, VA, USA), and a polymerase chain reaction (PCR)-based assay (GeneXpert® C. difficile; Cepheid, Sunnyvale, CA, USA) that detects C. difficile toxin genes and conventional methods as well. In this study, 50.5% of the patients were male, 50 patients were outpatients, 32 were from inpatient clinics and 13 patients were from the intensive care unit. Results: Of the 95 stool samples tested for GDH, 28 were positive. Six samples were positive by PCR, while nine samples were positive for toxin A/B. The hypervirulent strain NAP-1 and binary toxin was not detected. The rate of occurrence of toxigenic C. difficile was 5.1% in the samples. Cefaclor, ampicillin-sulbactam, ertapenem, and piperacillin-tazobactam were the most commonly used antibiotics by patients preceding the onset of diarrhea. Among the patients who were hospitalized in an intensive care unit for more than 7 days, 83.3% were positive for CDI by PCR screening. If the PCR test is accepted as the reference: C. difficile Toxin A/B ELISA sensitivity and specificity were 67% and 94%, respectively, and GDH sensitivity and specificity were 100% and 75%, respectively. Conclusion: Tests targeting C. difficile toxins are frequently applied for the purpose of diagnosing CDI in a clinical setting. However, changes in the temperature and reductant composition of the feces may affect toxin stability, potentially yielding false-negative test results. Therefore, employment of a GDH EIA, which has high sensitivity, as a screening test for the detection of toxigenic strains, may prevent false-negative results, and its adoption as part of a multistep diagnostic algorithm may increase accuracy in the diagnosis of CDIs

The distribution of genotype of the Hepatitis C virus (HCV) RNA positive patients

Amaç: Flaviviredea ailesinden bir virus olan Hepatit C virusu(HCV) akut hepatitlerin %20’si, kronik hepatitlerin % 70’inden sorumludur. HCV’nin genotip tayini tedavide ve klinik sürecin takibinde önemlidir. Çalışmamızda Afyon Kocatepe Üniversitesi Tıp Fakültesi Mikrobiyoloji laboratuarına kan örnekleri gönderilen 34 HCV RNA pozitif hastada genotip dağılımının saptanması amaçlanmıştır. Yöntem: Örneklerin genotiplendirilmesinde Geno Sen’s HCV Genotyping 1/2/3/4 Real Time PCR Reagents Kiti (Corbett Research, Australia) kullanılmıştır. Hastaların viral yükleri 34x103 ile 17x106 arasında bulunmuş olup viral yük ortalamaları ise 46x105 olarak saptanmıştır. Çalı- şılan 34 örnekten 31’i genotip 1, 3’ü genotip 4 olarak bulunmuştur. Sonuç: Sonuç olarak klinik sürecin takibi ve antiviral tedavi seçiminde genotip tayinin yol gösterici olması sebebiyle bu tip çalışmaların önemli olduğu düşünülmektedir.Objective: Hepatit C virus (HCV), which is a virus from the family Flaviviredea, is responsible for 20% of acute hepatitis and 70% of chronic hepatitis. Determination of HCV genotype is important in the treatment and the clinical follow-up process. In this study, we aimed to determine the genotype distribution of 34 HCV RNA positive patients whose sera were sent to Afyon Kocatepe University, Faculty of Medicine Microbiology laboratory. Method: Geno Sen’s HCV Genotyping 1/2/3/4 Real Time PCR Reagents Kit (Corbett Research, Australia) was used for genotype determination of those samples. Patients’ viral loads were found between 34x103-17x106 and mean viral load was 46x105. Thirty one samples, out of 34, were found genotype 1 while the other 3 samples were found genotype 4. Results: Consequently, this type of studies are considered to be crucial since genotype determination has a guiding role in clinical follow-up process and the selection of antiviral therapy

Investigation of mecA genes in staphylococcus strains isolated from clinical samples

