Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay

Introduction: The aim of this study was to investigate the presence of carbapenemase production and carbapenem resistance mechanisms in 47 carbapenem resistant Klebsiella pneumoniae isolates by phenotypic confirmatory tests and molecular assay. Methodology: Carbapenem resistance genes KPC, OXA-48 and NDM were investigated with the BD MAX CRE assay kit in the BD MAX real time PCR instrument. Modified Hodge test, MBL gradient strip test, D70C Carbapenemase Detection Set, Temocillin gradient strip test methods were used as phenotypic confirmatory tests. Clonal relationship between study isolates was investigated with pulsed-field gel electrophoresis. Results: Analysis with BD MAX CRE assay revealed OXA-48 positivity in 17 (36%) strains, NDM positivity in 6 (13%) strains and coexistence of OXA-48 + NDM positivity in 8 (17%) strains. In 16 (34%) strains, none of the KPC, OXA-48 and NDM genes were detected. While MHT was the most sensitive phenotypic confirmatory test, D70C disc set had not been considered as a useful tool to assist the search for carbapenemase production. Temocillin gradient test alone could not be considered as sufficient to detect the presence of OXA-48. PFGE analyses revealed that 23 of 31 carbapenemase producing strains were in three major PFGE genotypes (A, B and C). Conclusions: This study revealed that carbapenem resistance observed in K. pneumoniae isolates was mainly due to OXA-48 and NDM genes and the increase of carbapenem resistance among K. pneumoniae strains in our hospital was due to the interhospital spread of especially 3 epidemic clones. © 2019 Ciftci et al.Firat University Scientific Research Projects Management Unit, FÃœBAP: 4093-TU1-14This study was supported by Suleyman Demirel University Scientific Research Projects Unit with project number 4093-TU1-14

Seroepidemiological investigation of toxocariasis in the is-parta Region of Turkey

Background: Toxocariasis is a common disease around the world. Our objective was to determine Toxocara seroprevalence in humans in the city of Isparta, Southwest Turkey, in respect of some determinants such as age, socio-economic level, residence in city center or rural area etc. Methods: Five hundred and thirty four individual participants from Isparta center and 85 from Asagi Gokdere village were included in the study. T. cati specific antibodies were analyzed using excretory-secretory (ES)-enzyme-linked immunosorbent assay (ELISA) method. Results: T. cati antibodies were detected as positive in 73 (13.6%) of 534 samples which were collected from subjects living in the city center and 24 (28.2%) of 85 samples from Asagi Gokdere village. Toxocara seropositivity was detected among 15.6% of whole study group. The seroprevalence of toxocariasis was significantly higher among subjects from village than in subjects from city center (P=0.001). While gender, high school education, source of the water which is used, family income and geophagia/eating nail behaviors were the features which were detected as being associated with toxocariasis seropositivity (odds ratios=0.5; 6.52; 3.61; 0.43; 0.13 respectively), owning dogs or cats and hand washing were detected as being not associated with toxocariasis seropositivity (P > 0.05). Furthermore, Toxocara seropositivity was significantly higher among subjects in 0-10 than >40 year-old group (P=0.02).Conclusion: It can be suggested that untreated lost pet population, environmental contamination, and way of life have influence on the epidemiology of toxocariasis