Enterobakter Türlerinde Geniş Spektrumlu Antibiyotik Kullanımının Karbapenem Direnci Üzerine Etkisi

Öz

Amaç: Enterobacteriaceae familyasına ait bakteri türlerinde karbapenem direnci dünya çapında önemi giderek artan bir sağlık sorunu haline gelmiştir. Geniş spektrumlu antibiyotik kullanımının
karbapenem direnci gelişimi üzerine etkisini araştırmayı amaçladık.

Yöntem: Hastanemizin çeşitli polikliniklerinden Ocak 2019 ile Ağustos 2021 arasında kültür örnekleri mikrobiyoloji laboratuvarına gönderilen toplam 82673 hasta mevcut idi. Kültürlerinde Gram negatif enterik bakteri üremesi olanlar ile karbapenem dirençli Gram negatif enterik bakteri üremesi olanların kültürleri kaydedildi.

Bulgular: Çalışmaya alınan hastaların 71’i (%56,8) kadın, 54’ü (%43,2) erkekti. 125 hastanın 91’inin (%73,1) son 12 ayda antibiyotik kullanım öyküsü vardı. 376 hastanın 125’inin (%33,2) kültüründe karbapenemlere dirençli Gram negatif enterik bakteri üremesi saptandı. Geniş spektrumlu antibiyotik kullanım öyküsü olan hastaların , antibiyotik kullanma öyküsü olmayanlara göre (%0,19’a karşı %0,05; p<0,001) kültürlerinde karbapenem dirençli Gram negatif bakteri üreme oranı anlamlı olarak daha yüksekti. Antibiyotik kullanımı öyküsü olanlarda karbapenem direnci geliştirme riskinin 3,49 kat arttığı belirlendi. (Odds oranı =3,49; %95 GA: 1,92-6,33).

Sonuç: Çalışmamızda elde edilen sonuçlar, geniş spektrumlu antibakteriyel kullanımının Gramnegatif enterik bakterilerde karbapenem direnci gelişimi ile ilişkili olabileceğini içermektedir. Bu olası ilişkinin daha net tespiti için detaylı çalışmalar önemli bilgiler sağlayacaktır.

Anahtar Kelimeler

• Karbapenem Direnci
• Karbapenemaz
• Enterobakter
• Antibiyotik Kullanımı

The Effect of Broad-Spectrum Antibiotic Use on Carbapenem Resistance in Enterobacteriaceae Species

Öz

Objective: Carbapenem resistance in bacterial species belonging to the Enterobacteriaceae famil has become an increasingly important health problem worldwide. We aimed to investigate the effect of broad-spectrum antibiotic use on the development of carbapenem resistance.

Methods: A total of 82673 patients whose culture samples were sent to the microbiology laboratory from various polyclinics of our hospital between January 2019 and August 2021. Those with Gramnegative enteric bacterial growth in their cultures and those with carbapenem-resistant Gramnegative enteric bacterial growth in their cultures were recorded.

Results: The patients included in the study consisted of 71 (56.8%) females and 54 (43.2%) males. Of 125 patients, 91 (73.1%) had a history of antibiotic use in the last 12 months. Carbapenemresistant Gram-negative enteric bacterial growth was detected in the culture of 125 (33.2%) of 376 atients. Among the patients with a history of broad-spectrum antibiotic use, the ratio of those with carbapenem-resistant Gram-negative bacterial growth in their cultures was significantly higher than those without a history of antibiotic use (0.19% vs. 0.05%; p<0.001). It was determined that the risk of developing carbapenem resistance increased by 3.49 times in those with a history of antibiotic use (Odds ratio =3.49; 95% CI: 1.92-6.33).

Conclusion: The results obtained in our study indicate that broad-spectrum antibacterial use may be associated with the development of carbapenem resistance in Gram-negative enteric bacteria. Detailed studies will provide important information for a clearer determination of this possible relationship.

Anahtar Kelimeler

• Carbapenem Resistance
• Carbapenemase
• Enterobacteriaceae
• Antibiotic Use

Kaynakça

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