Amaç: Staphylococcus aureus geniş bir spektrumda enfeksiyonlara neden olan, özellikle metisiline dirençli suşları ile ciddi hastane enfeksiyonları oluşturan bir etkendir. Uzun süreli antibiyotik kullanımı direnç gelişimi için önemli olup bu direnci (metisilin ve diğer beta-laktam antibiyotiklere) mecA geni oluşturur. Tedavisi oldukça zor ve maliyetlidir. Bu yüzden metisiline dirençli S. aureus (MRSA) suşlarının doğru tanısı çok önemlidir. Gereç ve yöntem: Bu çalışmaya 2004-2005 yılları arasında çeşitli klinik örneklerden izole edilen 193 stafilokok izolatı dahil edilmiş olup (S.aureus %79.3, koagülaz negatif stafilokok %20.7) suşlarda metisilin direnci Clinical and Laboratory Standards Institute (CLSI) önerilerine göre oksasilin disk difüzyon yöntemiyle gerçekleştirilmiştir. Örneklerde mecA gen varlığı PCR ile araştırılmıştır. Bulgular: Çalışmada toplam 193 Stafilokok incelenmiştir (Staphylococcus aureus %79.3, koagülaz negatif stafilokok %20.7). Oksasilin disk difüzyon yöntemiyle 141 izolat metisiline dirençli bulunurken PCR metoduyla 144 izolatta mecA gen varlığı saptanmıştır. İki metod arasında anlamlı istatistiksel fark görülmemiştir. PCR çalışmalarıyla ortaya konan mecA gen varlığı temel alınarak yapılan karşılaştırmada disk difüzyon yönteminin MRSA tespiti için sensitivitesinin %96.5, spesifitesinin %96.0 olduğu gözlenmiştir. Sonuç: Stafilokoklarda metisilin direncinin saptanmasında en güvenli yöntemin PCR yardımıyla mecA gen varlığının araştırılması olduğu, bunun yanı sıra disk difüzyon yönteminin de ucuz, kolay ve spesifik bir alternatif olabileceği kanısına varılmıştır.Aim: Staphylococcus aureus is a potentially pathogenic that causes a board spectrum of infections. Methicillin resistant S. aureus (MRSA) is also one of the important pathogens causing hospital infections, which is a global problem. The long time use of antibiotics this microorganism developed important resistance mechanisms. Resistance to methicillin and other beta-lactam antibiotics is caused by mecA gene. Treatment is fairly difficult and costly. Therefore it is very important to correctly diagnose these MRSA. Material and methods: In this study, samples were isolated from various clinical materials collected between 2004-2005. Staphylococci isolated from clinic speciments were screened for methicillin resistance by oxacillin disc diffusion method according to the Clinical and Laboratory Standards Isntitue (CLSI) guidelines. Afterwards all strains were tested for the presence of the mecA gene by PCR. Results: A total of 193 Staphylococci were analyzed (Staphylococcus aureus 79.3%, coagulase negative Staphylococci 20.7%). One hundred forty one isolates were found oxacillin-resistant by disc diffusion method. One hundred forty four isolates were found mecA positive by PCR. There were no significant differences for two methods. Compared with, mecA gene PCR assay's the sensitivity and specificity of disk diffusion for detecting MRSA were found 96.5% and 96.0% respectively. Conclusion: The detection of mecA gene by PCR is most reliable approach for MRSA, nevertheless disc diffusion is quite useful and specific method which can be used as a method in clinical microbiological laboratory

Investigation of mecA genes in staphylococcus strains isolated from clinical samples

