Adıyaman'da Diyabetik Ayak Ülserinde Bakteriyel Etiyoloji ve Etkenlere ait Antibiyotik Duyarlılık Sonuçları

Amaç: Çalışmamızda diyabetik ayak ülserleri (DAÜ) gelişen hastalarda izole edilen mikrobiyal ajanları ve bu ajanların antibiyotik duyarlılık profillerini göstermeyi amaçladık.Gereç ve Yöntemler: 100 Hastaya ait diyabetik ayak ülserinden alınan 248 sürüntü örneğinden çalışılan kültür sonuçları retrospektif olarak değerlendirildi. Klinik ve Laboratuvar Standartları Enstitüsü (CLSI) yönergelerine göre yapılmış olan antimikrobiyal duyarlılık durumları belirlendi. Bulgular: Gram-pozitif koklar (GPK) (%54,7) gram-negatif basillerden (GNB) (%42,4) daha fazla izole edilmişti. En fazla üreyen bakteri S.aureus (%20,9) iken, GNB'den en fazla E.coli (%9,6) basilleri üremişti. 48 S.aureus izolatından 13 tanesini (27,08) Metisiline dirençli S.aureus (MRSA) oluşturmaktaydı. Genişlemiş Spektrumlu Beta-Laktamaz (GSBL) pozitifliği %43,3 olarak saptandı. S.aureus suşları Teikoplanin, Linezolid ve Vankomisine % 100 duyarlılık gösteriyordu. E.coli suşları %95,5 oranında Amikacin ve İmipenem, %90,9 oranında Meropenem ve %81,8 oranında Ertapenem duyarlılığı gösteriyordu. MRSA bütün suşları Teikoplanin, Vankomisin ve Levofloksasin'e duyarlıydı.Sonuç: Çalışmamızda DAÜ enfeksiyonlarında en yaygın olarak S.aureus, Gram-negatif basillerden en sık E.coli saptandı. GPK enfeksiyonlarının ampirik tedavisinde Teikoplanin, Vankomisin ve Linezolid, GNB enfeksiyonlarında ise Amikacin, İmipenem, Meropenem ve Ertanem'in kullanılması daha uygun olabilir. DAÜ tedavisinde izole edilen baskın organizmalara ve yerel antimikrobiyal yatkınlık modellerine dikkat edilmesi gerekmektedir.

Bacterial Etiology and Antibiotic Susceptibility of Diabetic Foot Ulcer Infections in Adiyaman

Objective: The aim of this study was to investigate the microbial agents isolated in patients who developed diabetic foot ulcer and to present the antibiotic sensitivity profiles of these agents.Material and Methods: Retrospective evaluation was made of the culture results of 248 smear samples taken from 100 patients with diabetic foot ulcer (DFU). The antimicrobial sensitivity status was determined according to the Clinic and Laboratory Standards Institute (CLSI) guidelines.Results: Gram-positive cocci (GPC) at 54.7% and gram-negative bacilli (GNB) at 42.4% were the agents most commonly isolated. The most common bacteria determined were S. aureus (20.9%), and of GNB, E. coli (9.6%) bacilli. From 48 S. aureus isolates, 13 (27.08%) were Methicillin-resistant S. aureus (MRSA). Extended spectrum beta-lactamase (ESBL) positivity was determined in 43.3%. All of the S. aureus isolates were 100% sensitive to Vancomycin, Teicoplanin and Linezolid. Antibiotic sensitivity rates of E. coli isolates was 95.5% for Amikacin and Imipenem, 90.9% for Meropenem and 81.8% for Ertapenem. All strains of MRSA were found to be sensitive for Vancomycin, Teicoplanin and Levofloxacin.Conclusion: The most commonly found agents were S. aureus as GPC and E. coli as GNB in DFU infections in our study. Teicoplanin, Vancomycin and Linezolid were determined with 100% sensitivity in gram-positive infections, Amikacin or Gentamycin, or a Carbapenem such as Imipenem, Meropenem or Ertanem for GNB infections can be recommended as a suitable option in the empirical treatment of DFU. Isolating the dominant organisms and determining the local antimicrobial susceptibility patterns of clinical isolates should be considered for effective DFU treatment.

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