Çeşitli Klinik Örneklerden İzole Edilen ID Stenotrophomonas maltophilia Suşlarının Antibiyotik Duyarlılıkları
Stenotrophomonas maltophilia, hastane enfeksiyonu etkeni olarak giderek artan sıklıkla karşılaşılan fırsatçı bir patojendir ve geniş spektrumlu antibiyotiklerin çoğuna dirençlidir. Bu çalışmada, yaklaşık beş yıllık süre boyunca izole edilmiş S.maltophilia suşlarının dağılımının ve antibiyotik duyarlılıklarının incelenmesi amaçlanmıştır. Ocak 2014-Eylül 2018 tarihleri arasında çeşitli klinik örneklerden izole edilen toplam 53 S.maltophilia suşunun antibiyotiklere direnç oranları incelenmiştir. Bakteri identifikasyonu ve antibiyotik duyarlılığı için BD Phoenix 100 Otomatize Sistemi (Becton Dickinson Diagnostic Systems, Sparks, ABD) kullanılmıştır. S.maltophilia suşlarının % 21’i poliklinik, % 79’u yataklı servis hastalarına ait örneklerden izole edilmiştir. Yatan hastaların % 50’sinin yoğun bakım ünitesinde tedavi gördüğü gözlenmiştir. Antibiyotik duyarlılıkları sırası ile trimetoprimsülfametoksazol (TMP-SXT), levofloksasin ve seftazidim için, % 88.6, % 85 ve % 30 şeklindedir. Tigesiklin minimum inhibitör konsantrasyon (MİK) değeri 2 mg/l’nin üzerinde dirençli kabul edildiğinde tigesikline % 83 duyarlılık saptanmıştır. Çalışmamızda, seftazidime karşı saptanan direnç nedeniyle, üçüncü kuşak sefalosporinlerin hastanemizde S.maltophilia’nın ampirik tedavisinde kullanılamayacağı sonucuna varılmıştır. TMP-SXT ve levofloksasin direncimiz henüz korkulacak boyutlarda olmamasına rağmen artan direnç oranları açısından dikkat edilmesi gerektiği görülmüştür.
Antibiotic Susceptibility of Stenotrophomonas maltophilia Isolated from Various Clinical Specimens
Stenotrophomonas maltophilia is an opportunistic emergent pathogen causing hospital-acquired infections and it is resistant to majority of the broad spectrum antibiotics. The aim of this study was to investigate the distribution and antimicrobial susceptibility patterns of S.maltophilia strains isolated in approximately five years. In this study; a total of 53 S.maltophilia strains, isolated from various clinical specimens between January 2014-September 2018 were investigated in terms of antibiotic resistance rates. The isolates were identified and antibiotic susceptibility tests performed by BD Phoenix 100 automated system (Becton Dickinson Diagnostic Systems, Sparks, USA). Out of 53 S.maltophilia strains, 21 % were isolated from outpatient clinics and 79 % from hospitalized patients. And 50 % of hospitalized patients were admitted to the Intensive Care Unit. Antibiotic susceptibilities to trimetoprim-sulfametoksazol (TMP-SXT), levofloxacin and ceftazidim were; 88.6 %, 85 % and 30 %, respectively. When considering the MIC value >2 ug/ml resistant for tigecycline; 83 % of the isolates were susceptible. In our study, it was concluded that third-generation cephalosporins cannot be used in the empirical treatment of S.maltophilia in our hospital due to the detection of the resistance to ceftazidime. Although TMP-SXT and levofloxacin resistance are not yet to be feared, increased resistance rates should be taken into consideration.
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