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Enterococcus faecalis plays a significant role in hospital-acquired infections (HAIs), and combination of penicillin with aminoglycoside is important in therapy of invasive HAIs. Penicillin resistance in this organism is due to modification of the drug target, penicillin-binding protein (PBP5), its overproduction and expression of β-lactamase. Although rare, this phenotype is often associated with multi-resistant high-risk enterococcal clonal complexes (HiRECCs), such as CC2 and CC9 which may promote its spread in the near future.
In this study, a hundred Klebsiella pneumoniae strains isolated from urinary tract infections were evaluated in terms of genotyping, susceptibility to certain antibiotics and detection of extended spectrum of beta lactamase (ESBL) production. The random amplified polymorphic DNA (RAPD-PCR) method was used to identify the genetic differentiation of K pneumoniae isolates. A total of 26 different DNA bands ranging between 334 bp and 28033 bp were detected among the strains. It was found that 100 K. pneumoniae strains revealed 11 different RAPD profiles. Antibiotic susceptibility tests were conducted using a disc diffusion method against 16 antibiotics. Fifty-five different resistance profiles were determined among the strains. ESBL-productions of the strains were determined by the double disc synergy test (DDST) and ESBL E-test methods. ESBL production rates among the strains were found to be 55% by E-test method and 45% by DDST method. While ESBL-producing K. pneumoniae strains showed the greatest resistance to penicillin G (100%), followed by piperacillin (92.7%) and erythromycin (85.4%), the resistance rates of non ESBLproducing strains to those antibiotics were determined as 97.8%, 88.8% and 88.8%, respectively. Both groups of strains showed the highest sensitivity to meropenem. Based on the results obtained from the study, it was concluded that the detection of ESBL-producing strains by the E-test method was more sensitive than by the DDST method. Phenotypic and genotypic identification methods should be used together to detect ESBL presence. The RAPD-PCR method alone will not be adequate in the genotyping of the strains and alternative DNA-based methods should be used.
The incidence of extended-spectrum β-lactamases (ESBLs) was analyzed in Enterobacteriaceae population circulating in the Upper Silesian Child and Mother Health Center in Katowice (USC&MHC). Altogether 1164 clinical specimens, collected from children hospitalized in 8 different hospital units of USC&MHC were investigated. Five hundred and eighty-five clinical isolates of the family Enterobacteriaceae were identified in specimens collected from 403 patients. Two hundred and twenty-nine Enterobacteriaceae strains (39%) isolated from 162 patients were found to be putative ESBL producers as revealed by double-disc synergy (DDS) test. ESBL activity was the most prevalent in the population of Klebsiella pneumoniae (77%), followed by Klebsiella oxytoca (50%), Serratia marcescens (43%), Escherichia coli (30%), Enterobacter spp. (18%) and Proteus mirabilis (12%). ESBL producers demonstrated also wide resistance to the non-β-lactam antimicrobial co-trimoxazole (93%) and the aminoglycosides netilmicin (88%), gentamicin (84%) and amikacin (79%).
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