HIGH RATE OF COLISTIN AND FOSFOMYCIN RESISTANCE AMONG CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE IN TURKEY

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Yildiz S. S., KAŞKATEPE B., Simsek H., Sariguzel F.

ACTA MICROBIOLOGICA ET IMMUNOLOGICA HUNGARICA, cilt.66, sa.1, ss.103-112, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 66 Sayı: 1
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1556/030.65.2018.042
  • Dergi Adı: ACTA MICROBIOLOGICA ET IMMUNOLOGICA HUNGARICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.103-112
  • Anahtar Kelimeler: carbapenem-resistant Enterobacteriaceae, colistin, fosfomycin, broth microdilution, agar dilution, KLEBSIELLA-PNEUMONIAE, EMERGENCE, PLASMID, IDENTIFICATION, ANTIBIOTICS, MULTICENTER, GENES, MCR-2
  • Erciyes Üniversitesi Adresli: Evet

Özet

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 con (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.