Hande ARSLAN, Kurt Özlem AZAP, Özbalıkçı Sedef KARAMAN, Funda TİMURKAYNAK

Hastane infeksiyon etkeni olarak izole edilen non-fermentatif gram negatif bakterilerde siprofloksasin, ofloksasin ve levofloksasinin in-vitro etkinliğinin karşılaştırılması

Hastane infeksiyonlarından izole edilen non-fermentatif bakteriler üzerine uzun süredir kullanımda olan siprofloksasin (SİP) ve ofloksasin (OFL) ile son yıllarda kullanıma giren levofloksasinin (LEV) in-vitro etkinliğinin karşılaştırılması amaçlandı. Çalışmaya Ocak 2001-Ocak 2003 tarihlerinde hastane infeksiyon etkeni olarak izole edilen 228 nonfermentatif bakteri susu (107 Pseudomonas aeruginosa, 86 Acinetobacter baumannii, 26 Stenotrophomonas mal-tophilia, 9 Burkholderia cepacia) alındı. Tüm izolatlar standart mikrobiyolojik yöntemlerle tiplendirildi. Bakteriler çalışma gününe kadar -20 "C'de saklandı. Antibiyotik tozları üretici firmalardan (siprofloksasin Bayer, ofloksasin ve levofloksasin Aventis) sağlandı. MİK değerleri ağar dilusyon yöntemi ile Muller-Hinton ağar kullanılarak belirlendi. Antibiyotik duyarlılık sınırları NCCLS kriterlerine göre okundu. Kontrol susu olarak P.aeruginosa ATCC 27853 ve E. coli ATCC 25922 kul¬lanıldı. P. aeruginosa için siprofloksasinin en düşük MİK50 ve MİK90 değerlerine sahip antibiyotik olduğu belirlendi. Acinetobacter baumanii için çalışılan üç kinolonun da MİK50 ve MİK90 değerlerinin duyarlılık sınırının üzerinde olduğu gözlendi. S. maltophilia ve B. cepacia' ya karşı en iyi in-vitro etki OFL ve LEV ile sağlandı. Siprofloksasinin P. aeruginosa infeksiyonları için hala en etkili antibiyotik olduğu belirlendi. S. maltophilia ve B. cepacia ile gelişen infeksiyonların tedavisinde ofloksasin ve levofloksasin iyi bir alternatif olabilir.

Comparison in-vitro activities of ciprofloxacin, ofloxacin and levofloxacin against non-fermentative bacteria isolated from nonsocomial infections

To compare the in-vitro activities of new broad spectrum (levofloxacin, LEV) and previously developed (ciprofloxacin OP, ofioxacin OFX) quinolones against clinical isolates of non-fermentative bacteria. Two hundered twenty eight nonfermentative bacteria (107 Pseudomonas aeruginosa, 86 Acinetobacter baumannii, 26 Stenotrophomonas maltophila, 9 Burkholderia cepacia) recovered from clinical isolates between January 2001 to January 2003 were studied. All isolates were identified by standard methods and kept frozen at -20 °C until use. Antibiotic powders were provided by their respective manufacturers (CIP Bayer, OFX and LEV Aventis). MICs were determined by agar dilution method on Muller-Hinton agar and results were interpreted according to the recommendations of NCCLS. Control strains were P. aeruginosa A TCC 27853 and E. coli A TCC 25922. Ciprofloxacin was the most active compound tested againts P. aeruginosa, while levofloxacin and ofioxacin showed the best in-vitro activity against S. maltophilia and B. cepacia. We also found high MIC values for all quinolones tested against A. baumannii According to our results CIP is still the most effective quinolone against P. aeruginosa. Levofloxacin and ofioxacin could become therapeutic options for treating infections due to S. maltophilia and B. cepacia.

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