{"id":13889,"date":"2021-01-05T01:21:41","date_gmt":"2021-01-04T22:21:41","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/\/2021\/01\/05\/karbapenemaz-ureten-klebsiella-pneumoniae-suslarinin-fosfomisin-ve-kloramfenikol-duyarliliklarinin-arastirilmasi\/"},"modified":"2021-01-05T01:21:41","modified_gmt":"2021-01-04T22:21:41","slug":"karbapenemaz-ureten-klebsiella-pneumoniae-suslarinin-fosfomisin-ve-kloramfenikol-duyarliliklarinin-arastirilmasi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2021\/01\/05\/karbapenemaz-ureten-klebsiella-pneumoniae-suslarinin-fosfomisin-ve-kloramfenikol-duyarliliklarinin-arastirilmasi\/","title":{"rendered":"Karbapenemaz \u00dcreten Klebsiella pneumoniae Su\u015flar\u0131n\u0131n Fosfomisin ve Kloramfenikol Duyarl\u0131l\u0131klar\u0131n\u0131n Ara\u015ft\u0131r\u0131lmas\u0131"},"content":{"rendered":"<p><strong>Ama\u00e7<\/strong>: Antimikrobiyal diren\u00e7, t\u00fcm d\u00fcnyada son y\u0131llar\u0131n en ciddi sa\u011fl\u0131k sorunlar\u0131ndan birisidir. Son y\u0131llarda, \u00fclkemiz de ba\u015fta olmak \u00fczere bir\u00e7ok \u00fclkede \u00e7oklu antibiyotik direncine sahip Klebsiella pneumoniae ciddi sorun olu\u015fturmaktad\u0131r. Bu \u00e7al\u0131\u015fman\u0131n amac\u0131, rektal s\u00fcr\u00fcnt\u00fc \u00f6rneklerinden izole edilen karbapeneme diren\u00e7li K. pneumoniae su\u015flar\u0131nda dirence neden olan molek\u00fcler mekanizmalar\u0131n tespiti ve bu bakterilerin tedavide alternatif olabilecek kloramfenikol ve fosfomisine duyarl\u0131l\u0131klar\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131d\u0131r.<\/p>\n<p><strong>Y\u00f6ntemler<\/strong>: \u00c7al\u0131\u015fmaya, yo\u011fun bak\u0131m \u00fcnitesi hastalar\u0131ndan al\u0131nan rektal s\u00fcr\u00fcnt\u00fc \u00f6rneklerinden 2 mg\/lt meropenem i\u00e7eren MacConkey agar\u0131nda izole edilen 46 K. pneumoniae su\u015fu dahil edilmi\u015ftir. Su\u015flar\u0131n karbapeneme diren\u00e7leri gradyan \u015ferit y\u00f6ntemiyle meropenem minimum inhibit\u00f6r konsantrasyon de\u011ferleri belirlenerek do\u011frulanm\u0131\u015ft\u0131r. Karbapeneme diren\u00e7li bulunan k\u00f6kenlerde blaKPC, blaNDM, blaOXA, blaIMP ve blaVIM genlerinin varl\u0131\u011f\u0131 ger\u00e7ek zamanl\u0131 polimeraz zincir reaksiyonu y\u00f6ntemi kullan\u0131larak ara\u015ft\u0131r\u0131lm\u0131\u015ft\u0131r. Kloramfenikol duyarl\u0131l\u0131\u011f\u0131 s\u0131v\u0131 mikrodil\u00fcsyon, fosfomisin duyarl\u0131l\u0131\u011f\u0131 ise gradyan \u015ferit y\u00f6ntemleriyle de\u011ferlendirilmi\u015ftir.