Abstract
Treatment options are limited in infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, with carbapenems generally preferred. Disturbingly, however, carbapenem-resistant strains are emerging worldwide. Here we report two clinical isolates, one Escherichia coli and one Klebsiella pneumoniae, each with high-level carbapenem resistance (imipenem minimum inhibitory concentration of 32 microg/mL). They were isolated following imipenem therapy from two hospital patients who had received imipenem therapy in different regions of Turkey. Both isolates produced OXA-48-like carbapenemases, enzymes so far reported only from Turkey. Both isolates also had group 1 CTX-M-type ESBLs and had lost major outer membrane proteins. OXA-48-like carbapenemases appear to be scattered in Turkey and surveillance to determine their prevalence is warranted.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Anti-Bacterial Agents / pharmacology*
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Bacterial Outer Membrane Proteins / chemistry
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Bacterial Outer Membrane Proteins / genetics
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Bacterial Outer Membrane Proteins / metabolism*
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Carbapenems / pharmacology*
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DNA, Bacterial / genetics
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DNA, Bacterial / isolation & purification
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Drug Resistance, Bacterial
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Escherichia coli / drug effects*
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Escherichia coli / enzymology
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Escherichia coli Infections / microbiology
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Female
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Humans
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Klebsiella Infections / microbiology
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Klebsiella pneumoniae / drug effects*
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Klebsiella pneumoniae / enzymology
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Male
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Microbial Sensitivity Tests
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Middle Aged
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Porins / chemistry
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Porins / genetics
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Reverse Transcriptase Polymerase Chain Reaction
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Transformation, Bacterial
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Turkey
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beta-Lactam Resistance / genetics
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beta-Lactamases / genetics
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beta-Lactamases / metabolism*
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beta-Lactams / pharmacology
Substances
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Anti-Bacterial Agents
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Bacterial Outer Membrane Proteins
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Carbapenems
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DNA, Bacterial
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Porins
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beta-Lactams
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beta-Lactamases
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oxacillinase