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Open access

Nermin Hande Avcioglu and Isil Seyis Bilkay

Abstract

Background

Klebsiella species are important opportunistic pathogens causing a variety of infections, especially in hospitalized and immunocompromised patients.

Objectives

To investigate the clinical prevalence of five different Klebsiella species (K. pneumoniae, K. ornithinolytica, K. oxytoca, K. terrigena, and K. rhinoscleromatis) including antibiotic resistance profiles using six different antibiotics and combinations (trimethoprim-sulfamethoxazole, ampicillin-sulbactam, imipenem, piperacillin-tazobactam, ciprofloxacin, ceftizoxime).

Methods

Resistance of Klebsiella spp. including multidrug resistant (MDR) strains was determined by using a Kirby–Bauer disk diffusion method and genotypical analysis was performed by enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR).

Results

Urine samples and the urology service unit were the most common sources of K. ornithinolytica, K. pneumoniae, and K. terrigena strains. The greatest drug resistance was observed against trimethoprim-sulfamethoxazole (88%), the least resistance was observed against imipenem (12%). Apart from these, 11 different antibiotypes were generated and antibiotype AI (resistant only to trimethoprim-sulfamethoxazole) was the most frequently observed (40%). MDR profiles of Klebsiella spp. were also investigated and 25% of all Klebsiella spp. strains were found to be MDR; and 65% of these were isolated from urine samples. MDR strains were mostly found to be K. ornithinolytica (35%) followed by K. pneumoniae (29%). Genotyping was performed by using ERIC PCR and Klebsiella spp. strains were grouped in 23 genotypes with a similarity coefficient of 70%.

Conclusions

Antibiotyping and antibiotype profiles may provide valuable information for hospitalized patients that could identify problem spots and allow evidence-based provision of preventive measures against nosocomial emergence of infections with new MDR strains.

Open access

Gulcan Sahal and Isil Seyis Bilkay

Abstract

Background

Biofilm formation on indwelling devices is one of the most important mechanisms playing a role in device-related urinary tract infections caused by Proteus mirabilis. Increasing antibiotic resistance of microorganisms has raised questions concerning the relationship between biofilm formation and drug resistance.

Objectives

To determine clinical prevalence, antibiotic resistance of, and biofilm formation by P. mirabilis strains.

Methods

We studied the susceptibilities of various P. mirabilis strains isolated from different clinical materials by a disc-diffusion method. Biofilm formation was determined by a crystal violet binding assay.

Results

Two (13%) of 15 P. mirabilis strains were found to be strong biofilm formers (SBF). Both SBF P. mirabilis strains were isolated from urine samples from children less than 15 years old in a pediatric emergency unit. Cefixime, cefazolin, ceftriaxone, amikacin, and piperacillin/tazobactam were the most effective antibiotics against 15 P. mirabilis strains (100%), whereas SBF P. mirabilis strains were multidrug resistant or (resistant to 5 different antimicrobial classes). Both of the SBF P. mirabilis strains, but neither of the weak biofilm forming P. mirabilis strains were resistant to ampicillin and ceftazidime among β-lactam antibiotics, or tobramycin and gentamicin among aminoglycoside antibiotics used in the present study.

Conclusions

Children comprise the only patients infected with SBF P. mirabilis strains and both SBF P. mirabilis strains displayed high antimicrobial resistance in our setting.