Öz
Giriş: Aminoglikozitler, Pseudomonas aeruginosa enfeksiyonlarının tedavisi için tercih edilen ilaçlardır. P. aeruginosa’daki aminoglikozit direnci, sıklıkla kazanılmış aminoglikozit modifiye edici enzimler (AME) yoluyla meydana gelmektedir. Bu çalışmada, karbapenem dirençli ve duyarlı izolatlarda P. aeruginosa’da AME varlığını araştırmayı amaçladık.
Yöntem: Amikasin ve/veya gentamisine direnç gösteren çeşitli klinik örneklerden alınan toplam 98 P. aeruginosa izolatı bu çalışmaya dahil edildi. İzolatların 54’ü karbapenem dirençliydi. PZR amplifikasyonu ile altı AME geninin (aac(6’)-Ib,aac(6’)-IIa, aac(3’)-IIa, aph(3’ )-Ia,aph(3’)-VIa, ant(2’’)-Ia) varlığı araştırıldı.
Bulgular: En sık saptanan AME geni aac(6’)-Ib (n=13, %13,2) olup, bunu ant(2’’)-Ia (n=7, %7,1) izlemiştir. Aac(6’)-Ib, karbapenem dirençli izolatlarda en yaygın AME (11/54, %20,3) iken, ancak karbapenem duyarlı izolatlarda ant(2’’)-Ia en yaygın AME (4/44, %9) idi. İzolatların 74’ünde AME genlerinin hiçbiri saptanmadı. Karbapenem dirençli izolatlarda aac(6’)-Ib pozitifliği, karbapenem duyarlı izolatlardan istatistiksel olarak daha yüksek bulundu.
Sonuç: Aminoglikozitler, karbapenem dirençli P. aeruginosa izolatlarında tercih edilen ilaçlardan biridir. Ancak, çoklu ilaç direnç belirleyicilerinin transferi nedeniyle, karbapenem dirençli izolatlarda AME varlığı olarak daha yüksektir ve Gram-negatif bakteriler arasında direnç belirleyicilerinin izlenmesi çok önemlidir.
Anahtar Kelimeler: Aminoglikozit modifiye edici enzimler, P. aeruginosa, karbapenem direnci
Kaynakça
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