Öz
Giriş: Acinetobacter baumannii antibiyotiklere karşı artan direnci nedeniyle günümüzde sorunlu bir etken olarak karşımıza çıkmaktadır. Direnç genleri ve A. baumannii izolatları tarafından biyofilm üretimi, organizmanın önemli bir hastane patojeni olmasını sağlayan hayatta kalma yollarıdır. Bu çalışmanın amacı, A. baumannii klinik izolatlarında antimikrobiyal direnç paternlerini, aminoglikozid ve karbapenem direnç genlerini ve biyofilm oluşumunu belirlemektir.
Gereç ve Yöntem: Nisan 2018’den Mart 2019’a kadar yürütülen bu kesitsel çalışmada; İran’da Yasuj ve Bandar Abbas bölgelerinde bulunan hastanelerden toplam 133 A. baumannii izolatı izole edildi. Antimikrobiyal duyarlılık disk difüzyon kullanılarak belirlendi. Karbapenem ve aminoglikozid direnç genleri polimeraz zincir reaksiyonu yöntemi ile araştırıldı. Biyofilm oluşturma yeteneği, mikrotitre plak yöntemi kullanılarak değerlendirildi.
Bulgular: Bu çalışmada tüm izolatlar blaOXA-51-like içermekteydi ve A. baumannii olarak doğrulandı. Karbapenemler ve aminoglikozidler için yüksek düzeyde direnç gözlemlendi. Oksasilinaz genleri olan blaOXA-23-like ve blaOXA-24-like prevalansları sırasıyla 89 (%66,9) ve 46 (%34,6) idi. Ayrıca, blaOXA-23-like ve blaOXA-24-like birlikteliği 10 (%7,5) izolatta saptanmıştır. Sırasıyla aac (3)-I ve aph (3’)-I 73 (%54,9) ve 69 (%51,9) izolatta pozitif bulundu. Ayrıca izolatların 55’inde (%41,4) iki gen bir arada bulundu. Sonuçlar, izolatların 129’unun (%97) güçlü, üçünün (%2,3) orta ve birinin (%0,8) zayıf biyofilm üreticisi olduğunu göstermiştir.
Sonuç: Sonuçlar, blaOXA-23-like ve aac (3)-I genlerinin en yaygın direnç genleri olduğunu ortaya koydu. İzolatların büyük çoğunluğu güçlü biyofilm üreticisi ve ile ilaca dirençli olduğundan, gelecekte ilaca dirençli A. baumannii izolatlarının bulaşmasını kontrol etmek için enfeksiyon kontrol programları ve politikaları sıklıkla güncellenmelidir.
Kaynakça
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