Abdurrahman KİREMİTÇİ, Argun Arzu TÜRKKAN, Yurdanur AKGÜN, Gül DURMAZ, NİLGÜN KAŞİFOĞLU

Klinik örneklerden anaerop bakterilerin soyutlanması ve antibiyotik duyarlılıklarının belirlenmesi

Ocak 2007-Mart 2008 tarihleri arasında soyutlanan anaerop bakteriler ve antibiyotik duyarlılıkları incelenmiştir. İzolatların tanımlanması geleneksel yöntemlerle yapılmış, toplam 243 klinik örnekten 54 anaerop izolat soyutlanmıştır. Klinik örneklerin çoğunu kan (% 39.5) ve apse örnekleri (% 28.8) oluşturmuş, örneklerin 33’ünde (% 13.6) anaerop üreme saptanmış, bunların 14’ünde (% 5.8) sadece anaerop, 19’unda (% 7.8) ise aerop ve anaeroplar birlikte üretilmiştir. Örneklerin 74’ünde (% 30.5) sadece aerop üreme gözlenmiştir. Anaerop kan kültürü yapılan 96 örneğin 5’inde (% 5) anaerop üreme saptanmıştır. Anaeroplardan en çok Bacteroides spp. (% 28), Porphyromonas spp. (% 19) ve Peptostreptococcus spp. (% 11) izole edilmiştir. Bacteroides spp. izolatların % 80’inde nitrosefin testiyle beta-laktamaz üretimi saptanmıştır. Tikarsilin-klavulanat, sefoksitin, imipenem, klindamisin, metronidazol, linezolid ve tigesiklinin minimal inhibitör konsantrasyonları E-test ile belirlenmiş, tikarsilin-klavulanat ve linezolid tüm anaerop izolatlara karşı etkin bulunmuştur. Klindamisin daha düşük etkinliğe sahip olup izolatların % 35’inde direnç saptanmıştır. Klindamisine direnç en fazla Bacteroides spp. izolatlar arasında saptanmıştır (% 53). Sefoksitine direnç düşük oranda bulunmuştur (% 7). İmipenem ve tigesiklin tüm aneroplara karşı etkin olup sadece bir B.fragilis izolatı imipeneme ve bir B.fragilis dışı Bacteroides izolatı ise tigesikline dirençli bulunmuştur. Metronidazol direnci tüm anaeropların % 18’inde ve birer B.fragilis ve Peptostreptococcus spp. izolatında saptanmıştır.

Anahtar Kelimeler:

Kültür ortamı, Anti-enfektif ajanlar, Bakteriler, anaerobik, Bacteroides fragilis, Mikrobiyal duyarlılık testleri, İlaç direnci, bakteriyel

Isolation and antimicrobial susceptibility of anaerobic bacteria isolated from clinical samples

The species and antimicrobial susceptibility of anaerobic bacteria isolated between January 2007 and March 2008 were analysed. Isolates were identified by conventional methods. A total of 54 anaerobic isolates were recovered from 243 clinical specimens. Most common clinical specimens were blood (39.5 %) and abscess (28.8 %). Anaerobes were recovered in 33 specimens (13.6 %). Only aerobes were isolated in 74 (30.5 %), and mixed aerobes and anaerobes were recovered in 19 (7.8 %) specimens. Of the 96 anaerobe blood cultures 5 (5 %) were positive for anaerobic bacteria. The most commonly identified anaerobe bacterium was Bacteroides spp. (28 %), followed by Porphyromonas spp. (19 %) and Peptostreptococcus spp. (11 %). Beta-lactamase production was detected in 80 % of the Bacteroides spp. isolates by nitrocefin test. Minimal inhibitory concentrations of ticarcillin-clavulanat, cefoxitin, imipenem, clindamycin, metronidazole, linezolid and tigecycline were determined by E-test. Ticarcillin-clavulanat and linezolid were active against all of the anaerobic isolates. Clindamycin was less active, to which 35 % of isolates were resistant. Resistance to clindamycin was most frequent among Bacteroides spp. isolates (53 %). The rate of resistance to cefoxitin was low (7 %). Imipenem and tigecycline showed good activity against all isolates, and only one B. fragilis was found resistant to imipenem and one non-fragilis Bacteroides strain to tigecycline. Metronidazole resistance was detected in one of Bacteroides spp, one of Peptostreptococcus spp., and in 18 % of all anaerobic isolates.

Keywords:

Culture Media, Anti-Infective Agents, Bacteria, Anaerobic, Bacteroides fragilis, Microbial Sensitivity Tests, Drug Resistance, Bacterial,

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