Analysis of the Distribution Characteristics and Antibiotic Resistance of Nonfermentative Bacteria Isolated from Urine Cultures

Abstract

Nonfermentative bacteria are an important cause of urinary tract infection in patients with underlying disease and hospitalization. The aim of this study was to investigate the distribution and antibiotic resistance profiles of nonfermentative bacteria isolated from urine cultures. Nonfermentative bacteria (n=1,395) isolated from urine samples in the Clinical Microbiology Laboratory of Hacettepe University Faculty of Medicine Hospital between October 2017 and October 2019 were examined retrospectively. The bacteria were identified by conventional methods and MALDI-TOF MS. Antibiotic susceptibility tests were performed with BD Phoenix automated system, disc diffusion, gradient test and broth microdilution. During the study period, 6.6 % of the bacteria isolated from urine cultures were nonfermentative bacteria. Among the nonfermentative bacteria, Pseudomonas spp. (68.3 %) was the most common, followed by Acinetobacter spp. (18.8 %) and Stenotrophomonas maltophilia (9.6 %) respectively. Others were Achromobacter spp. (n=16), Burkholderia spp. (n=6), Alcaligenes faecalis (n=5), Delftia acidovorans (n=5), Chryseobacterium indologenes (n=3), Elizabethkingia meningoseptica (n=3), Myroides spp. (n=2), Comamonas kerstersii (n=1), Cupriavidus spp. (n=1), Ralstonia pickettii (n=1), Roseomonas mucosa (n=1) and Sphingomonas paucimobilis (n=1). Antibiotic resistance rates were highest in Acinetobacter baumannii/calcoaceticus complex isolates. Nonfermentative bacteria cause serious infections and high antibiotic resistance rates are detected in these bacteria. For this reason, each center should determine the distribution and antimicrobial resistance patterns of nonfermentative bacteria at certain intervals.

Keywords

• antibiotic resistance
• nonfermentative bacteria
• urine culture

İdrar Kültürlerinden İzole Edilen Nonfermentatif Bakterilerin Dağılım Özelliklerinin ve Antibiyotik Direncinin Analizi

Abstract

Nonfermentatif bakteriler altta yatan hastalığı olan ve hastanede yatan hastalarda önemli üriner sistem enfeksiyonu etkenleridir. Bu çalışmada idrar kültürlerinden izole edilen nonfermentatif bakterilerin dağılımının ve antibiyotik direnç profillerinin incelenmesi amaçlanmıştır. Hacettepe Üniversitesi Tıp Fakültesi Hastanesi Klinik Mikrobiyoloji Laboratuvarı’nda Ekim 2017-Ekim 2019 tarihleri arasında idrar örneklerinden izole edilen 1.395 nonfermentatif bakteri retrospektif olarak incelenmiştir. Bakterilerin tanımlanması konvansiyonel yöntemler ve MALDI-TOF MS ile yapılmıştır. Antibiyotik duyarlılık testleri BD Phoenix otomatize sistemi, disk difüzyon, gradiyent test ve sıvı mikrodilüsyon ile gerçekleştirilmiştir. Çalışma süresinde idrar kültürlerinden izole edilen bakterilerin % 6,6’sını nonfermentatif bakteriler oluşturmuşlardır. Nonfermentatif bakteriler arasında en sık Pseudomonas spp. (% 68,3) izole edilmiş, bunu sırası ile Acinetobacter spp. (% 18,8) ve Stenotrophomonas maltophilia (% 9,6) izlemiştir. Diğer izole edilen nonfermentatif bakteriler ise Achromobacter spp. (n=16), Burkholderia spp. (n=6), Alcaligenes faecalis (n=5), Delftia acidovorans (n=5), Chryseobacterium indologenes (n=3), Elizabethkingia meningoseptica (n=3), Myroides spp. (n=2), Comamonas kerstersii (n=1), Cupriavidus spp. (n=1), Ralstonia pickettii (n=1), Roseomonas mucosa (n=1) ve Sphingomonas paucimobilis’tir (n=1). Antibiyotik direnç profilleri değerlendirildiğinde en yüksek direnç oranları Acinetobacter baumannii/calcoaceticus kompleks izolatlarında saptanmıştır. Nonfermentatif bakterilerin ciddi enfeksiyonlara neden olmaları ve bu bakterilerde yüksek antibiyotik direnç oranlarının saptanması nedeniyle her merkez belirli aralıklar ile nonfermentatif bakterilerin dağılımını ve antimikrobiyal direnç paternlerini tespit etmelidir.

Keywords

• antibiyotik direnci
• idrar kültürü
• nonfermentatif bakteriler

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