YARA KÜLTÜRLERİNDEN İZOLE EDİLEN BAKTERİLERİN ANTİMİKROBİYAL DUYARLILIKLARI: ÜÇ YILLIK DEĞERLENDİRME

Yara enfeksiyonları özellikle az gelişmiş ve gelişmekte olan ülkelerde önemli bir sağlık sorunudur. Bu çalışmada etkin tedavi seçimine yardımcı olmak için, yara enfeksiyonuna yol açan mikroorganizmaların ve bunların antimikrobiyal duyarlılık paternlerinin ortaya çıkarılması amaçlanmıştır. Çalışmamızda, 2014-2017 yılları arasında izlenen hastaların mikrobiyoloji laboratuvarına gönderilen yara sürüntü örneklerinden izole edilen mikroorganizmaların retrospektif olarak değerlendirilmesi yapılmıştır. Enfeksiyon etkeni olduğu düşünülen mikroorganizmaların tanımlaması MALDI-TOF MS (bioMérieux, Fransa), antimikrobiyal duyarlılığı ise VITEK-2 (bioMérieux, Fransa) otomatize sistemi ile çalışılmıştır. Toplam 4492 yara örneği değerlendirilmiştir. 2014 yılında % 42.3, 2015 yılında % 54.1, 2016 yılında ise % 65.1 olmak üzere, toplam materyalin % 55’inde etken izole edilmiştir. Yara kültürlerinde en fazla üreyen bakteri Escherichia coli olup bunu Staphylococcus aureus ve Pseudomonas spp. izlemektedir. Yoğun bakım ünitelerinden en sık Pseudomonas spp. (% 16.5) izole edilirken, çocuk servislerinden ve dahili bilimlerden en sık S.aureus (sırasıyla % 31.1 ve % 16.1), cerrahi bilimlerden ise en sık E.coli (% 21.4) izole edilmiştir. Kolistin ve karbapenemler E.coli’de en etkili antimikrobiyaller olarak saptanmıştır. S.aureus’ların % 18.4’ü metisiline dirençli bulunmuş olup, hiçbir suşta glikopeptid ve linezolid direnci görülmemiştir. Her klinikten yara enfeksiyonu etkeni olarak farklı mikroorganizmaların izole edilmiş olması düzenli sürveyans çalışmasının yapılması ve bu doğrultuda akılcı antimikrobiyal kullanımı için antimikrobiyal duyarlılıklarının belirlenmesi gerektiğini göstermiştir.

Antimicrobial Susceptibilities of Bacteria Isolated from Wound Cultures: A Three-Year Evaluation

Wound infections are important health problems especially in underdeveloped and developing countries. In this study, it was aimed to identify the microorganisms causing wound infection and their antimicrobial susceptibility patterns in order to assist in the selection of effective treatment. We retrospectively evaluated the microorganisms isolated from wound swab specimens sent to the microbiology laboratory of patients followed between 2014-2017. The identification of the microorganisms thought to cause infection was done with MALDITOF MS (bioMérieux, France) and the antimicrobial susceptibility with VITEK-2 (bioMérieux, France) automated system. A total of 4492 wound cultures were evaluated. Microorganisms were isolated from 55 % of the specimens; 42 % in 2014, 54.1 % in 2015 and 65.1 % in 2016. The most common bacteria in wound cultures were Escherichia coli, followed by Staphylococcus aureus and Pseudomonas spp. Pseudomonas spp. (16.5 %) was most frequently isolated from intensive care unit. S.aureus was the most frequently isolated bacteria from pediatric and internal medicine units (31.1 % and 16.1 % respectively), and E.coli was most frequently isolated from surgical sciences (21.4 %). Colistin and carbapenems were detected as the most effective antimicrobials against E.coli isolates. Of the S.aureus isolates, 18.4 % were methicillin resistant, and no glycopeptide or linezolid resistance was detected. Isolation of different microorganisms from each clinic has shown that regular surveillance studies and antimicrobial susceptibility testingare a necessity for rational antimicrobial use in this direction.

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