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    Investigation of carbapenem resistance and the first identification of Klebsiella pneumoniae carbapenemase (KPC) enzyme among Escherichia coli isolates in Turkey: A prospective study
    (Elsevier Sci Ltd, 2016) Kuskucu, Mert Ahmet; Karakullukcu, Asiye; Ailiken, Mailihaba; Otlu, Bans; Mete, Bilgul; Aygun, Gokhan
    Background: The aim of this study was to determine the presence of carbapenem resistance and carbapenemase production in Escherichia coil isolates from clinical samples in Turkey. Methods: The prospective study included a total of 4.052 Escherichia coli isolates collected from patients admitted to a hospital from March 2011 to May 2012. We used ertapenem disc for screening carbapenemase production, and the confirmation was performed by using Etest. The resistance mechanisms and genetic relatedness of the carbapenem resistant strains were investigated by using PCR (polymerase chain reaction) and pulsed -field gel electrophoresis (PFGE), respectively. Results: Among the 4.052 E coli isolates, 24 (0.59%) were found to be carbapenem resistant. Of these, only 5 isolates were positive for OXA-48 and 2 isolates were positive for ICIebsiella pneumoniae carbapenemase (KPC)-2. The KPC-2 producing E. coil strains (n = 2) were both isolated from the same patient. The bla(KPC) genes were confirmed using DNA sequence analysis. The genetic relationship between the 24 E. coil strains studied by PFGE revealed that the strains were genetically unrelated. Conclusions: This article confirms, to our knowledge for the first time, the detection of KPC-2-producing E. coil in Turkey, with OXA-48 being the most frequent carbapenemase in the study. (C) 2016 Elsevier Ltd. All rights reserved.