Çeşitli Klinik Örneklerden 2006-2011 Yılları Arasında İzole Edilen Acinetobacter Türleri ve Antibiyotik Duyarlılıkları

Öz

Amaç: Son altı yılda, hastanemizde izole edilen Acinetobacter türlerinin dağılımı ve antibiyotik duyarlılıklarının incelenmesi amaçlanmıştır.Yöntem: Çalışmaya; Ondokuz Mayıs Üniversitesi Tıp Fakültesi Hastanesi Merkez Laboratuvarı Bakteriyoloji Subdisiplin Laboratuvarına, Ocak 2006 - Haziran 2011 tarihleri arasında çeşitli kliniklerden gönderilen örneklerden izole edilen Acinetobacter türleri dahil edilmiştir. İzolatların tanımlanmasında ve antibiyotik duyarlılıklarının yöntemler ve Vitek 2 Compact bioMérieux-SA, Fransa otomatize sistemi kullanılmıştır.belirlenmesinde konvansiyonel Bulgular: Çalışma döneminde toplam 3.212 Acinetobacter türü izole edilmiştir. Acinetobacter izolatlarının tür dağılımı ve oranları; Acinetobacter baumannii - Acinetobacter calcoaceticus complex 3006 %93,6 , Acinetobacter lwoffii 83 %2,6 , Acinetobacter junii 27 %0,8 , Acinetobacter haemolyticus 19 %0,6 ve Acinetobacter spp. 77 %2,4 olarak bulunmuştur. En fazla Acinetobacter izolatı 747 %23,2 trakeal aspirat örneğinden ve en çok yoğun bakım ünitesinden gönderilen 705 %21,9 örnekten izole edilmiştir. Son altı yılda seftazidim direnci %70,2’den %82,7’e, sefepim %26,4’dan %79,7’e, imipenem %27,2’den %77,2’ye, meropenem %4,5’ten %77’ye, siprofloksasin %40,4’dan %78,9’a yükselmiştir. 2011 yılı ilk altı aylık dönemde tigesikline %5,9, kolistine %0,2 oranlarında direnç saptanmıştır. Ampisilin-sulbaktam direnç oranlarında belirgin değişim gözlenmemiştir.Conclusion: As of the first half of 2011, when all the findings were evaluated, high-rate of resistance to cefepime, piperacillin-tazobactam, ceftazidime, ceftriaxone, meropenem, imipenem, ciprofloxacin and levofloxacin were determined and it was observed that this level had a tendency to increase. Colistin resistance in Acinetobacter species was observed as minimal. The reduction seen during the years in the resistance rate of gentamycin, an antibiotic from the aminoglycoside group, was attributed to its less frequent use in recent years. As shown in our study, generally antibiotic resistance is gradually increasing in Acinetobacter species. In the future, new antibiotics will be required for the treatment of infections caused by Acinetobacter species. In conclusion, we are in the opinion that rate of appearance of pan-resistant strains which may pose serious problems in the near future should be decelerated by promoting the rational use of antibiotics

Anahtar Kelimeler

• Acinetobacter, antibiyotik direnci, karbapenemler

Acinetobacter species isolated from various clinical specimens between 2006-2011 years and their susceptibilities against antibiotics

Öz

Objective: The aim of this study was to investigate the distribution and antibiotic susceptibility of Acinetobacter species isolated in our hospital in the last six years.Method: Acinetobacter species isolated from various clinical samples sent to Ondokuz Mayıs University, Medical Faculty Hospital Central Laboratory, Bacteriology Sub - Discipline Laboratory between January 2006 and June 2011 were included. Conventional methods and Vitek 2 Compact bioMérieux-SE, France automated systems were used for the identification and antibiotic susceptibility of the isolates.Results: During the study period, a total of 3.212 Acinetobacter species were isolated. Species distribution of Acinetobacter isolates and their ratios were found as follows: Acinetobacter baumannii - Acinetobacter calcoaceticus complex n=3006; 93.6% , Acinetobacter lwoffii n=83; 2.6% , Acinetobacter junii n=27; 0.8% , Acinetobacter haemolyticus n=19; 0.6% and Acinetobacter spp. n=77; 2.4% . Acinetobacter isolates were isolated at the most from tracheal aspirate samples n=747; 23.2% and samples sent from intensive care units n=705; 21.9% . Ceftazidime resistance increased from 70.2% to 82.7%; cefepime from 26.4% to 79.7%; imipenem from 27.2% to 77.2%; meropenem from 4.5% to 77% and ciprofloxacin from 40.4% to 78.9% in the last six years. In the first six months of 2011, the resistance ratios to tigecycline and colistin were determined as 5.9% and 0.2% respectively. No significant changes were observed in ampicillin-sulbactam resistance ratios.Conclusion: As of the first half of 2011, when all the findings were evaluated, high-rate of resistance to cefepime, piperacillin-tazobactam, ceftazidime, ceftriaxone, meropenem, imipenem, ciprofloxacin and levofloxacin were determined and it was observed that this level had a tendency to increase. Colistin resistance in Acinetobacter species was observed as minimal. The reduction seen during the years in the resistance rate of gentamycin, an antibiotic from the aminoglycoside group, was attributed to its less frequent use in recent years. As shown in our study, generally antibiotic resistance is gradually increasing in Acinetobacter species. In the future, new antibiotics will be required for the treatment of infections caused by Acinetobacter species. In conclusion, we are in the opinion that rate of appearance of pan-resistant strains which may pose serious problems in the near future should be decelerated by promoting the rational use of antibiotics

Anahtar Kelimeler

• Acinetobacter, antibiotic resistance, carbapenems

Kaynakça

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