PALYATİF SERVİS HASTALARININ ÇEŞİTLİ KLİNİK ÖRNEKLERİNDE ÜREYEN BAKTERİLER VE ANTİBİYOTİK DİRENÇ ORANLARI

Öz

Palyatif servis hastalarında güncel enfeksiyon etkeni profilinin ve antibiyotik direnç paternlerinin bilinmesi kültür ve antibiyogram sonuçlarının belirlenmesine kadar başlanacak ampirik tedavi yönetimi açısından büyük öneme sahiptir. Çalışmamızda hastanemiz palyatif servisinde yatarak tedavi gören hastaların klinik örneklerinden izole edilen mikroorganizma dağılımının ve bu izolatların antibiyotik direnç profillerinin araştırılması amaçlanmıştır. Bu çalışmada 2022-2023 yılları arasında Samsun Gazi Devlet Hastanesi palyatif servisinde yatan 264 hastanın mikrobiyoloji laboratuvarına gönderilen klinik örnekleri değerlendirildi. Hastaların medyan yaşı 76 (aralık: 65-87) idi ve hastaların %41’i erkekti. En sık idrar yolu enfeksiyonu etkenleri Klebsiella spp. (%27.4) ve Escherichia coli (%27.4), en sık solunum yolu enfeksiyonu etkeni Acinetobacter baumannii (%36.7), en sık yara yeri enfeksiyonu etkeni Pseudomonas aeruginosa (%30) idi. En düşük direnç oranları Klebsiella izolatlarında seftazidim-avibaktam (%4.8) ve kolistine (%9.5); E. coli izolatlarında seftazidim-avibaktam (%0), kolistin (%0), imipenem (%7.1) ve meropeneme (%7.1); Acinetobacter izolatlarında kolistine (%0); Pseudomonas izolatlarımda kolistin (%0) ve seftazidim-avibaktama (%23.1); enterokok izolatlarında ise vankomisine (%0) karşı idi. Çalışmamızdan elde edilen bulgular palyatif servis hastalarında idrar ve kan dolaşımı enfeksiyonu olgularına en sık Klebsiella ve E. coli’nin yol açtığını ve bu enfeksiyonlarda özellikle seftazidim-avibaktam ve kolistinin en etkili tedavi seçenekleri olduğunu, Acinetobacter ve Pseudomonas’ın etken olduğu olgularda da kolistinin en etkili antibiyotik olduğunu göstermiştir.

Anahtar Kelimeler

• Palyatif servis
• enfeksiyon
• antibiyotik direnci

Bacteria Grown in Various Clinical Samples of Palliative Service Patients and Antibiotic Resistance Rates

Öz

Knowing the current infectious agent profile and antibiotic resistance patterns in palliative service patients is of great importance in terms of empirical treatment management until the culture and antibiogram results are determined. Our study aimed to investigate the distribution of microorganisms isolated from clinical samples of patients receiving inpatient treatment in the palliative service of our hospital and the antibiotic resistance profiles of these isolates. In this study, clinical samples sent to the microbiology laboratory of 264 patients hospitalized in the palliative service of Samsun Gazi State Hospital between 2022 and 2023 were evaluated. The median age of the patients was 76 years (range: 65-87), and 41% of the patients were male. The most common causes of urinary tract infections were Klebsiella spp. (27.4%) and Escherichia coli (27.4%), the most common respiratory tract infection agent was Acinetobacter baumannii (36.7%), and the most common wound infection agent was Pseudomonas aeruginosa (30%). Lowest resistance rates were against ceftazidime-avibactam (4.8%) and colistin (9.5%) in Klebsiella isolates; ceftazidime-avibactam (0%), colistin (0%), imipenem (7.1%) and meropenem (7.1%) in E. coli isolates; colistin (7.1%) in Acinetobacter isolates. 0%); colistin (0%) and ceftazidime-avibactam (23.1%) in Pseudomonas isolates; and vancomycin (0%) in Enterococcus isolates. The findings obtained from our study indicate that Klebsiella and E. coli are the most common causes of urinary and bloodstream infections in palliative service patients, and that ceftazidime-avibactam and colistin are the most effective treatment options in these infections, and that colistin is the most effective treatment option in cases caused by Acinetobacter and Pseudomonas.

Anahtar Kelimeler

• Palliative service
• infection
• antibiotic resistance

Kaynakça

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