Distribution of clinical isolates obtained from sterile body fluids: a four-year retrospective data

Year 2021, Volume: 4 Issue: 6, 907 - 911, 24.09.2021

Alev Çetin Duran , Tuğba Kula Atik , Nermin Özen , Ali Korhan Sig , Onur Irmak

https://doi.org/10.32322/jhsm.981918

Cited By: 1

Abstract

Aim: Infections of sterile body fluids (SBFs) require rapid and accurate diagnosis and treatment, since their morbidities and mortalities are high. To achieve this goal, definite epidemiologic data is absolutely required, since empiric and preemptive treatments are mainly based on this. The aim of this study was to evaluate infectious agents isolated from SBFs, susceptibility results and molecular analysis (PCR) data, retrospectively.
Material and Method: Clinical samples of SBFs (Cerebrospinal, pleural, peritoneal, pericardial and synovial fluids) obtained from January 2017 to December 2020 in Atatürk City Hospital (tertiary center) were included. Identification of bacterial and fungal agents and antibiotic susceptibility were done by conventional and automated system (BD Phoenix™, Becton Dickinson Co., Sparks, MD, USA). Löwenstein-Jensen media and BACTEC Mycobacteria Growth Indicator Tube 960 (Becton Dickinson Co., Sparks, MD, USA) were used for mycobacterial analysis. Bosphore Viral Meningitis Panel Multiplex PCR Kit (Anatolia Geneworks, İstanbul, Turkey) were applied to detect HSV-1, HSV-2, VZV, Enterovirus and/or Parechovirus.
Results: A total of 221 (9.74%) organisms were detected among 2269 samples. Particularly common gram negative bacterial agents covered the top of the list (Escherichia coli, Pseudomonas spp., Klebsiella spp. and Acinetobacter baumannii-Acinetobacter calcoaceticus complex). Staphylococcus aureus was the most frequent gram positive strain, followed by enteroccocci. Most of the A. baumannii isolates were multidrug resistant, Pseudomonas spp. showed over than 20% resistance rate to ceftazidime, cefepime and piperacillin-tazobactam. All enterococci were vancomycin-susceptible, one S. aureus strain was methicillin-resistant. All Mycobacterium tuberculosis complex isolates were found to be susceptible to first-line anti-tuberculosis drugs.
Conclusions: Continuous laboratory surveillance even in local phase is important to guide clinicians. Even though our data did not show significant changes, improvements on laboratory capabilities and clinical awareness must be done. Isolation rates might be underestimated due to requirement of improvements in our laboratory, especially about sampling, anaerobe transportation and usage of blood culture vials.

Keywords

meningitis, pleuritis, infection, sterile sample, sterile body site

Supporting Institution

yok

Project Number

yok

Thanks

The authors wish to declare special thanks to Muradiye YARAR, M.D., İlkay BIÇAK, M.D. and Osman KILINÇ, M.D. (Ataturk State Hospital, Department of Medical Microbiology, Balikesir, Turkey) for their precious support.

References

• Özekinci T. Plevral sıvının mikrobiyolojik ve immünolojik analizi. Güncel Göğüs Hastalıkları Serisi 2015; 3: 316-8.
• Öktem A, Çelik HT, Göçer E, Ceyhan M, Yiğit Ş, Yurdakök M. Yenidoğan döneminde septik artrit ve osteomiyelit: deneyimlerimiz ve güncel bilgilerin gözden geçirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi 2016; 59: 1-13.
• Kleines M, Scheithauer S, Schiefer J, Häusler M. Clinical application of viral cerebrospinal fluid PCR testing for diagnosis of central nervous system disorders: a retrospective 11-year experience. Diagn Microbiol Infect Dis 2014; 80: 207-15.
• Sayıner AA. Viral merkezi sinir sistemi infeksiyonlarında tanı. ANKEM Derg 2005; 19: 130-6.
• Zeytinoğlu A, Erensoy S, Sertöz R, et al. Santral sinir sistemi enfeksiyonlarında viral etiyolojinin İzmir’de bir üniversite hastanesinin yedi yıllık verileri üzerinden değerlendirilmesi. Mikrobiyol Bul 2017; 51: 127-35.
• Varıcı-Balcı FK, Sayıner AA. Viral etkenlere bağlı santral sinir sistemi enfeksiyonlarının yedi yıllık değerlendirmesi. Mikrobiyol Bul 2019;53: 434-41.
• Akkaya O, Güvenç Hİ, Güzelant A, et al. Menenjit etkenlerinin Real-time PCR Yöntemiyle Araştırılması. Türk Mikrobiyol Cem Derg 2017; 47: 131-7.
• Kahraman H, Tünger A, Şenol Ş, et al. Toplum kökenli santral sinir sistemi enfeksiyonlarında bakteriyel ve viral etiyolojinin moleküler yöntemlerle değerlendirilmesi. Mikrobiyol Bul 2017; 51: 277-85.
• European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 11.0, Basel, Switzerland. https://www.eucast.org [Date of Access: 11 August 2021].
• Tsegay E, Hailesilassie A, Hailekiros H, Niguse S, Saravanan M, Abdulkader M. Bacterial isolates and drug susceptibility pattern of sterile body fluids from tertiary hospital, Northern Ethiopia: a four-year retrospective study. J Pathog. 2019; 2019: 5456067.
• Rouf M, Nazir A. Aerobic bacteriological profile and antimicrobial sensitivity pattern of bacteria isolated from sterile body fluids: A study from a Tertiary Care Hospital in North India. Microbiol Res J Int 2019; 28: 1-10.
• Young N, Thomas M. Meningitis in adults: diagnosis and management. Internal Med J 2018; 48: 1294–307.
• Griffiths MJ, McGill F, Solomon T. Management of acute meningitis. Clin Med 2018 18: 164–9.
• Poorabbas B, Mardaneh J, Rezaei Z, et al. Nosocomial Infections: Multicenter surveillance of antimicrobial resistance profile of Staphylococcus aureus and Gram negative rods isolated from blood and other sterile body fluids in Iran. Iran J Microbiol 2015; 7: 127-35.
• World Health Organization (WHO). Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR), Annual 2020 Report, 2020. https://www.euro.who.int/__data/assets/pdf_file/0003/469200/Central-Asian-and-European-Surveillance-of-Antimicrobial-Resistance.-Annual-report-2020-eng.pdf (Date of Access: 11 August 2021).
• Mataj V, Guney M, Sig AK, et al. An Investigation into bacterial bloodstream infections and antibiotic resistance profiles in a tertiary hospital for a ten-year period. Clin Lab 2020; 66: 1467-77.
• Ulusal Antimikrobiyal Direnç Sürveyans Sistemi. https://hsgm.saglik.gov.tr/tr/uamdss (Date of Access: 11 August 2021).
• Diekema DJ, Hsueh PR, Mendes RE, et al. The microbiology of bloodstream infection: 20-year trends from the SENTRY antimicrobial surveillance program. Antimicrob Agent Chemother 2019; 63: e00355-19.
• European Centre for Disease Prevention and Control. Antimicrobial resistance in the EU/EEA (EARS-Net) - Annual Epidemiological Report 2019. Stockholm: ECDC; 2020. https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-resistance-europe-2019 (Date of Access: 17 June 2021).
• Sesli Çetin E, Kaya S, Demirci M, Cicioglu Aridogan B. Comparison of the BACTEC blood culture system versus conventional methods for culture of normally sterile body fluids. Adv Ther 2007; 24: 1271-7.
• Udayan U, Dias M. Evaluation of BACTECTM blood culture system for culture of normally sterile body fluids. Indian J Crit Care Med 2014; 18: 829-30.