title: Characterisation of drug resistance of nosocomial ESBL-producing E. coli isolates obtained from a Turkish university hospital between 2009 and 2012 by pulsed field gel electrophoresis and antibiotic resistance tests.
abstract: In this study, drug resistance of 28 ESBL-producing Escherichia coli isolates obtained from 144 patients hospitalized at the Yüzüncüyil University Hospital at Van (YUH), Turkey, between 2009 and 2012 were characterized by pulsed field gel electrophoresis and antibiotic susceptibility tests. Antibiotic resistance profile was determined by Phoenix automated system (BD, USA). The ratio of ESBL-producing E. coli strains was determined to be 19.4% (28 out of 144 E. coli isolates). It was determined that the anaesthesiology, paediatrics and thoracic medicine intensive care units in YUH were cross-contaminated between 2009 and 2012 by ESBL-producing E. coli strains, which is a sign of nosocomial infection in YUH. Analysis of PFGE results gave rise to two main PFGE profiles, profile-A with four subprofiles and profile-B with three subprofiles, where profile-A predominates over profile-B (14%). Comparison of the antibiotic resistance profile with the PFGE profile yielded similarities while some differences also exist due to either identical restriction enzyme cutting sites with slightly different genetic sequences in between the cutting sites or newly formed restriction enzyme cutting sites that do not affect antibiotic resistance genes. Enterobacteriaceae, particularly E. coli, have developed resistance in YUH by producing ESBLs against oxyimino and non-oxyimino cephalosporins, and penicillin-type antibiotics. Therefore, more effective antibiotics such as cefoxitin or cefoperazone-sulbactam should be used for the treatment of future nosocomial infections in YUH while hospital staff should take care with hygiene, such as hand washing.
authors.affiliation: Molecular Microbiology Research and Application Laboratory, Refik Saydam National Public Health Agency, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Karagöz
authors.affiliation: Department of Clinical Bacteriology and Infections, School of Medicine Research Hospital, Yüzüncü Yil University, Van, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Sunnetcioglu
authors.affiliation: Department of Clinical Bacteriology and Infections, School of Medicine Research Hospital, Yüzüncü Yil University, Van, Turkey.
authors.forename: Mehmet Resat
authors.initials: MR
authors.lastname: Ceylan
authors.affiliation: Department of Microbiology, School of Medicine Research Hospital, Yüzüncü Yil University, Van, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Bayram
authors.affiliation: Biotechnology Institute, Ankara University, Ankara, Turkey; Department of Medical Pharmacology, School of Medicine, Mevlana University, Konya, Turkey 6Department of Medical Genetics, School of Medicine, Selçuk University, Konya, Turkey 7Department of Gastroenterology, School of Medicine Research Hospital, Yüzüncü Yil University, Van, Turkey.
authors.forename: Gozde
authors.initials: G
authors.lastname: Yalcin
authors.affiliation: Department of Medical Genetics, School of Medicine, Selçuk University, Konya, Turkey.
authors.forename: Nadir
authors.initials: N
authors.lastname: Kocak
authors.affiliation: Department of Gastroenterology, School of Medicine Research Hospital, Yüzüncü Yil University, Van, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Suvak
authors.affiliation: Department of Medical Pharmacology, School of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Cenk A
authors.initials: CA
authors.lastname: Andac
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods*; D004926:Escherichia coli / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006785:Hospitals, University; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014421:Turkey
chemical_list: D000900:Anti-Bacterial Agents