Produkcija karbapenemaza kod bolničkih multirezistentnih sojeva Klebsiella pneumoniae i Escherichia coli u Srbiji

  • Anika Djordje Trudić Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Zora Jelesić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
  • Mira Mihajlović-Ukropina University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
  • Deana Medić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
  • Branka Zivlak University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
  • Vera Gusman University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
  • Milan Djilas Institute for Public Health of Vojvodina, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP150917260T
Ključne reči: enterobacteriaceae||, ||enterobacteriaceae, drug resistance, bacterial||, ||lekovi, rezistencija mikroorganizama, carbapenems||, ||karbapenemi, cross infection||, ||infekcija, intrahospitalna, genome, ||genom, bakterijski, serbia||, ||srbija, beta lactamases||, ||beta-laktamaze,

Sažetak


Uvod/Cilj. Rezistencija na karbapeneme među medicinski značajnim enterobakterijama kao što su Klebsiella pneumoniae i Escherichia coli u porastu je širom sveta. Zabrinjavajuća je činjenica da su terapijske mogućnosti kod infekcija uzrokovanih multirezistentnim sojevima ograničene ili ih nema. Do sada nije rađena sveobuhvatnija studija o produkciji karbapenemaza kod enterobakterija u Srbiji. Cilj istraživanja bio je utvrđivanje produkcije karbapenemaza kod bolničkih multirezistentnih sojeva K. pneumoniae i E. coli u Srbiji. Metode. Izolati K. pneumoniae i E. coli rezistentni na najmanje jedan karbapenem (imipenem, meropenem, ertapenem) prikupljani su od novembra 2013. do maja 2014. Bakterijski sojevi izolovani su iz klinički značajnih uzoraka od bolesnika lečenih u 14 bolnica u Srbiji. Rezistencija na karbapeneme potvrđena je fenotipskim testom i reakcijom lančane polimerizacije u Nacionalnoj referentnoj laboratoriji za registrovanje i praćenje rezistencije bakterijskih sojeva na antimikrobna sredstva u Novom Sadu. Rezultati. Od ukupno 129 prikupljenih sojeva, bio je 121 (93,8%) izolat K. pneumoniae i 8 (6,2%) izolata E. coli. Iz urina je izolovano 70 (54,3%) sojeva, iz krvi 26 (20,2%), iz sekreta rana 19 (14,7%) i 14 (10,9%) iz sekreta donjeg respiratornog trakta. Geni koji kodiraju karbapenemaze su nađeni kod 58 (45%) izolata. Gen bla New Delhi metallo-beta-lactamases (blaNDM), dokazan je kod 33 (27,3%) izolata K. pneumoniae, bla oxacillinases-48 (blaOXA-48) kod 10 (8,3%), bla K. pneumonia carbapenemase (blaKPC) kod 1 (0,8%), a kod 7 (5,4%) izolata su istovremeno nađeni geni blaOXA-48 i blaNDM. Kod 7 izolata E. coli su detektovani blaNDM geni. Zaključak. Najčešći tip karbapenemaza u Srbiji kod multirezistentnih izolata K. pneumoniae i E. coli je NDM. Istovremena produkcija OXA-48 i NDM detektovana je kod izolata K. pneumoniae. Prema našem saznanju, prvi put je nađena produkcija KPC u Srbiji.

Biografije autora

Anika Djordje Trudić, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Centar za mikrobiologiju, virusologiju i imunologiju, asist. dr
Zora Jelesić, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Centar za mikrobiologiju, prof. dr
Mira Mihajlović-Ukropina, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Centar za mikrobiologiju, prof. dr
Deana Medić, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Centar za mikrobiologiju, doc. dr
Branka Zivlak, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Centar za mikrobiologiju, asist. dr

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Objavljeno
2017/09/19
Broj časopisa
Vol. 74 Br. 8 (2017)
Rubrika
Originalni članak