COVID-19 Pnömonili Hastaların Solunum Yolu Örneklerinde Sekonder Bakteriyel Ajanlar ve Antibiyotik Direnç Profilleri

Öz

Amaç: COVID-19 pnömonisi olan hastalardaki sekonder bakteriyel pnömoni etkenleri ve antibiyotik direnç oranlarının değerlendirilmesi ve sonuçların pandemi öncesi dönemle karşılaştırılmasıdır. Materyal ve Metot: Ocak 2020-Aralık 2020 arasında COVID-19 tanısı konan hastaların endotrakeal aspirat sıvı ve bronkoalveolar sıvı örneklerinde üreyen bakteriler ve antibiyotik direnç oranları, pandemiden önceki yıl gelen hasta örnekleriyle retrospektif olarak karşılaştırılmıştır. Kültürde üremesi olan örnekler, otomatize sistemle (VITEK 2, bioMérieux, France) tür düzeyinde tanımlanmış ve antimikrobiyal duyarlılıkları EUCAST kriterlerine göre değerlendirilmiştir. Bulgular: 2019 da mikrobiyolojik kültürlerinde üreme saptanan 900 hasta örneği incelendi. Acinetobacter baumannii %36, Klebsiella pneumoniae %23, Pseudomonas aeruginosa %14, Staphylococcus aureus ise %8 oranında saptandı. 2020 de ise 660 hasta örneği incelendi ve sırasıyla aynı bakteriler %43, %23, %16 ve %5 oranında saptandı. K. pneumoniae'nin 3. kuşak sefalosporin direncinde ve A. baumannii'nin gentamisin ve tobramisin direncinde pandemi öncesine göre anlamlı bir artış görüldü. Sonuç: COVID-19 pandemisinde solunum sekresyonlarında çoğunlukla çok ilaca dirençli Gram negatif bakterilerin ürediği görüldü. COVID-19 hastalığı olanlarda, bölgesel bakteriyel etkenler ve antibiyotik direnç profilleri bilinip, uygun ampirik tedavi seçilmelidir.

Anahtar Kelimeler

• Antibiyotik direnci
• bakteriyel süperenfeksiyon
• COVID-19
• pnömoni
• yoğun bakım ünitesi

Secondary Bacterial Agents and Antibiotic Resistance Profiles in Respiratory Tract Specimens of Patients with COVID-19 Pneumonia

Öz

Objective: To assess secondary bacterial pneumonia agents and antibiotic resistance rates in patients with COVID-19 pneumonia and to compare findings with the pre-pandemic period. Materials and Methods: Bacteria grown in endotracheal aspirate fluid and bronchoalveolar fluid samples of patients diagnosed with COVID-19 between January 2020 and December 2020, and antibiotic resistance rates were retrospectively compared with samples of the year before the pandemic. Isolates were identified at the species level with an automated system (VITEK 2, bioMérieux, France), and antimicrobial susceptibility was determined according to EUCAST criteria. Results: A total of 900 culture results were examined in 2019. Acinetobacter baumannii was detected in 36%, Klebsiella pneumoniae in 23%, Pseudomonas aeruginosa in 14%, and Staphylococcus aureus in 8%. In 2020, 660 culture results were examined, and the same bacteria were detected in 43%, 23%, 16%, and 5%, respectively. K. pneumoniae's resistance to third-generation cephalosporins, and A. baumannii's resistance to gentamycin and tobramycin, were found to have increased significantly during the pandemic period. Conclusions: The growth of multidrug-resistant Gram-negative bacteria was frequently detected in respiratory secretions obtained during the COVID-19 pandemic. Regional bacterial agents and antibiotic resistance profiles should be clarified, and empirical therapy should be selected accordingly in COVID-19.

Anahtar Kelimeler

• Antibiotic resistance
• bacterial superinfection
• COVID-19
• intensive care unit
• pneumoniae

Kaynakça

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