<\/p>\n<p><strong>Bulgular<\/strong>: T\u00fcm K. pneumoniae su\u015flar\u0131nda en az bir karbapenemaz geni saptanm\u0131\u015ft\u0131r. Bunlardan, OXA-48 tipi karbapenemaz geninin t\u00fcm su\u015flarda pozitif oldu\u011fu, ayr\u0131ca su\u015flar\u0131n 12 (%26)\u2019sinde OXA-48 ve NDM-1, 1 (%2)\u2019inde ise OXA-48, NDM-1 ve IMP-1 karbapenemaz genlerinin ayn\u0131 anda varl\u0131\u011f\u0131 saptanm\u0131\u015ft\u0131r. Karbapeneme diren\u00e7li K. pneumoniae su\u015flar\u0131ndan sadece 3 (%6)\u2019\u00fc fosfomisine duyarl\u0131 bulunmu\u015f olmakla beraber, 23 (%50)\u2019\u00fc kloramfenikole duyarl\u0131 bulunmu\u015ftur. Birden fazla t\u00fcrde karbapenemaz \u00fcreten su\u015flarda gerek kloramfenikol gerekse de fosfomisin direncinin daha y\u00fcksek olma e\u011filimi g\u00f6zlenmi\u015ftir.<\/p>\n<p><strong>Sonu\u00e7lar<\/strong>: K. pneumoniae su\u015flar\u0131ndan sadece %6\u2019s\u0131n\u0131n fosfomisine duyarl\u0131 bulunmas\u0131, \u00fclkemizde diren\u00e7li k\u00f6kenlerin neden oldu\u011fu infeksiyonlar\u0131n tedavisinde bir se\u00e7enek olma ihtimalinin d\u00fc\u015f\u00fck oldu\u011funu g\u00f6stermektedir. Kloramfenikol duyarl\u0131l\u0131\u011f\u0131 fosfomisine oranla daha y\u00fcksek (%50) bulunmu\u015f olmakla beraber, bu antibiyoti\u011fin sistemik infeksiyonlarda kullan\u0131lmaya ba\u015flanmas\u0131yla ilgili daha fazla klinik veriye gerek vard\u0131r. \u00d6te yandan, farkl\u0131 karbapenemazlar\u0131 bir arada \u00fcreten k\u00f6kenler gerek kloramfenikol gerekse de fosfomisine daha diren\u00e7li olabilmektedir.<\/p>\n<p>Klimik Dergisi 2020; 33(1): 15-8.<\/p>\n<p><strong>Cite this article as<\/strong>: Borsa BA, G\u00fcng\u00f6rd\u00fc-Dalar Z, Karakulluk\u00e7u A, \u00d6zalp VC, Ayg\u00fcn G. [Investigation of fosfomycin and chloramphenicol susceptibility of carbapenemase-producing Klebsiella pneumoniae strains]. Klimik Derg. 2020; 33(1): 15-8. Turkish.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ama\u00e7: Antimikrobiyal diren\u00e7, t\u00fcm d\u00fcnyada son y\u0131llar\u0131n en ciddi sa\u011fl\u0131k sorunlar\u0131ndan birisidir. Son y\u0131llarda, \u00fclkemiz de ba\u015fta olmak \u00fczere bir\u00e7ok \u00fclkede \u00e7oklu antibiyotik direncine sahip Klebsiella pneumoniae ciddi sorun olu\u015fturmaktad\u0131r. Bu \u00e7al\u0131\u015fman\u0131n amac\u0131, rektal s\u00fcr\u00fcnt\u00fc \u00f6rneklerinden izole edilen karbapeneme diren\u00e7li K. pneumoniae su\u015flar\u0131nda dirence neden olan molek\u00fcler mekanizmalar\u0131n tespiti ve bu bakterilerin tedavide alternatif olabilecek [&hellip;]<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[4195,4383,2962,3021],"class_list":["post-13889","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-fosfomisin","tag-karbapenemler","tag-klebsiella-pneumoniae","tag-kloramfenikol"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/13889","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=13889"}],"version-history":[{"count":0,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/13889\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=13889"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=13889"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=13889"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}