Enfeksiyon Etkeni Nonfermenter Gram Negatif İzolatlar ve Antibiyotik Dirençleri: Üç Yıllık Veri

Öz

Amaç: Bu çalışmanın amacı, üç yıllık dönemde bir üçüncü basamak hastanenin enfeksiyon etkeni nonfermenter gram negatif izolatlarını ve antibiyotik direnç profillerini belirlemektir.

Materyal ve Metot: Balıkesir Atatürk Şehir Hastanesi’ndeki çeşitli kültürlerden, Ocak 2017-Aralık 2019 arasında, toplamda 3817 nonfermenter gram negatif organizma izole edilmiştir ve retrospektif olarak incelenmiştir. Tanımlama ve antibiyotik duyarlılıkları konvansiyonel yöntemler ve PhoenixTM 100 sistemi (Becton Dickinson, MA, ABD) ile yapılmıştır

Bulgular: Toplamda; 2201 (%57,7) P. aeruginosa, 1283 (%33,6) A. baumannii-calcoaceticus kompleks, 202 (%5,3) S. maltophilia ve 131 (%3,4) B. cepacia kompleks suşu izole edildi. Suşların %54,5’i yoğun bakım ünitelerinden izole edildi ve bunu dahili branş (%33,4) ve cerrahi branş servisleri (%12,1) takip etti. Tüm A. baumannii-calcoaceticus kompleks suşlarında test edilen altı antibiyotiğin dördüne %70’in üzerinde direnç belirlendi. Beta-laktam antibiyotik direncinin yanında (genellikle %30’dan fazla gözlendi), florokinolon direnci de (%30,4) yüksekti. S. maltophilia izolatlarında, kotrimaksazol direnci %10’un altında kaldı. B. cepacia kompleks izolatlarında, seftazidim direnci yıllar içinde artış gösterdi (2018, %22,2; 2019, %67,0).

Sonuç: Antibiyotik direnci sorunu yalnız yeni antibiyotiklerin geliştirilmesi ile değil, ayrıca bilinen antibiyotiklerin etkinliğinin arttırılması ile kazanılabilir. Bu amaca yönelik işlemlerde ilk basamak, yerel sürveyans çalışmaları gibi güncel durumun tespitidir. 

Anahtar Kelimeler

• Acinetobacter
• antimicrobial resistance
• Burkholderia
• Pseudomonas
• Stenotrophomonas

Non-Fermenting Gram-Negative Isolates as Infecting Agents and Antibiotic Resistance: Three-Year Data

Abstract

Objective: This study aimed to investigate clinical non-fermenting gram-negative isolates and antibiotic resistance profiles for three years in a tertiary hospital.

Materials and Methods: A total of 3817 non-fermenting gram-negative strains isolated from various cultures between January 2017 and December 2019 in Balıkesir Atatürk City Hospital were investigated retrospectively. Identification and antibiotic susceptibilities were performed using conventional methods and PhoenixTM 100 system (Becton Dickinson, MA, USA).

Results: A total of 2201 (57.7%) P. aeruginosa, 1283 (33.6%) A. baumannii-calcoaceticus complex, 202 (5.3%) S. maltophilia and 131 (3.4%) B. cepacia complex strains were identified. The majority of strains were isolated from intensive care units (54.5%), followed by internal medicine (33.4%) and surgical services (12.1%). All A. baumannii-calcoaceticus complex species showed over 70% resistance to most antibiotics. In addition to β-lactam antibiotic resistance (generally over 30%), resistance to fluoroquinolones (30.4%) seemed to have particular importance. Co-trimoxazole showed below 10% resistance in S. maltophilia isolates. In B. cepacia complex, ceftazidime resistance increased in years (2018, 22.2%; 2019, 67.0%). Conclusion: The issue of antibiotic resistance cannot be won by just developing novel antimicrobials, but also by increasing the efficiency of current ones. The first step is to “diagnose” the current condition, like local surveillance studies. 

Keywords

• Acinetobacter
• antimicrobial resistance
• Stenotrophomonas
• Burkholderia
• Pseudomonas

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