Abstract
Objective: Colistin is frequently used in infections caused by multi-drug resistant Acinetobacter baumannii and Pseudomonas aeruginosa, which cause infections resulting in mortality, especially in intensive care units. In our study, it was aimed to reveal the distribution of colistin resistance rates according to years in A. baumannii and P. aeruginosa strains.
Material and Methods: Colistin resistance profile was evaluated in A. baumannii and P. aeruginosa strains isolated from blood and catheter cultures from patients hospitalized in intensive care units at Karadeniz Technical University Health Research and Application Center between January 2013 and October 2019. Demographic, clinical, and laboratory features of the patients; patient files, infection control committee data, and infectious diseases and clinical microbiology consultation forms were obtained.
Results: After removing the replications, 555 of the 1469 isolated samples were evaluated. The 555 samples included in this study were isolated from 389 patients, 66.7% of the growths were A. baumannii and 33.3% were P. aeruginosa. Colistin resistance rates in neurosurgery, internal diseases, anesthesiology and reanimation, neurology intensive care units, respectively; 6.3%, 5.2%, 2.6%, 1.9%, while no resistance was detected in the chest intensive care unit. In all intensive care units, the colistin-resistance rate was 3.2%. While the resistance rate increased gradually over the years, it was higher in A. baumannii than in P. aeruginosa. Among patients with colistin-resistant growth, the mortality rate was 77.8% and the overall mortality rate was 3.6%.
Conclusion: Colistin resistance rate increase is noted in our study over the years In addition, since resistant breedings are seen to increase mortality, it is thought that to prevent inappropriate and unnecessary use of colistin, to determine the factors that cause resistance, each center should establish treatment protocols by following their epidemiological data and antibiotic susceptibility profile.