Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit

Introduction: Gram-negative sepsis constitutes a significant cause of mortality and morbidity in the burns intensive care unit (BICU). In the current era of a global antibiotic resistance crisis, it is imperative to monitor the geographical distribution of carbapenem-resistant microorganisms. Theref...

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Main Authors: Özge ÇAYDAŞI, Nur BENZONANA, Füsun CAN, Demet HACISEYİTOĞLU, Kaan GİDEROĞLU, Raşit Serdar ÖZER, Önder ERGÖNÜL
Format: Article
Language:English
Published: Bilimsel Tip Yayinevi 2024-03-01
Series:Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
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Online Access:http://floradergisi.org/managete/fu_folder/2024-01/2024-29-01-96-104.pdf
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author Özge ÇAYDAŞI
Nur BENZONANA
Füsun CAN
Demet HACISEYİTOĞLU
Kaan GİDEROĞLU
Raşit Serdar ÖZER
Önder ERGÖNÜL
author_facet Özge ÇAYDAŞI
Nur BENZONANA
Füsun CAN
Demet HACISEYİTOĞLU
Kaan GİDEROĞLU
Raşit Serdar ÖZER
Önder ERGÖNÜL
author_sort Özge ÇAYDAŞI
collection DOAJ
description Introduction: Gram-negative sepsis constitutes a significant cause of mortality and morbidity in the burns intensive care unit (BICU). In the current era of a global antibiotic resistance crisis, it is imperative to monitor the geographical distribution of carbapenem-resistant microorganisms. Therefore, we aimed to determine the resistance rates of gram-negative microorganisms and the mechanisms that cause carbapenem resistance in the BICU. Materials and Methods: From February 2015 to February 2016, we conducted a patient follow-up in the BICU of our hospital. Carbapenem-resistant gram-negative bacteria were identified in the blood cultures of 39 patients. Forty-nine episodes of bacteremia in 39 patients were included in this study. The study assessed the relationship between patients’ demographic characteristics, signs associated with burn, abbreviated burn severity index (ABSI), and acute physiology and chronic health evaluation (APACHE-II) score with mortality. The carbapenemase enzyme was identified using genotypic methods. Carbapenemase gene regions in DNA samples were investigated by multiplex polymerase chain reaction (PCR). Results: Out of the total cases, 77% were male patients with a median age of 36 (1-89) years. Flame burn was detected as the most common. The mortality rate in this study was 43%. Statistically significant relationships were identified between ABSI and APACHE-II scores with mortality. Of the blood culture isolates, 27 (55%) were Acinetobacter baumannii, 17 (34%) Pseudomonas aeruginosa, three (6%) Klebsiella pneumoniae, one (2%) Enterobacter cloacae, one (2%) Proteus vulgaris. OXA-23 enzyme was detected in all of the A. baumannii strains. KPC enzyme was detected in one of the P. aeruginosa strains. NDM was found in two of the K. pneumoniae strains, and NDM-1 and OXA-48 enzymes were detected together in one. NDM enzyme was detected in the E. cloacae strain. Conclusion: In this study, it was observed that A. baumannii strains are the most prevalent agents causing bacteremia in the burns intensive care unit (BICU). While the OXA-23 gene was detected in all of the A. baumannii strains, the Carbapenemase enzyme was not detected in 94% of the P. aeruginosa strains. It is anticipated that these data will guide the selection of antibiotics in the burns intensive care unit (BICU).