Amaç: Staphylococcus aureus geniş bir spektrumda enfeksiyonlara neden olan, özellikle metisiline dirençli suşları ile ciddi hastane enfeksiyonları oluşturan bir etkendir. Uzun süreli antibiyotik kullanımı direnç gelişimi için önemli olup bu direnci (metisilin ve diğer beta-laktam antibiyotiklere) mecA geni oluşturur. Tedavisi oldukça zor ve maliyetlidir. Bu yüzden metisiline dirençli S. aureus (MRSA) suşlarının doğru tanısı çok önemlidir. Gereç ve yöntem: Bu çalışmaya 2004-2005 yılları arasında çeşitli klinik örneklerden izole edilen 193 stafilokok izolatı dahil edilmiş olup (S.aureus %79.3, koagülaz negatif stafilokok %20.7) suşlarda metisilin direnci Clinical and Laboratory Standards Institute (CLSI) önerilerine göre oksasilin disk difüzyon yöntemiyle gerçekleştirilmiştir. Örneklerde mecA gen varlığı PCR ile araştırılmıştır. Bulgular: Çalışmada toplam 193 Stafilokok incelenmiştir (Staphylococcus aureus %79.3, koagülaz negatif stafilokok %20.7). Oksasilin disk difüzyon yöntemiyle 141 izolat metisiline dirençli bulunurken PCR metoduyla 144 izolatta mecA gen varlığı saptanmıştır. İki metod arasında anlamlı istatistiksel fark görülmemiştir. PCR çalışmalarıyla ortaya konan mecA gen varlığı temel alınarak yapılan karşılaştırmada disk difüzyon yönteminin MRSA tespiti için sensitivitesinin %96.5, spesifitesinin %96.0 olduğu gözlenmiştir. Sonuç: Stafilokoklarda metisilin direncinin saptanmasında en güvenli yöntemin PCR yardımıyla mecA gen varlığının araştırılması olduğu, bunun yanı sıra disk difüzyon yönteminin de ucuz, kolay ve spesifik bir alternatif olabileceği kanısına varılmıştır.Aim: Staphylococcus aureus is a potentially pathogenic that causes a board spectrum of infections. Methicillin resistant S. aureus (MRSA) is also one of the important pathogens causing hospital infections, which is a global problem. The long time use of antibiotics this microorganism developed important resistance mechanisms. Resistance to methicillin and other beta-lactam antibiotics is caused by mecA gene. Treatment is fairly difficult and costly. Therefore it is very important to correctly diagnose these MRSA. Material and methods: In this study, samples were isolated from various clinical materials collected between 2004-2005. Staphylococci isolated from clinic speciments were screened for methicillin resistance by oxacillin disc diffusion method according to the Clinical and Laboratory Standards Isntitue (CLSI) guidelines. Afterwards all strains were tested for the presence of the mecA gene by PCR. Results: A total of 193 Staphylococci were analyzed (Staphylococcus aureus 79.3%, coagulase negative Staphylococci 20.7%). One hundred forty one isolates were found oxacillin-resistant by disc diffusion method. One hundred forty four isolates were found mecA positive by PCR. There were no significant differences for two methods. Compared with, mecA gene PCR assay's the sensitivity and specificity of disk diffusion for detecting MRSA were found 96.5% and 96.0% respectively. Conclusion: The detection of mecA gene by PCR is most reliable approach for MRSA, nevertheless disc diffusion is quite useful and specific method which can be used as a method in clinical microbiological laboratory

The distribution of genotype of the Hepatitis C virus (HCV) RNA positive patients

Amaç: Flaviviredea ailesinden bir virus olan Hepatit C virusu(HCV) akut hepatitlerin %20’si, kronik hepatitlerin % 70’inden sorumludur. HCV’nin genotip tayini tedavide ve klinik sürecin takibinde önemlidir. Çalışmamızda Afyon Kocatepe Üniversitesi Tıp Fakültesi Mikrobiyoloji laboratuarına kan örnekleri gönderilen 34 HCV RNA pozitif hastada genotip dağılımının saptanması amaçlanmıştır. Yöntem: Örneklerin genotiplendirilmesinde Geno Sen’s HCV Genotyping 1/2/3/4 Real Time PCR Reagents Kiti (Corbett Research, Australia) kullanılmıştır. Hastaların viral yükleri 34x103 ile 17x106 arasında bulunmuş olup viral yük ortalamaları ise 46x105 olarak saptanmıştır. Çalı- şılan 34 örnekten 31’i genotip 1, 3’ü genotip 4 olarak bulunmuştur. Sonuç: Sonuç olarak klinik sürecin takibi ve antiviral tedavi seçiminde genotip tayinin yol gösterici olması sebebiyle bu tip çalışmaların önemli olduğu düşünülmektedir.Objective: Hepatit C virus (HCV), which is a virus from the family Flaviviredea, is responsible for 20% of acute hepatitis and 70% of chronic hepatitis. Determination of HCV genotype is important in the treatment and the clinical follow-up process. In this study, we aimed to determine the genotype distribution of 34 HCV RNA positive patients whose sera were sent to Afyon Kocatepe University, Faculty of Medicine Microbiology laboratory. Method: Geno Sen’s HCV Genotyping 1/2/3/4 Real Time PCR Reagents Kit (Corbett Research, Australia) was used for genotype determination of those samples. Patients’ viral loads were found between 34x103-17x106 and mean viral load was 46x105. Thirty one samples, out of 34, were found genotype 1 while the other 3 samples were found genotype 4. Results: Consequently, this type of studies are considered to be crucial since genotype determination has a guiding role in clinical follow-up process and the selection of antiviral therapy

