Aminoglycoside Resistance in Common Pathogens

Abstract

This study investigated the resistance patterns to aminoglycosides among 137 bacterial isolates derived from various clinical specimens submitted to the Microbiology Laboratory at XXX Training and Research Hospital in the year 2005. The bacterial isolates were Escherichia coli (n=34), Klebsiella pneumoniae (n=30), Pseudomonas aeruginosa (n=30), Acinetobacter baumannii (n=23), and Staphylococcus aureus (n=20). Staphylococcus aureus was further classified into methicillin-susceptible strains (MSSA, n=13) and methicillin-resistant strains (MRSA, n=7). We examined the susceptibility against eight distinct aminoglycosides. Isepamicin exhibited the lowest overall resistance rates within Gram-negative bacilli, particularly among isolates of P. aeruginosa and A. baumannii derived from intensive care units (ICUs). Streptomycin presented the highest levels of resistance. Statistically significant differences in resistance rates were observed between ICU and non-ICU isolates for gentamicin (χ² = 11.19, p = 0.0037), amikacin (χ² = 8.82, p = 0.0121), and isepamicin (χ² = 9.67, p = 0.0079). This suggests an increased resistance rate in intensive care units. MRSA strains were more resistant to various aminoglycosides, including gentamicin, tobramycin, and isepamicin, in comparison to MSSA strains. These observed differences were not statistically significant. These resistance patterns highlight the limitations of older drugs like streptomycin and kanamycin. The sustained efficacy of isepamicin and netilmicin positions them as viable treatment alternatives, particularly for infections caused by multidrug-resistant organisms. The results point to the necessity for routine susceptibility testing, careful antimicrobial stewardship, and judicious antibiotic selection to enhance patient outcomes and address resistance in high-risk environments such as the ICU.

Keywords

• Amikacin
• Aminoglycoside resistance
• Intensive Care Unit
• Isepamicin

Sık Rastlanan Patojenlerdeki Aminoglikozit Direnci

Abstract

Bu çalışmada, 2005 yılında XXX Eğitim ve Araştırma Hastanesi Mikrobiyoloji Laboratuvarı’na gönderilen çeşitli klinik örneklerden izole edilen 137 bakteriyel izolatın aminoglikozid direnç paternleri incelenmiştir. İzolatlar arasında Escherichia coli (n=34), Klebsiella pneumoniae (n=30), Pseudomonas aeruginosa (n=30), Acinetobacter baumannii (n=23) ve Staphylococcus aureus (n=20) yer almakta olup, S. aureus izolatları metisiline duyarlı (MSSA, n=13) ve metisiline dirençli (MRSA, n=7) olarak sınıflandırılmıştır. Sekiz farklı aminoglikozide karşı duyarlılık test edilmiştir. Gram-negatif izolatlar arasında isepamisin için, özellikle yoğun bakım ünitesinden (YBÜ) elde edilen P. aeruginosa ve A. baumannii suşlarında en düşük direnç oranları gözlenmiştir. Streptomisin ise en yüksek direnç oranlarına sahiptir. YBÜ izolatları ile genel izolatlar arasında gentamisin (χ² = 11.19, p = 0.0037), amikasin (χ² = 8.82, p = 0.0121) ve isepamisin (χ² = 9.67, p = 0.0079) için istatistiksel olarak anlamlı direnç farkları saptanmıştır. S. aureus izolatları arasında MRSA suşları, gentamisin, tobramisin ve isepamisine karşı daha yüksek direnç göstermiştir ancak bu farklar istatistiksel olarak anlamlı bulunmamıştır. Elde edilen bulgular eski jenerasyon antibiyotiklerin (streptomisin, kanamisin) sınırlı etkinliğini yansıtmaktadır. İsepamisin ve netilmisin gibi ajanlar, çok ilaca dirençli enfeksiyonların tedavisinde değerli seçenekler olarak öne çıkmakta olup, bu çalışma antibiyotik direnciyle mücadelede düzenli duyarlılık testlerinin ve antimikrobiyal yönetimin önemini vurgulamaktadır.

Keywords

• Amikasin
• Aminoglikozid direnci
• İsepamisin
• Yoğun Bakım Ünitesi

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