SELAHATTİN ATMACA, TUNCER ÖZEKİNCİ, SALİM YAKUT, NEZAHAT AKPOLAT, Kadri GÜL

2015-2017 YILLARI ARASINDA İZOLE EDİLEN CITROBACTER SUŞLARINDA ANTİBİYOTİK DİRENCİ

.Bu çalışmada Nisan 2015-Mart 2017 tarihleri arasında infeksiyon etkeni olarak izole edilen Citrobacter suşlarının antibiyotik dirençlerinin belirlenmesi amaçlanmıştır. İzole edilen 72 Citrobacter suşundan 37'si Citrobacter freundii 35'i diğer Citrobacter türleri olarak identifiye edilmiştir. İzole edilen suşların farklı antimikrobiyallere minimum inhibitör konsantrasyon değerleri incelenmiş ve ampisiline % 99, seftazidime % 25, aztreonam ve trimetoprim/sülfametoksazole % 22, siprofloksasine % 15, piperasilin/tazobaktam ve gentamisine % 11, sefepime % 10, meropeneme % 1 ve amikasine % 0 oranlarında direnç saptanmıştır. Amikasin ve meropenem en etkili antibiyotikler olarak bulunmuş, bunları sefepim, gentamisin ve piperasilin/tazobaktam izlenmiştirÇalışmada amikasin ve meropenemin Citrobacter infeksiyonları için iyi bir tedavi alternatifi olduğu sonucuna varılmıştır

Antibiotic Resistance of Citrobacter Strains Isolated Between 2015 and 2017

Antibiotic Resistance of Citrobacter Strains Isolated Between 2015 and 2017Citrobacter is a group of bacteria that causes hospital-acquired infections mostly in newborn and immunosuppressed patients. The aim of this study to antibiotic resistance of Citrobacter strains isolated from clinical specimens between April 2015 and March 2017 as infection agents. 37 C.freundii and 35 other Citrobacter strains, totally 72 Citrobacter strains were isolated. When MIC values of isolates were taken into consideration altogether, rate of resistance were as follows: 99 % to ampicillin, 25 % to ceftazidime, 22 % to trimethoprim/sulfamethoxazole and aztreonam, 15 % to ciprofloxacin, 11 % to piperasillin/tazobactam and gentamisin, 10 % to cefepime, % 1 to meropenem and % 0 to amikacin, amikacin and meropenem are determined that the most efficient antibiotics, these antibiotics were followed by cefepime, gentamisin and piperasillin/tazobactam against to Citrobacter strains. It has been concluded that amikacin and meropenem are good treatment alternatives for Citrobacter infections in our study

PDF

___

1. Akalın H. Enterobacter ve diğer Gram negatif enterikler, “Topçu AW, Söyletir G, Doğanay M (eds.) İnfeksiyon Hastalıkları ve Mikrobiyolojisi, 2.baskı’’ kitabında s.1583-84, Nobel Tıp Kitapevleri, İstanbul (2002).
2. Choi SH, Lee J, Park S et al. Prevalence, microbiology, and clinical characteristics of extendedspectrum β-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii in Korea, Eur J Clin Microbiol Infect Dis 2007;26(8):557-61. https://doi.org/10.1007/s10096-007-0308-2
3. Doran TI. The role of Citrobacter in clinical disease of children: review, Clin Infect Dis 1999;28(2): 384-94. https://doi.org/10.1086/515106
4. EUCAST (The European Committee on Antimicrobial Susceptibility Testing).Breakpoint tables for interpretation of MICs and zone diameters. Version 7.1, 2017. http://www.eucast.org
5. Gülhan B, Özekinci T, Meşe S, Atmaca S. 2004- 2006 yılları arasında izole edilen Citrobacter suşlarında antibiyotik direnci, ANKEM Derg 2007;21(2): 91-4.
6. Konemann EW, Allen SD, Janda WM et al. Colour, Atlas and Textbook of Diagnostic Microbiology, philadelphia: JB lippincott company, 6. baskı 171- 252, (2006).
7. Maraki S, Vardakas KZ, Mavromanolaki VE et al. In vitro susceptibility and resistance phenotypes in contemporary Citrobacter isolates in a University Hospital in Crete, Greece, Infect Dis 2017;49(7):532-39. https://doi.org/10.1080/23744235.2017.1297896
8. Monira S, Shabnam SA, Ali SI et al. Multi-drug resistant pathogenic bacteria in the gut of young children in Bangladesh, Gut Pathogens 2017; 20(9):19. https://doi.org/10.1186/s13099-017-0170-4
9. Murray PR, Rosenthal KS, Pfaller MA. Tıbbi Mikrobiyoloji, 7. baskı, s.270, Pelikan Kitabevi, Ankara (2016).
10. Priyadarshini, Rani KL, Ramaswamy R. Isolation and antibiotic sensitivity pattern of Citrobacter species with ESBL and AmpC detection at tertiary care hospital, Bangalore, J Evolution Med Dent Sci 2016;5(30):1553-6. https://doi.org/10.14260/jemds/2016/365
11. Samonis G, Karageorgopoulos D, Kofteridis D et al. Citrobacter infections in a general hospital: characteristics and outcomes, Eur J Clin Microbio Infect Dis 2009;28(1):61-8. https://doi.org/10.1007/s10096-008-0598-z
12. Santos C, Ramalheira E, Da Silva G, Mendo S. Genetically unrelated multidrug-and carbapenem- resistant Citrobacter freundii detected in outpatients admitted to a Portuguese hospital, J Global Antimicrob Resist 2017;8(1):18-22. https://doi.org/10.1016/j.jgar.2016.09.010
13. Shahid M. Citrobacter spp. simultaneously harboring blaCTX-M, blaTEM, blaSHV, blaampC, and insertion sequences IS26 and orf513: an evolutionary phenomenon of recent concern for antibiotic resistance, J Clin Microbiol 2010;48(5):1833-38. https://doi.org/10.1128/JCM.01467-09
14. Ünaldı Ö, Engin D,Çırak MY. Genişlemiş spektrumlu beta-laktamaz üretiminin saptanmasında agar tarama plakları ve çift disk sinerji yönteminin karşılaştırılması, Mikrobiyol Bul 2007;41(3): 369-76.