Diverse efficacy of CarbaNP test among OXA-48 carbapenemase producing Enterobacterales in an endemic region

After the first description of OXA-48 type carbapenemase, it has become endemic in Europe, Mediterranean and North African countries in a short time. OXA-48 carbapenemase is the most difficult type to determine and accurate diagnosis is crucial especially in endemic areas. The CarbaNP test was described as a rapid phenotypic evaluation method of carbapenemases activity. Sensitivity and specifity of this test were high within all carbapenemases genes. In our study, we evaluated the efficacy of CarbaNP test in routine laboratories located in an endemic area of OXA-48 producing Enterobacterales. A total of 53 Enterobacterales isolates were included in this study. Antimicrobial susceptibility of the isolates to imipenem, meropenem and ertapenem was determined. Polymerase Chain Reaction (PCR) was carried out for the detection of carbapenemases genes (bla(KPC), bla(NDM), bla(BIC), bla(IMP), bla(VIM), bla(SPM), bla(AIM), bla(DIM), bla(GIM), bla(SIM), and bla(OXA-48)). The Carba NP test was performed as in the protocol described previously. Altogether 31 isolates (58.4%) were bla(OXA-48) positive (18 Klebsiella pneumoniae, 8 Escherichia coli, 2 Serratia marcescens, 1 Enterobacter aerogenes, 1 Pantoea agglomerans and 1 Morganella morganii). Among these isolates 3 (5.6%) and 2 (3.7%) isolates were also positive for bla(VIM) and bla(SPM), respectively. The sensitivity and specifity of CarbaNP test were found 64.5, and 68.2% respectively. It was observed that determination of positive isolates is hard to distinguish and subjective. The CarbaNP test has suboptimal results and low of sensitivity and specifity for detection of OXA-48 producing Enterobacterales, and not suitable for detection of bla(OXA-48) positive isolates in routine laboratories in endemic areas

Biofilm Formation Research of Coagulase-Negative Staphylococci Isolates' Isolated from Blood and Hand Culture at Nanofilm Covered Micro Plaques by Plasma Polymerization Technique: An Experimental Model

Introduction: Coagulase-negative staphylococci (CNS) can protect themselves from the effects of antibiotics by producing biofilms through breeding on biomaterials, medical equipment and devices. It is possible to influence biofilm formation with the aid of various surface modifications. In our study, plasma polymerization method, which is a surface modification technique, was used. The plasma polymerization technique is an environmentally-friendly technique that allows you to modify the nanometer level only at the surface without affecting the stack using the fourth state of the material. The possibility to generate surfaces with different properties (hydrophilic, hydrophobic, biocompatible etc.) by the help of various monomers and gases has made this technique more popular. In this study, the effect of the microplate surfaces modified by three different monomers on the biofilm formation of CNS was investigated. Materials and Methods: A total of 60 isolated CNS isolates from blood and hand cultures were included into the study. As control strains, Staphylococcus epidermidis ATCC 35984, known to be biofilm positive, and S. epidermidis ATCC 12228 which do not form biofilm, were used. Slime formation was determined by the quantitative plaque assay method described by Christensen. In microplates, which were plain or modified by three different monomers, the biofilm formation behavior of all strains was investigated simultaneously and comparatively. Results: There was no difference in biofilm positivity between strains isolated from hand and blood. A total of 71.6% biofilm formation was observed on microplates, which were not coated with plasma technique, and on plasma-modified microplated surfaces, 80% (monomer: 3- mercaptopropionic acid), 65% (monomer: 2-hydroxyethyl methacylate) and 31.6% (monomer: ethylene glycol dimethacylate) biofilm formation was observed, respectively. It was found that ethylene glycol dimethacrylate in three monomers significantly inhibited biofilm formation when compared to other monomers. Conclusion: In recent years CNS, especially S. epidermidis has become the most frequently isolated bacteria in catheter infections and responsible for the 28% of nosocomial bacteremia. The widespread use of prosthetic and permanent devices has been shown as a reason for the increase in the frequency of this effect. In 90% of patients with S. epidermidis bacteremia, there is an intravascular catheter history. Biofilm is an extracellular structure containing water, proteins and carbohydrates and is responsible for the unwanted adhesion of microorganisms to host cells and artificial surfaces. The biofilm mechanism can be altered by the interaction between the material surface and the bacterial surface. In our study, in-vitro results were obtained showing the potential to reduce the risk of biofilm-associated infection by microorganism biofilm formation on modified surfaces with appropriate monomer selection