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spelling doaj.art-6ddaca0fb4a04c948f6bace4cfa090e42024-03-26T10:47:50ZengBilimsel Tip YayineviFlora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi1300-932X2024-03-012919610410.5578/flora.202401894Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care UnitÖzge ÇAYDAŞI0https://orcid.org/0000-0003-2804-3101Nur BENZONANA1https://orcid.org/0000-0002-0803-0891Füsun CAN2https://orcid.org/0000-0001-9387-2526Demet HACISEYİTOĞLU3https://orcid.org/0000-0001-7404-8347Kaan GİDEROĞLU4https://orcid.org/0000-0003-2696-8274Raşit Serdar ÖZER5https://orcid.org/0009-0001-9852-5467Önder ERGÖNÜL6https://orcid.org/0000-0003-1935-9235Clinic of Infectious Diseases and Clinical Microbiology, Sancaktepe Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, TürkiyeClinic of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, TürkiyeDepartment of Medical Microbiology, Koç University Faculty of Medicine, İstanbul, TürkiyeDepartment of Medical Microbiology, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, TürkiyeClinic of Plastic Reconstructive and Aesthetic Surgery, Taksim Training and Research Hospital, İstanbul, TürkiyeClinic of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, TürkiyeClinic of Infectious Diseases and Clinical Microbiology, Koç University Faculty of Medicine, İstanbul, TürkiyeIntroduction: Gram-negative sepsis constitutes a significant cause of mortality and morbidity in the burns intensive care unit (BICU). In the current era of a global antibiotic resistance crisis, it is imperative to monitor the geographical distribution of carbapenem-resistant microorganisms. Therefore, we aimed to determine the resistance rates of gram-negative microorganisms and the mechanisms that cause carbapenem resistance in the BICU. Materials and Methods: From February 2015 to February 2016, we conducted a patient follow-up in the BICU of our hospital. Carbapenem-resistant gram-negative bacteria were identified in the blood cultures of 39 patients. Forty-nine episodes of bacteremia in 39 patients were included in this study. The study assessed the relationship between patients’ demographic characteristics, signs associated with burn, abbreviated burn severity index (ABSI), and acute physiology and chronic health evaluation (APACHE-II) score with mortality. The carbapenemase enzyme was identified using genotypic methods. Carbapenemase gene regions in DNA samples were investigated by multiplex polymerase chain reaction (PCR). Results: Out of the total cases, 77% were male patients with a median age of 36 (1-89) years. Flame burn was detected as the most common. The mortality rate in this study was 43%. Statistically significant relationships were identified between ABSI and APACHE-II scores with mortality. Of the blood culture isolates, 27 (55%) were Acinetobacter baumannii, 17 (34%) Pseudomonas aeruginosa, three (6%) Klebsiella pneumoniae, one (2%) Enterobacter cloacae, one (2%) Proteus vulgaris. OXA-23 enzyme was detected in all of the A. baumannii strains. KPC enzyme was detected in one of the P. aeruginosa strains. NDM was found in two of the K. pneumoniae strains, and NDM-1 and OXA-48 enzymes were detected together in one. NDM enzyme was detected in the E. cloacae strain. Conclusion: In this study, it was observed that A. baumannii strains are the most prevalent agents causing bacteremia in the burns intensive care unit (BICU). While the OXA-23 gene was detected in all of the A. baumannii strains, the Carbapenemase enzyme was not detected in 94% of the P. aeruginosa strains. It is anticipated that these data will guide the selection of antibiotics in the burns intensive care unit (BICU).http://floradergisi.org/managete/fu_folder/2024-01/2024-29-01-96-104.pdfantibiotic resistancegram-negative bacteriacarbapenemase
spellingShingle Özge ÇAYDAŞI
Nur BENZONANA
Füsun CAN
Demet HACISEYİTOĞLU
Kaan GİDEROĞLU
Raşit Serdar ÖZER
Önder ERGÖNÜL
Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit
Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
antibiotic resistance
gram-negative bacteria
carbapenemase
title Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit
title_full Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit
title_fullStr Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit
title_full_unstemmed Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit
title_short Determination of Carbapenem Resistance in Gram-Negative Bacteremia in the Burn Intensive Care Unit
title_sort determination of carbapenem resistance in gram negative bacteremia in the burn intensive care unit
topic antibiotic resistance
gram-negative bacteria
carbapenemase
url http://floradergisi.org/managete/fu_folder/2024-01/2024-29-01-96-104.pdf
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