The distribution of intestinal parasites detected in the Afyon Kocatepe University, Medical Faculty, Hospital Between 2003 and 2007

Araştırmanın amacı Ocak 2003- Nisan 2007 tarihleri arasında AKÜ Tıp Fakültesi rutin mikrobiyoloji laboratuarına başvuran hastalarda bağırsak parazitlerinin dağı- lımını ve sıklığını değerlendirmekti. Toplam 5802 örnek için nativ-lugol ve selofan bant yöntemleri kullanılarak parazitolojik inceleme yapıldı. Örneklerin %6,5'inde parazit tespit edildi. Parazit saptanan örneklerin %43,5'i kadın, %56,5'i erkekti. En sık saptanan parazit türleri Entamoeba spp. (%53) (Entamoeba histolytica/dispar), Giardia intestinalis (%23) ve Blastocystis hominis (%11) idi. Çalışmamızda saptanan diğer parazit türleri ise Enterobius vermicularis (%9), Taenia spp.(%1,6), Ascaris lumbricoides (0.8%), Hymenolepis nana (%0,5) ve Iodamoeba butschii (%0.3) oldu. Olguların mevsimsel dağılımında yaz ve sonbahar aylarında artış dikkati çekti. Parazitoz prevelansında önceki yıllara oranla düşüş dikkati çekse de, paraziter hastalıkların bölgemiz için hala önemli bir sağlık sorunu olmaya devam ettiği görüldü.The purpose of the present study was to investigate retrospectively the distribution and prevalence of intestinal parasites in patients who presented at the routine microbiology laboratory of the AKU Medical Faculty, between the January 2003-April 2007. Parasitological examinations were done with native-Lugol and cellophane-tape methods, in a total of 5802 samples. Parasites were found in 6.5% of the samples. Of the positive samples, 43.5% were females and 56.5%, male. The most prevalent parasites were Entamoeba spp. (53%) (Entamoeba histolytica/dispar), Giardia intestinalis (23%) and Blastocystis hominis (%11). Enterobius vermicularis (9%), Taenia spp.(1.6%), Ascaris lumbricoides (0.8%), Hymenolepis nana (0.5%) and Iodamoeba butschii (0.3%) were the other parasites detected in this study. Even though a decrease in the prevalence of parasitosis was apparent, it was noticed that the parasitic diseases are still a significant health problem in our region

The distribution of intestinal parasites detected in the Afyon Kocatepe University, Medical Faculty, Hospital Between 2003 and 2007

