Investigation of antimicrobial resistance and ESBL/Carbapenemase presence in Enterobacterales strains isolated from food workers Gıda çalışanlarından izole edilen Enterobacterales suşlarında antimikrobiyal direnç ve GSBL/Karbapenemaz varlığının araştırılması


Çakıcı N., Çevik Y. N., Yildiz S. S., Akçalı A., Demirel Zorba N. N.

Turk Hijyen ve Deneysel Biyoloji Dergisi, vol.78, no.3, pp.351-362, 2021 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 78 Issue: 3
  • Publication Date: 2021
  • Doi Number: 10.5505/turkhijyen.2021.89814
  • Journal Name: Turk Hijyen ve Deneysel Biyoloji Dergisi
  • Journal Indexes: Scopus, Academic Search Premier, CAB Abstracts, Veterinary Science Database, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.351-362
  • Keywords: carbapenem, Cephalosporin, enterobacterales, enterobacterales, food workers, gıda çalışanları, karbapenem, MALDI-TOF MS, MALDI-TOF MS, Sefalosporin
  • Çanakkale Onsekiz Mart University Affiliated: Yes

Abstract

Objective: This study was carried out to determine the antimicrobial resistance and the production status of ESBL, carbapenemase in community-acquired Enterobacterales members obtained from food industry workers. Methods: Hand swab samples of food workers (n: 300) working in hospitals (n: 9) and food businesses (n: 17) in Çanakkale city center and districts were taken into Brain Heart Infusion Broth (BHI) medium. Inoculum was inoculated into EMB medium after 24 hours of incubation at 37oC. Classical identification and MALDI-TOF MS method were used to identify bacteria. Disk diffusion and minimal inhibitory concentration (MIC) methods were applied to measure resistance against cefotaxime, ceftazidime, meropenem and ertapenem antibiotics and were evaluated according to EUCAST 2020. ESBL and carbapenemase phenotypic confirmation tests were performed according to the screening test results. The CTX-M gene was investigated in ESBL positive isolates using the PCR method. Bulgular: Elde edilen 222 adet gram negatif bakterinin Results: Distribution of 222 gram-negative bacteria on the basis of species; 129 (%58.1) Klebsiella pneumoniae, 32 (14.4%) Enterobacter cloacae, 31 (13.9%) Acinetobacter baumannii, 11 (4.9%) Escherichia coli, 8 (3.6%) Enterobacter asburiae, 4 (1.8%) Escherichia hermanni, 3 (1.4%) Enterobacter aerogenes 2 (0.9%) Klebsiella oxytoca, 2 (0.9%) Enterobacter cancerogenus. It was determined that 7 (3.7%) of the Enterobacterales members (n: 191) were resistant to cefotaxime (<17 mm) according to clinical limit values. According to the combined disc and double disc synergy test results of 13 isolates whose cefotaxime inhibition diameter was detected below the ESBL screening limit value, 2 bacteria (K. pneumoniae, E. cloacae) were found to be ESBL positive. According to the PCR method, it was determined that the K. pneumoniae isolate carried the CTX-M gene and was isolated from a food worker in the hospital. No carbapenem resistance was found in any of the Enterobacterales strains and A. baumannii isolates. Meropenem MIC values of 46 Enterobacterales species with a meropenem inhibition zone diameter smaller than 28 mm were found between 8 mg/l and 0.125 mg/l. Combination disc test was applied to 2 isolates whose diameter was below the carbapenemase screening limit (< 25mm) and accordingly it was found that they were carbapenemase negative. Conclusion: The low rate of resistant bacteria hand carriers in the community (3.7%), the very low ESBL positivity of the community-acquired isolates (1.04%), and the absence of carbapenemase positivity suggest that antibiotic resistant isolates are low in food workers. The detection of gram-negative bacteria in this number of food workers made us think that hygiene training should be given importance.