Molecular Epidemiology of Carbapenem-Resistant Enterobacterales Strains Isolated from Blood Cultures in Antalya, Turkey

Abstract

Objective: The aim of this study was to investigate the prevalence of carbapenemase and CTX-M genes among 330 blood culture isolates of Enterobacterales with reduced susceptibility to at least 1 carbapenem, between 2010 and 2015.

Methods: BD Max CRE assay and in-house PCR were used to detect carbapenemase and CTX-M genes.

Results: At least 1 carbapenemase gene was detected among 113 (74.3%) of the 152 carbapenem resistant isolates. The OXA-48 (69.7%) was the most common carbapenemase followed by VIM, NDM and IMP, whereas no tested isolates were KPC-positive. Eighty-six isolates (56.6%) had CTX-M and 65 had both OXA-48 and CTX-M. Carbapenemase production in Enterobacterales was significantly increased in years (P < .05).

Conclusion: Our study indicates that there is ongoing endemic circulation of the OXA-48 producing organism in our facility. It is noteworthy that more than half of the OXA-48 producing strains also produced CTX-M enzyme.

Keywords: CTX –M; Enterobactericeae isolates; OXA-48; bloodstream isolates; carbapenem resistant enterobacteriaceae; carbapenemase-producing carbapenem-resistant Enterobacteriaceae.