Harran Üniversitesi Hastanesi’nde Yatan Hastaların Kan Kültürlerinden İzole Edilen Acinetobacter Suşlarının Antibiyotiklere Direnç Profili

Abstract

Amaç: Acinetobacter baumannii özellikle hastanede yatan ve immün yetmezliği olan hastalarda ciddi bakteremilere sebep olabilen bir bakteridir. Bu çalışmada 2017-2019 yılları arasında Harran Üniversitesi Hastanesi’nde (Urfa, Türkiye) yatan hastaların kan kültürlerinden izole edilen 92 A. baumannii ve 5 A. lwoffii izolatının antibiyotiklere olan direnci incelenmiştir.
Materyal ve Metod: Kan kültürü şişelerinin inkübasyonu için Versa-TREK (Trek Diagnostic System, USA) cihazı kullanıldı. Pasajlar %5 kanlı agara ve eozin metilen blue agara (EMB) yapıldı. Pasajlarda üreyen bakterilerin tanımlanmasında MALDI-TOF MS (Bruker, Germany) ve Vitek 2 compact sistemi (bioMérieux, France) kullanıldı. Meropenem, siprofloksasin, amikasin, gentamisin, tobramisin, tigesiklin ve trimetoprim-sulfametoksazole olan dirençler VITEK 2 compact sistemi ile, EUCAST önerileri temel alınarak değerlendirildi.
Bulgular: A. baumannii suşlarının antibiyotik direnç oranları; siprofloksasine %92, imipeneme %88, meropeneme %88, gentamisine %74, tobramisine %67, trimetoprim-sulfametoksazole %63, amikasine %53, tigesikline %10 şeklinde bulundu. A. lwoffi’nin direnç profili ise siprofloksasine, gentamisine, amikasine ve tobramisine 40%; trimethoprim sulfamethoxazole, imipeneme, meropeneme ve tigesikline 20% şeklinde idi.
Sonuç: Çalışmamız, A. baumannii’nin yüksek antibiyotik direncine sahip olduğunu göstermektedir. Ayrıca A. lwoffii’de artan bir antibiyotik direnç profili görülmektedir. Tigesiklin en duyarlı antibiyotikken, onu amikasin ve tobramisin izlemektedir.
Sonuç: Yeni antibiyotiklere, antibiyotik duyarlılık profillerine çabuk erişim olanağına ve ampirik tedavide doğru antibiyotiklerin seçimine ihtiyaç vardır.

Keywords

• bakteriyemi
• ilaç direnci
• acinetobacter baumannii
• yoğun bakım üniteleri

Antibiotic Resistance Profile of Acinetobacter Species Isolated from Blood Cultures of Inpatients in Harran University Hospital

Abstract

Objectives: Acinetobacter baumannii causes serious blood stream infections especially in immunocompromised and hospitalized patients. In this study, the distribution of antibacterial resistance among 92 A. baumannii isolates and 5 A. lwoffii isolates from blood cultures collected at Harran University Hospital (Urfa, Turkey) from 2017 to 2019 was investigated. Methods: Blood cultures were followed up in Versa-TREK (Trek Diagnostic System, USA) device; Passages were made to 5% blood agar and eosin methylene blue (EMB) agar. Passaged bacteria colonies were identified by MALDI-TOF MS (Bruker, Germany) and VITEK 2 compact system (bioMérieux, France). Sensitivities of Acinetobacter strains to meropenem, ciprofloxacin, amikacin, gentamicin, tobramycin, tigecycline and trimethoprim-sulfamethoxazole were tested by VITEK 2 compact system (bioMérieux, France). The results were evaluated by VITEK 2 device based on EUCAST's guide. Results: The antibiotic resistance rates of A. baumannii strains are as follows; ciprofloxacin 92%, imipenem %88, meropenem 88%, gentamicin 74%, tobramycin 67%, trimethoprim-sulfamethoxazole 63%, amikacin 53%, and tigecycline 10%. The resistance ratio of A. lwoffii strains are ciprofloxacin (40%), gentamicin 40%, amikacin 40%, tobramycin 40%, trimethoprim sulfamethoxazole 20%, imipenem %20, meropenem 20% and tigecycline 20%. Conclusions: Our study suggests A. baumannii strains have high resistance ratios to available antibiotics. A. lwoffii also has an increasing resistance profile. Tigecycline is the most sensitive antibiotic, followed by amikacin and tobramycin. New antibiotics, rapid access to antibiotic sensitivity results and correct selection of empiric antibiotics has clinical importance.

Keywords

• bacteremia
• intensive care units
• drug resistance
• acinetobacter baumannii

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