Frequency Of Extended Spectrum Beta Lactamase in Multiresistance Gram Negative Bacteria Isolated From Kidney Transplantation Patient

Abstract

Infections by bacteria remain a major cause of morbidity and mortality in transplant recipients. Since the pattern of infections change continually due to evolving donor recipient characteristics, surgical techniques and immunosuppression regimens ,with widespread use of antibiotics for prevention and treatment in transplant recipients the prevalence of resistance to antibiotics among infection by bacteria is increasing. Extended spectrum beta-lactamases (ESBL) are especially common in E. coli and Klebsiella species (Tuğmen, etal. 2016:64). This family of clinically important enzymes is transported via large plasmids, causing multiple resistance and can easily spread between strains (Saygılı, etal. 2017: 223). In this study, 300 wound and urine samples were taken from the patients who applied to Zheen international and Rizgary teaching hospital in Erbil city. Isolates were detected using microscopic, morphological and biochemical tests in January-November 2018. In addition, antibiotic susceptibility test was performed against 19 antibiotics using the Vitec 2 compact system according to the standard protocol. Isolation of 26 (8.67%) . Gram-negative bacteria from 300 samples taken from kidney transplant patients was distributed according to their sources. The highest gram-negative bacteria percentage was isolated from 17 men (65.4%) and 9 women (34.6%). The most common isolates were E. coli 21 (7%), K. pneumonia 2 (0.67%), P. aeruginosa 1 (0.33%) and Enterobacter spp 2 (0.67%). The highest resistance rate was against ampicillin, amoxicillin and ampicillin / clavulanic acid (100%). İsolates, resistance rates meropenem (92%), imipenem (88%), nalidixic acid (48%) and also recorded high resistance rate to different classes of antibiotics particularly in urine samples. In this study, it was aimed to determine gram negative bacteria among kidney transplant recipients and to investigate the antimicrobial susceptibilities of causative agents. As a result, it can be expected to lead to the development of multidrug resistance against commonly used antibiotics after transplantation and high social and economic costs. It is necessary to regularly monitor the frequency of ESBL secreting bacteria in hospitals and prevent their spread.