Resistance States of Nonfermentative Gram Negative Bacteria Isolated from Blood Cultures to Various Antibiotics

Öz

Objective: Aim of this study is to identify nonfermentative Gram-negative bacteria isolated from blood cultures of patients undergoing treatment in various clinics in our hospital,to examine antimicrobial resistance profiles
Methods: June 2016 – June 2019 blood cultures sent to the Microbiology Laboratory were retrospectively evaluated. Blood cultures were tested in BacT/Alert (BioMerieux, France) automated system of. Identification of growth microorganisms were tested in Vitek MS (BioMérieux, France) automated system and antibiotic sensitivity determined on Mueller - Hinton (BioMérieux, France) agar by disk diffusion method and Vitek2 Compakt (BioMerieux, France) automated system. Antibiotic susceptibility rates were evaluated according to EUCAST (European Committee on Antimicrobial Susceptibility Testing) criteria.
Results: Over a period of 3 years, 668 nonfermentative bacteria were isolated from blood cultures. The 299 (45%) of the microorganisms isolated are Acinetobacter spp. and 270 of them were identified as Acinetobacter baumannii. And 189 (28%) of them were Pseudomonas spp. and 164 of them were identified as Pseudomonas aeruginosa. Stenotrophomonas maltophilia was isolated from 42 (6%) specimen. Acinetobacter spp. has the highest resistance rates against levofloxacin and ciprofloxacin as 76%. Pseudomonas spp. has the highest resistance rates against piperacillin as 32%. All Stenotrophomonas maltophilia isolates were found to be sensitive to trimethoprim/ sulfomethoxazole.
Conclusion: Antibiogram results of nonfermentative Gram negative bacteria in blood cultures obtained in our hospital, is important to shed light on the antimicrobial resistance patterns that will occur in the coming years. Blood-stream infection factors and sensitivity tests should be followed continuously and effective treatment protocols should be applied

Anahtar Kelimeler

• Nonfermentative bacteria
• antibiotic resistance
• blood culture

Kan Kültürlerinden İzole Edilen Nonfermentatif Gram Negatif Bakterilerin Çeşitli Antibiyotiklere Direnç Durumları

Öz

Amaç:Bu çalışmadaki amacımız, hastanemizde çeşitli kliniklerde tedavi görmekte olan hastaların kan kültürlerinden izole edilen nonfermentatif gram negatif bakterileri tanımlamak, antimikrobiyal direnç profillerini incelemektir. Yöntem:Tıbbi Mikrobiyoloji laboratuvarına Haziran 2016 – Haziran 2019 tarihleri arasında gönderilen kan kültürleri retrospektif olarak değerlendirildi. Kan kültürleri otomatize sistem ile BacT/Alert (BioMerieux, Fransa) çalışıldı. Üreyen mikroorganizmaların tanımlanması Vitek MS (BioMérieux, Fransa) ile antibiyotik duyarlılıkları Mueller- Hinton (BioMérieux, Fransa) agarda disk difüzyon yöntemi ve VITEK 2 (BioMerieux, Fransa) otomatize sistemle belirlenmiştir.Antibiyotik duyarlılık oranları EUCAST (European Committee on Antimicrobial Susceptibility Testing) kriterlerine göre değerlendirilmiştir. Bulgular: Laboratuvarımızda3 yıllık sürede kan kültürlerinden 668 nonfermentatif bakteri izole edildi.İzole edilen mikroorganizmaların 299’u (%45) Acinetobacter spp. ve bunların 270 tanesi Acinetobacter baumanniiolarak tespit edildi. 189’ u (%28) Pseudomonas spp. ve bunların 164 tanesi Pseudomonas aeruginosa olarak tespit edildi.42’ sini (%6)Stenotrophomonas maltophilia, geriye kalan 138’ ini (%21) diğer nonfermentatif bakteriler oluşturmaktadır. Acinetobacter spp. en yüksekdirenç oranlarılevofloksasin ve siprofloksasin için %76 olarak saptanmıştır. Pseudomonas spp. en yüksek direnç oranları piperasilin için %32 olarak saptanmıştır. Stenotrophomonas maltophilia’ ların hepsi trimetoprim/ sülfometoksazol’ e duyarlı saptanmıştır. Sonuç:Hastanemizde elde ettiğimiz kan kültürlerindeki nonfermentatif bakterilerin antibiyotik direnç sonuçları, gelecek yıllarda oluşacak antimikrobiyal direnç paternlerine ışık tutması bakımından önem taşımaktadır.Kan dolaşımı enfeksiyonu etkenlerinin ve duyarlılık testlerinin devamlı olarak takip edilerek etkin tedavi protokollerinin uygulanması gerekmektedir.

Anahtar Kelimeler

• kan kültürü
• gram negatif nonfermentatif bakteri
• antimikrobiyal direnç

Kaynakça

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