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oai:gumushane-rdlopen.rawdatalibrary.net:gumushane/106512026-10-23T21:01:48Zopenairedrivercom_gumushane_10000col_gumushane_10001com_gumushane_10007col_gumushane_10171

Distribution of β-Lactamase Genes Among Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated From Patients in TurkeyIraz, MeryemDüzgün, Azer OzadSandalli, CemalDoymaz, Mehmet ZiyaAkkoyunlu, YaseminSaral, AysegulPeleg, Anton Y.Özgümüs, Osman BirolBeris, Fatih SabanKaraoglu, HakanÇiçek, Aysegul Copurbla(TEM-165)ColistinK. pneumoniaeNDM-1OXA-48Background: The emergence of carbapenem-resistant Klebsiella pneumoniae poses a serious problem to antibiotic management. We investigated the beta-lactamases in a group of carbapenem-resistant K. pneumoniae clinical isolates from Turkey. Methods: Thirty-seven strains of K. pneumoniae isolated from various clinical specimens were analyzed by antimicrobial susceptibility testing, PCR for the detection of p-lactamase genes, DNA sequencing, and repetitive extragenic palindronic (REP)- FOR analysis. Results: All 37 isolates were resistant to ampicillin, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefoperazone/sulbactam, cefepime, imipenem, and meropenem. The lowest resistance rates were observed for colistin (2.7%), tigecycline (11%), and amikacin (19%). According to FOR and sequencing results, 98% (36/37) of strains carried at least one carbapenemase gene, with 32 (86%) carrying OXA-48 and 7 (19%) carrying NDM-1. No other carbapenemase genes were identified. All strains carried a CTX-M-2-like beta-lactamase, and some carried SHV- (97%), TEM- (9%), and CTX-M-1-like (62%) beta-lactamases. Sequence analysis of bla(TEM) genes identified a bla(TEM-166) with an amino acid change at position 53 (Arg53Gly) from bla(TEM-1b), the first report of a mutation in this region. REP-FOR analysis revealed that there were seven different clonal groups, and temporo-spatial links were identified within these groups. Conclusions: Combinations of beta-lactamases were found in all strains, with the most common being OXA-48, SHV, TEM, and CTX-M-type (76% of strains). We have reported, for the first time, a high prevalence of the NDM-1 (19%) carbapenemase in carbapenem-resistant K. pneumoniae from Turkey. These enzymes often co-exist with other beta-lactamases, such as TEM, SHV, and CTX-M beta-lactamases.KOREAN SOC LABORATORY MEDICINE2015-11Articlehttps://rdlopen.rawdatalibrary.net/r/gumushane/10651https://doi.org/10.3343/alm.2015.35.6.5952234-3806enANNALS OF LABORATORY MEDICINEinfo:eu-repo/semantics/openAccessinfo:eu-repo/semantics/articlehttps://gumushane-rdlopen.rawdatalibrary.net/tr/items/gumushane/10651