Yusuf YAKUPOĞULLARI, Aşçı Zülal TORAMAN, Ahmet KİZİRGİL

Genişlemiş spektrumlu beta-laktamaz üreten kan izolatı Klebsiella suşlarına karşı beta-laktamaz inhibitörlü antibiyotiklerin in-vitro etkinliği

Kan kültürlerinden soyutlanan genişlemiş spektrumlu beta-laktamaz üreten Klebsiella suşlarında piperasilin-tazobaktam, sefoperazon-sulbaktam, tikarsilin-klavulanat, amoksisilin-klavulanat ve ampisilin-sulbaktamın in-vitro etkinliği E-test ile araştırılmıştır. 56 Klebsiella pneumoniae suşunun 35’inde (% 62.5) ve 21 Klebsiella oxytoca suşunun dokuzunda (% 43) çift disk sinerji yöntemi ile genişlemiş spektrumlu beta-laktamaz saptanmıştır. Genişlemiş spektrumlu beta-laktamaz üreten bu suşların 21’i (% 48) piperasilin-tazobaktama, 20’si (% 45) sefoperazon-sulbaktama, beşi (% 11) tikarsilin-klavulanata, beşi (% 11) amoksisilin-klavulanata ve üçü (% 7) ampisilin-sulbaktama duyarlı bulunmuştur. Çalışılan antibiyotikler içinde, piperasilin-tazobaktam ve sefoperazon-sulbaktam duyarlılığı göreceli olarak daha yüksek olmakla birlikte, kan dolaşımı infeksiyonları gibi hayatı tehdit eden durumlarda, beta-laktamaz inhibitörlü antibiyotiklerin ancak çok az sayıdaki duyarlı suşlarda kullanılabileceği sonucuna ulaşılmıştır.

Anahtar Kelimeler:

Anti-bakteriyel ajanlar, beta-Laktamazlar, Kan, Kültür ortamı, Mikrobiyal duyarlılık testleri, Klebsiella

In vitro activity of antibiotics with beta-lactamase inhibitors against extended-spectrum beta-lactamase producing blood isolates of Klebsiella strains

In vitro activity of piperacillin-tazobactam, cefoperazone-sulbactam, ticarcillin-clavulanate, amoxicillin-clavulanate and ampicillin-sulbactam were investigated with E-test in blood isolates of extended-spectrum beta-lactamase producing Klebsiella strains. Of the total 56 Klebsiella pneumoniae and 21 Klebsiella oxytoca, extended-spectrum beta-lactamase was detected in 35 (62.5 %) K.pneumoniae and nine (43 %) K.oxytoca strains by double disk synergy test. Of the extendedspectrum beta-lactamase producing strains, 21 (48 %) were found as susceptible to piperacillin-tazobactam, 20 (45 %) to cefoperazone-sulbactam, five (11 %) to ticarcillin-clavulanate, five (11 %) to amoxicillin-clavulanate and three (7 %) to ampicillin-sulbactam. Although, there were relatively higher susceptibility to piperacillin-tazobactam and cefoperazonesulbactam than other combinations, the efficacy ratios were low even for these two combinations. This shows that betalactam and beta-lactamase inhibitor combinations can be used rarely in life threatening conditions, such as blood stream infections.

Keywords:

Anti-Bacterial Agents, beta-Lactamases, Blood, Culture Media, Microbial Sensitivity Tests, Klebsiella,

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