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Antimicrobial resistance profile of Escherichia coli causing bacteremia in patients in intensive care units

Journal article published in 2015 by Suleyman Durmaz, Asli Kiraz, Duygu Percin, Mehmet Doganay
This paper is available in a repository.
This paper is available in a repository.

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Preprint: policy unknown
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Postprint: policy unknown
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Published version: policy unknown

Abstract

Aims: A crucial mechanism of antibiotic resistance of Escherichia coli (E.coli), a member of gram-negative bacteria that cause infections in intensive care units (ICUs), is beta-lactamase production. This study aims to determine extended-spectrum betalactamase (ESBL) production frequency and antibiotic resistance profile of E.coli strains isolated from blood cultures of adult patients in different intensive ICUs at Erciyes University-Kayseri, Turkey. Materials and methods: This study includes only one E.coli strain per patient. Antibiotic susceptibility test of 81 E.coli strains were performed using Kirby-Bauer disk diffusion method. ESBL-production was determined using double-disk synergy test. Results: A total of 58 (72%) strains were isolated from patients in internal ICUs while 23 (28%) strains were isolated from patients in surgical ICUs. A total of 44 (54.3%) strains were found to produce ESBL with ESBL-production rate of 55.2% in internal ICUs and 52.2% in surgical ICUs. Difference between the presence of ESBL-producing E.coli in male and female patients in ICUs is not statistically significant. 8 (9.8%), 46 (56.8%), 69 (85.2%), 22 (27.2%), and 44 (54.3%) and zero strains were resistant to amikacine, ciprofloxacine, ampicillin, piperacillin-tazobactam, cefotaxime, and imipenem, respectively, and no strains were resistant to imipenenm. Resistance to amikacin, ciprofloxacin, ampicillin and cefotaxime in ESBL producing strains were significantly higher than ESBL non-producing strains (p<0.05). Piperacillin-tazobactam resistance ratio for E.coli strains isolated from surgical ICUs was found to be significantly greater than those isolated from internal ICUs (p<0.05). Despite higher ratios of ESBL-production of E.coli strains, carbapenem resistance was not gratifyingly determined in the ICUs. Conclusion: Early diagnosis and immediate treatment of nosocomial bacteremia are important for patients' survival. Therefore, monitoring antibiotic susceptibility profiles of isolated microorganisms will guide clinicians for controlling infections.