Performance of CarbaNP and CIM tests in OXA-48 carbapenemase-producing Enterobacteriaceae

This study applied two phenotypic tests, namely “Carbapenemase Nordmann–Poirel” (CarbaNP) test and “Carbapenem Inactivation Method” (CIM), against the isolates carrying the carbapenem resistance genes. The study included 83 carbapenem-resistant Enterobacteriaceae isolates producing oxacillinase-48 (OXA-48) and 30 carbapenem-sensitive Enterobacteriaceae isolates. Out of the total isolates studied, 77 isolates (92.77%) were identified as Klebsiella pneumoniae and six isolates (7.23%) were identified as Escherichia coli by Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry. Polymerase chain reaction (PCR) method used to detect resistance genes found that 74 isolates (89.16%) produced OXA-48 carbapenemase, whereas nine isolates (10.84%) produced both OXA-48 and New Delhi metallo-beta-lactamase-1 (NDM-1). The isolates producing both OXA-48 and NDM-1 were found to be positive by both phenotypic tests. Among isolates carrying only blaOXA-48 gene alone, nine isolates (13.04%) for CarbaNP test and two isolates for CIM test (2.90%) displayed false negative results, respectively. The sensitivity of CarbaNP and CIM tests was found to be 89.16% and 97.59%, respectively, whereas the specificity was determined to be 100% for both tests. These findings suggest that CarbaNP and CIM tests are useful tools to identify the carbapenemase producers. Molecular methods like PCR are recommended to verify false negative tests predicted to have OXA-48 activity

High rate of colistin and fosfomycin resistance among carbapenemase-producing Enterobacteriaceae in Turkey

When the problem with carbapenem-resistant Enterobacteriaceae (CRE) increases, the older antimicrobial agents such as colistin and fosfomycin are used for the treatment of these infections. In this study, the broth microdilution method for colistin and the agar dilution method for fosfomycin were used for a total of 147 multidrug-resistant (MDR) or extensively drug-resistant (XDR) strains of CRE. The study included Klebsiella pneumoniae (91.16%), Escherichia coli (7.48%), Enterobacter cloacae (0.68%), and Serratia marcescens (0.68%). All these strains produce various types of carbapenemase, including OXA-48, NDM, and KPC. Some of these strains also have three different carbapenemase mechanisms, including OXA-48 (78.23%), NDM (2.04%), and KPC (0.68%) or OXA-48 and NDM (10.88%), or OXA-48 and KPC (0.68%). About 76.19% of the strains and 67.35% of the strains were resistant for colistin and fosfomycin, respectively. A total of 21 out of 35 colistin-susceptible strains were found to be susceptible to fosfomycin. This study showed that the resistance rates of colistin and fosfomycin are high. The MDR and XDR strains of CRE are spreading in our region and thus a monitoring system for CRE should be followed. Moreover, the applicability of antimicrobial stewardship programs should be increased in all inpatient and outpatient settings

Antibiotic consumption, resistance data, and prevention strategies

WOS: 000463053800025Dünyada ve ülkemizde antibiyotik tüketiminin artışına ilişkin veriler alarm vermektedir. Aşırı tüketim artan antibiyotik direncini tetiklemektedir. Ne yazık ki ülkemiz antibiyotik direncinin en fazla yaşandığı ülkelerdendir. Bu sorunları yenmek için son yıllarda ciddi çabalar verilse de halen alınması gereken çok yol vardır. Bugün hastanelerde antibiyotik tüketimi, tüketimin değerlendirilmesi ve strateji geliştirilmesi için antibiyotik yönetişimi kullanılmaktadır. Bu raporda, antibiyotik yönetişiminin başlıca bileşenleri, antibiyotik tüketiminin global ve ülkemiz genelindeki durumu, direnç verileri, direnci engellemeye yönelik stratejilerin değerlendirilmesi ve alınması gereken önlemlerin güncel veriler eşliğinde ortaya konulması amaçlanmıştır.Antibiotic consumption in the world and in our country. has reached alarm dimensions. This over-consumption has also made antibiotic resistance a major problem. Unfortunately, our country is one of the countries where antibiotic resistance is experienced. Serious efforts have been made in recent years to overcome these problems. However, there are still many distances to be taken. Today, evaluation of antibiotic consumption and consumption in hospitals is determined by antibiotic stewardship. In this report, antibiotics governance, antibiotic consumption in global and country-wide status, resistance data, evaluation of strategies to prevent resistance and measures to be taken are aimed