title: Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae isolates from Turkey with OXA-48-like carbapenemases and outer membrane protein loss.
abstract: Treatment options are limited in infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, with carbapenems generally preferred. Disturbingly, however, carbapenem-resistant strains are emerging worldwide. Here we report two clinical isolates, one Escherichia coli and one Klebsiella pneumoniae, each with high-level carbapenem resistance (imipenem minimum inhibitory concentration of 32 microg/mL). They were isolated following imipenem therapy from two hospital patients who had received imipenem therapy in different regions of Turkey. Both isolates produced OXA-48-like carbapenemases, enzymes so far reported only from Turkey. Both isolates also had group 1 CTX-M-type ESBLs and had lost major outer membrane proteins. OXA-48-like carbapenemases appear to be scattered in Turkey and surveillance to determine their prevalence is warranted.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Microbiology and Clinical Microbiology, 06100 Sihhiye, Ankara, Turkey. dolunayglm@yahoo.com
authors.forename: Dolunay
authors.initials: D
authors.lastname: Gülmez
authors.forename: Neil
authors.initials: N
authors.lastname: Woodford
authors.forename: Marie-France I
authors.initials: MF
authors.lastname: Palepou
authors.forename: Shazad
authors.initials: S
authors.lastname: Mushtaq
authors.forename: Gokhan
authors.initials: G
authors.lastname: Metan
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yakupogullari
authors.forename: Sesin
authors.initials: S
authors.lastname: Kocagoz
authors.forename: Omrum
authors.initials: O
authors.lastname: Uzun
authors.forename: Gulsen
authors.initials: G
authors.lastname: Hascelik
authors.forename: David M
authors.initials: DM
authors.lastname: Livermore
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001425:Bacterial Outer Membrane Proteins / Q000737:chemistry / Q000235:genetics / Q000378:metabolism*; D015780:Carbapenems / Q000494:pharmacology*; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology; D004927:Escherichia coli Infections / Q000382:microbiology; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018272:Porins / Q000737:chemistry / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014169:Transformation, Bacterial; D014421:Turkey; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D001425:Bacterial Outer Membrane Proteins; D015780:Carbapenems; D004269:DNA, Bacterial; D018272:Porins; D047090:beta-Lactams; D001618:beta-Lactamases; C108449:oxacillinase