MEHMET PARLAK, AYTEKİN ÇIKMAN, HÜSEYİN GÜDÜCÜOĞLU, Mustafa BERKTAŞ, Abdullah BEKTAŞ

Yoğun bakım ünitesinden izole edilen Burkholderia cepacia suşlarının çeşitli antibiyotiklere direnci

Burkholderia cepacia, özellikle yoğun bakım ünitelerinde ölümcül infeksiyonlara neden olan önemli bir patojendir. Çalışmada, hastanemiz yoğun bakım ünitesinden izole edilen B.cepacia suşlarının çeşitli antibiyotiklere karşı direnç oranları- nın belirlenmesi amaçlanmıştır. Yoğun bakım ünitelerinden gönderilen çeşitli klinik örneklerden izole edilen 43 B.cepacia suşu konvansiyonel yöntem- lerle idantifiye edilmiş, tür düzeyinde tiplendirme ve antibiyotik duyarlılıkları için BD Phoenix otomatize mikrobiyoloji siste- minden (Becton Dickinson, ABD) yararlanılmıştır. Suşların izole edildiği örnek türüne göre dağılımı; 23 kan, 12 idrar, 4 trakeal aspirat, 4 diğer (yara, kateter) olarak tespit edilmiştir. Antibiyotiklere direnç oranları ise meropeneme % 5, levofloksa- sine % 7, trimetoprim-sulfametoksazole % 7, seftazidime % 9 ve kloramfenikole % 32 olarak bulunmuştur. Sonuç olarak, yoğun bakım ünitelerinde yüksek mortalite nedeni olan B.cepacia suşları için elde ettiğimiz direnç oran- ları, yapılan diğer çalışmalarla kıyaslandığında daha düşük bulunmuştur. Ancak CLSInin önerdiği antibiyotik sayısının kısıtlı olması nedeniyle B.cepacia infeksiyonları dikkatle değerlendirilmelidir.

Anahtar Kelimeler:

Yoğun bakım üniteleri, Anti-bakteriyel ajanlar, İlaç direnci, mikrobiyal, Mikrobiyal duyarlılık testleri, Burkholderia cepacia

Resistance of Burkholderia cepacia strains ısolated from intensive care unit to various antibiotics

Burkholderia cepacia is an important pathogen that particularly causes fatal infections in intensive care units. In this study, we aimed to determine the resistance rates to various antibiotics of B.cepacia strains isolated in intensive care unit of our hospital. Forty-three B.cepacia strains isolated from various clinical specimens sent from intensive care unit were included in the study. After microorganisms had been identified as non-fermentative by conventional methods, BD Phoenix automated mic- robiology system (Becton Dickinson, USA) was utilized for species level identification and for antibiotic susceptibility tests. The distribution of isolated 43 B.cepacia strains according to the sample types was determined as 23 from blood, 12 from urine, 4 from tracheal aspirate, 4 from other specimens (wound, catheter). Resistance rates for antibiotics were as follows: 5 % for meropenem, 7 % for levofloxacin, 7 % for trimetoprime-sulfamethoxazole, 9 % for ceftazidime and 32 % for chlorampheni- col. As a result, obtained resistance rates for B.cepacia which is associated with high mortality in intensive care units, were found lower compared to the other studies. However, because of the limited number of antibiotics recommended by CLSI, B.cepacia infections should be carefully evaluated.

Keywords:

Intensive Care Units, Anti-Bacterial Agents, Drug Resistance, Microbial, Microbial Sensitivity Tests, Burkholderia cepacia,

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