TÜRKİYE’DE BİR DEVLET HASTANESİNDE 2010-2016 YILLARI ARASINDA PSEUDOMONAS AERUGINOSA ANTİMİKROBİYAL DUYARLILIK SONUÇLARI

Pseudomonas aeruginosa, nozokomiyal pnömoni, dolaşım sistemi infeksiyonları, üriner infeksiyon ve deri infeksiyonları gibi sağlık hizmetleri gerektiren infeksiyon etkenlerinin önemli bir bölümünü oluşturur. Bu çalışma, yıllara göre P.aeruginosa'nın antimikrobiyal duyarlılığının değişimini belirleyerek antimikrobiyal kullanım politikasının oluşturulmasına yardımcı olmayı amaçlamıştır.Hastanemizde 2010-2016 yılları arasında izole edilen P.aeruginosa suşlarının antimikrobiyal duyarlılıkları, örnek türleri ve hastaların demografik verileri retrospektif olarak incelenmiştir. Verileri aktarmak ve analiz etmek için Windows istatistik paket programı PASW Statistics 18 kullanılmıştır. Değişkenler arasındaki ilişkiler ki-kare testi ile analiz edilmiştir.Yatarak tedavi olan, 0-92 yaş aralığında bulunan 350 (% 35.9) kadın ve 625 (% 64.1) erkek hastadan 975 P.aeruginosa suşu izole edilmiştir. Örneklerin çoğunluğunun (529, % 54.3) yoğun bakım ünitesinde yatan hastalara ait olduğu tespit edilmiştir. P.aeruginosa, en sık solunum sistem örneklerinde izole edilmiştir. Ayakta tedavi gören, yaşları 0-95 arasında değişen 127 (% 33.1) kadın ve 257 (% 66.9) erkek hastada üreme saptanmıştır. Kliniklere göre dağılımına bakıldığında en sık pediatri polikliniğinden gelen örneklerde izole edilmiştir. Ayaktan tedavi gören hastaların en sık idrar örneğinde izole edilmiştir. En etkili antibiyotiklerin ayaktan hastalarda amikasin, piperazin-tazobaktam, imipenem ve meropenem, yatarak tedavi gören hastalarda aminoglikozid ve karbapenem olduğu tespit edilmiştir. Yıllara göre yatan hastalarda seftazidim, piperasilin-tazobaktam, gentamisin ve amikasin duyarlılığında artış, ayaktan hastalarda piperasilin-tazobaktam ve siprofloksasin duyarlılığında ise azalma görülmüştür.Klinik sonuçların optimizasyonu için etkili antimikrobiyal tedavinin hızlı başlatılmasının gerekli olduğu göz önüne alındığında, her hastane duyarlılık oranlarını izlemelidir. Böylece ampirik antimikrobik seçimi ve uygun tedavinin belirlenmesi için bir kılavuz oluşturulmalıdır

Pseudomonas aeruginosa Antimicrobial Susceptibility Results at a State Hospital in Turkey (2010-2016)

Pseudomonas aeruginosa constitutes an important part of infections requiring health care services such as nosocomial pneumonia, circulatory infections, urinary infection and skin infections. The present study aimed to help in creating an antimicrobial usage policy by identifying the change of antimicrobial susceptibility of P.aeruginosa according to years. The antimicrobial susceptibility of P.aeruginosa strains isolated between 2010-2016 in our hospital, specimen types and demographic data of the patients were examined retrospectively. PASW Statistics 18 for Windows statistical pack age program was used to transfer and analyze the data. The relation ships among variables were analyzed with the chi-square test. Nine hundred seventy-five P.aeruginosa strains were isolated from 350 (35.9 %) female and 625 (64.1 %) male patients who were in the age range of 0 to 92 years and who were treated as in patients in our hospital between 2010-2016. The majority of the specimens (529, 54.3 %) belonged to the patients from the intensive care unit. P.aeruginosa was most frequently isolated in respiratory tract specimens of in patients. Of the out patients, 127 (33.1 %) were female and 257 (66.9 %) were male and they were aged between 0-95 years. Considering the distribution of the patients according to the outpatient clinics, P.aeruginosa was most frequently isolated in pediatrics. In respect to the out patients P.aeruginosa was most frequently isolated in urine. The most effective antimicrobials were determined to be aminoglycosides and carbapenems for the in patients while they were found to be amikacin, piperacillin-tazobactam, imipenem and meropenem for the out patients. In patients were showed increased sensitivity of ceftazidime, piperacillin-tazobactam, gentamicin and amikacin, for years and outpatients were decreased sensitivity of piperacillin-tazobactam and ciprofloxacin. Considering that the rapid initiation of effective antimicrobial treatment is necessary for the optimization of clinical outcome, each hospital should monitor their susceptibility rates. Thus, a guidelines hould be created for the selection of empirical antimicrobial therapy and determination of appropriate treatment.

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