Karbapenem dirençli Gram-negatif mikroorganizmalarda seftazidim-avibaktam duyarlılıklarının değerlendirilmesi

Yıl 2023, , 625 - 629, 31.12.2023

Özlem Koca , Gül Aydın Tığlı , Hatice Nevgün Özen , Yeşim Çekin , Derya Seyman

https://doi.org/10.47582/jompac.1372443

Öz

Amaç: Yoğun bakım ünitelerinde yatan hastalarda karbapenem dirençli Gram negatif mikroorganizmalar giderek artmakta ve morbidite, mortalite ve maliyetin artmasına neden olmaktadır. Bu çalışmada, yoğun bakımdaki hastalardan alınan çeşitli örneklerden izole edilen karbapenem dirençli (CR) Gram-negatif bakterilerin neden olduğu enfeksiyonların tedavisinde hastanemizin yoğun bakım ünitesi (YBÜ) tarafından son yıllarda kullanılmaya başlanan seftazidim-avibaktam (caz-avi)'nin duyarlılığının araştırılması amaçlanmıştır.
Yöntemler: Çalışmada 1 Ocak 2021 ile 30 Ekim 2022 tarihleri arasında laboratuvarımıza gönderilen çeşitli klinik örneklerden izole edilen karbapenem dirençli Klebsiella pneumoniae (CRKP) ve karbapenem dirençli Pseudomonas aeruginosa (CRPA) suşları retrospektif olarak değerlendirilmiştir. Örneklerin kültür ve antibiyogram sonuçları Laboratuvar Bilgi Sistemi (LIS) üzerinden alınarak istatistiksel analizlerle değerlendirilmiştir. Seftazidim-avibaktam duyarlılığı disk difüzyon yöntemi kullanılarak araştırılmıştır.
Bulgular: Hastanemiz yoğun bakım ünitesinden çeşitli klinik örneklerden izole edilen 352 (%69,4) CRKP ve 155 (%30,6) CRPA suşunun seftazidim-avibaktam antibiyotik duyarlılık testi sonuçları analiz edilmiştir. CRKP suşlarının 313'ünün (%88,9) seftazidim-avibaktam'a duyarlı, 39'unun (%11,1) ise dirençli olduğu belirlenmiştir. CRPA suşlarının ise 131'inin (%84,5) duyarlı, 24'ünün (%15,5) dirençli olduğu belirlenmiştir.
Sonuç: Hastanemizden izole edilen karbapenem dirençli suşların caz-avi gibi yeni bir antimikrobiyal kombinasyona karşı bölgesel duyarlılığının belirlenmesi, direnç yayılımının daha iyi anlaşılmasına olanak sağlayacaktır.

Anahtar Kelimeler

Antibakteriyel-ajanlar, Avibaktam Seftazidim İlaç Kombinasyonu, Antimikrobiyal İlaç Direnci, Gram-Negatif Bakteriler

Evaluation of ceftazidime-avibactam susceptibility in carbapenem resistant Klebsiella pneumoniae and Pseudomonas aeruginosa isolates

Öz

Aims: Carbapenem-resistant Gram-negative microorganisms are gradually increasing in hospitalized patients in intensive care units and causes increased morbidity, mortality, and cost. This study aims to investigate the susceptibility of ceftazidime-avibactam (caz-avi), which has recently started to be used for the treatment of infections caused by carbapenem-resistant (CR) Gram-negative bacteria isolated from various samples received from the intensive care unit (ICU) of our hospital.
Methods: Carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) strains isolated from various clinical specimens that were sent to our laboratory between January 1st, 2021, and October 30th, 2022, were retrospectively evaluated in the study. The culture and antibiogram results of the samples were received over the laboratory information system (LIS) and evaluated using statistical analyses. Ceftazidime-avibactam susceptibility was studied using the disc diffusion method.
Results: Ceftazidime-avibactam antibiotic susceptibility test results of 352 (69.4%) CRKP and 155 (30.6%) CRPA strains isolated from various clinical samples from the ICU of our hospital were analyzed. Of the CRKP strains, 313 (88.9%) were found to be susceptible and 39 (11.1%) were found to be resistant to ceftazidime-avibactam. Of the CRPA strains, 131 (84.5%) were found to be susceptible and 24 (15.5%) were found to be resistant.
Conclusion: Determining the regional susceptibility of carbapenem-resistant strains isolated in our hospital to a new antimicrobial combination such as caz-avi will allow a better understanding of the spread of resistance.

Anahtar Kelimeler

Ceftazidime-avibactam, antimicrobial resistance, Gram negative bacteria

Etik Beyan

The study was performed with the permission of the Antalya Training and Research Hospital Ethics Committee (Date: 06.01.2022, Decision No: 1/8).

Kaynakça

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