Araştırmanın amacı Ocak 2003- Nisan 2007 tarihleri arasında AKÜ Tıp Fakültesi rutin mikrobiyoloji laboratuarına başvuran hastalarda bağırsak parazitlerinin dağı- lımını ve sıklığını değerlendirmekti. Toplam 5802 örnek için nativ-lugol ve selofan bant yöntemleri kullanılarak parazitolojik inceleme yapıldı. Örneklerin %6,5'inde parazit tespit edildi. Parazit saptanan örneklerin %43,5'i kadın, %56,5'i erkekti. En sık saptanan parazit türleri Entamoeba spp. (%53) (Entamoeba histolytica/dispar), Giardia intestinalis (%23) ve Blastocystis hominis (%11) idi. Çalışmamızda saptanan diğer parazit türleri ise Enterobius vermicularis (%9), Taenia spp.(%1,6), Ascaris lumbricoides (0.8%), Hymenolepis nana (%0,5) ve Iodamoeba butschii (%0.3) oldu. Olguların mevsimsel dağılımında yaz ve sonbahar aylarında artış dikkati çekti. Parazitoz prevelansında önceki yıllara oranla düşüş dikkati çekse de, paraziter hastalıkların bölgemiz için hala önemli bir sağlık sorunu olmaya devam ettiği görüldü.The purpose of the present study was to investigate retrospectively the distribution and prevalence of intestinal parasites in patients who presented at the routine microbiology laboratory of the AKU Medical Faculty, between the January 2003-April 2007. Parasitological examinations were done with native-Lugol and cellophane-tape methods, in a total of 5802 samples. Parasites were found in 6.5% of the samples. Of the positive samples, 43.5% were females and 56.5%, male. The most prevalent parasites were Entamoeba spp. (53%) (Entamoeba histolytica/dispar), Giardia intestinalis (23%) and Blastocystis hominis (%11). Enterobius vermicularis (9%), Taenia spp.(1.6%), Ascaris lumbricoides (0.8%), Hymenolepis nana (0.5%) and Iodamoeba butschii (0.3%) were the other parasites detected in this study. Even though a decrease in the prevalence of parasitosis was apparent, it was noticed that the parasitic diseases are still a significant health problem in our region

Detection of the frequency of PER-1 type extended-spectrum ?-lactamase–producing Acinetobacter baumannii clinical isolates in Turkey: a multicenter study

Background/aim: β-Lactamases are an important resistance mechanism in Acinetobacter baumannii. Pseudomonas extended-resistance (PER-1) type β-lactamase–producing strains have been reported from various geographic locations; however, PER-1 type β-lactamases from Turkish hospitals have not been investigated extensively. The aim of this study was to determine the prevalence of PER-1 type β-lactamases in A. baumannii isolates in various regions of Turkey. Materials and methods: A total of 763 clinical A. baumannii isolates were collected from 9 university hospitals and 2 state hospitals between 2008 and 2011. Molecular amplification of the OXA-51 gene from the A. baumannii genome was performed in order to verify identification of the species. Real-time polymerase chain reaction was used to detect blaPER-1 genes. Results: PER-1 was detected in 24.6% of the isolates. The annual frequencies of the PER-1 enzyme were detected as 52.2%, 35.9%, and 8.3% in 2008, 2009, and 2010, respectively. PER-1 prevalence decreased gradually over time. The differences observed in PER-1 prevalence among the regions of Turkey were statistically significant (chi-square test; P < 0.001). Conclusion: These data demonstrate that the frequency of detection of PER-1 type β-lactamases in A. baumannii species has decreased in Turkey. However, the increased carbapenem resistance, together with multidrug resistance, has created a worrisome situation regarding this pathogen

Detection Of The Frequency Of Per-1 Type Extended-Spectrum Β-Lactamase Producing Acinetobacter Baumannii Clinical İsolates İn Turkey: A Multicenter Study

Background/aim: β-Lactamases are an important resistance mechanism in Acinetobacter baumannii. Pseudomonas extended-resistance (PER-1) type β-lactamaseproducing strains have been reported from various geographic locations; however, PER-1 type β-lactamases from Turkish hospitals have not been investigated extensively. The aim of this study was to determine the prevalence of PER-1 type β-lactamases in A. baumannii isolates in various regions of Turkey. Materials and methods: A total of 763 clinical A. baumannii isolates were collected from 9 university hospitals and 2 state hospitals between 2008 and 2011. Molecular amplification of the OXA-51 gene from the A. baumannii genome was performed in order to verify identification of the species. Real-time polymerase chain reaction was used to detect blaPER-1 genes. Results: PER-1 was detected in 24.6% of the isolates. The annual frequencies of the PER-1 enzyme were detected as 52.2%, 35.9%, and 8.3% in 2008, 2009, and 2010, respectively. PER-1 prevalence decreased gradually over time. The differences observed in PER-1 prevalence among the regions of Turkey were statistically significant (chi-square test; P > 0.001). Conclusion: These data demonstrate that the frequency of detection of PER-1 type β-lactamases in A. baumannii species has decreased in Turkey. However, the increased carbapenem resistance, together with multidrug resistance, has created a worrisome situation regarding this pathogen