PREDOMINANCE OF COAGULASE-NEGATIVE STAPHYLOCOCCI AND ESCALATION OF GRAM-NEGATIVE RESISTANCE IN CEREBROSPINAL FLUID INFECTIONS (2018-2024)

Öz

Objective: This study aimed to evaluate the distribution of microorganisms isolated from cerebrospinal fluid (CSF) samples and their antibiotic susceptibility profiles between 2018 and 2024 in a tertiary hospital. Understanding the causative agents of meningitis and their resistance patterns is crucial for guiding empirical therapy and developing effective infection control strategies. Method: A total of 54 CSF samples were retrospectively analyzed. Patient demographics revealed that 46.3% were female and 53.7% were male, with nearly half (46.3%) of the cases occurring in individuals under 18 years of age. Standard microbiological techniques were used for pathogen identification, and antimicrobial susceptibility testing was performed according to routine laboratory protocols. The prevalence of common bacterial isolates and their resistance patterns were documented. Results: The most frequently isolated pathogens were coagulase-negative staphylococci (CoNS), Acinetobacter baumannii, and Klebsiella pneumoniae. Approximately 90% of CoNS isolates were found to be methicillin-resistant. Gram-negative isolates exhibited significant resistance patterns, including carbapenem and colistin resistance, which are particularly concerning due to their role as last-resort antibiotics. Vancomycin maintained complete efficacy against all staphylococcal and enterococcal isolates. A notable finding was the high proportion of pediatric patients, suggesting that children represent a particularly vulnerable group for central nervous system infections. Conclusion: The high rates of multidrug-resistant organisms observed in CSF isolates emphasize the importance of tailoring empirical treatment regimens based on local resistance data. Continuous monitoring of pathogens and their antibiotic susceptibility profiles is essential to improve infection control measures and to support the regular updating of empirical treatment guidelines for meningitis management.

Anahtar Kelimeler

• Cerebrospinal Fluid
• Antibiotic Resistance
• Meningitis
• Coagulase-Negative Staphylococci

BEYİN-OMURİLİK SIVISI ENFEKSİYONLARINDA KOAGÜLAZ-NEGATİF STAFİLOKOKLARIN BASKINLIĞI VE GRAM-NEGATİF DİRENCİN ARTIŞI (2018-2024)

Öz

Amaç: Bu çalışmada, 2018-2024 yılları arasında üçüncü basamak bir hastanede beyin-omurilik sıvısı (BOS) örneklerinden izole edilen mikroorganizmaların dağılımı ve antibiyotik duyarlılık profillerinin değerlendirilmesi amaçlandı. Menenjite neden olan etkenlerin ve direnç paternlerinin belirlenmesi, ampirik tedavinin yönlendirilmesi ve etkili enfeksiyon kontrol stratejilerinin geliştirilmesi açısından kritik önem taşımaktadır. Yöntem: Toplam 54 BOS örneği retrospektif olarak incelendi. Hastaların %46.3’ü kadın, %53.7’si erkek olup olguların yaklaşık yarısı (%46.3) 18 yaşın altındaydı. İzole edilen mikroorganizmalar standart mikrobiyolojik yöntemlerle tanımlandı ve antibiyotik duyarlılık testleri rutin laboratuvar protokolleri doğrultusunda gerçekleştirildi. Elde edilen verilerde sık izole edilen patojenler ve antibiyotik direnç profilleri analiz edildi. Bulgular: En sık izole edilen patojenler koagülaz-negatif stafilokoklar (KNS), Acinetobacter baumannii ve Klebsiella pneumoniae oldu. KNS izolatlarının yaklaşık %90’ı metisiline dirençli bulundu. Gram-negatif izolatlarda karbapenem ve kolistin gibi son seçenek antibiyotiklere karşı belirgin direnç paternleri saptandı. Vankomisin, tüm stafilokok ve enterokok izolatlarına karşı etkinliğini korudu. Dikkat çekici bir bulgu, pediatrik olguların yüksek oranıydı; bu da çocukların merkezi sinir sistemi enfeksiyonları için özellikle savunmasız bir grup olduğunu düşündürmektedir. Sonuç: BOS örneklerinden izole edilen ilaca çok dirençli mikroorganizmaların yüksek oranlarda görülmesi, menenjit tedavisinde ampirik tedavi protokollerinin yerel direnç verilerine göre uyarlanmasının önemini vurgulamaktadır. Patojenlerin ve antibiyotik direnç profillerinin düzenli olarak izlenmesi, enfeksiyon kontrol önlemlerinin geliştirilmesine ve ampirik tedavi kılavuzlarının güncellenmesine önemli katkı sağlayacaktır.

Anahtar Kelimeler

• Beyin Omurilik Sıvısı
• Antibiyotik Direnci
• Menenjit
• Koagülaz-Negatif Stafilokoklar

Kaynakça

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