YOĞUN BAKIM ÜNİTESİNDE SEDASYON İÇIN KULLANILAN AJANLARIN ANTİBAKTERİYEL AKTİVİTELERİNİN İN VİTRO YÖNTEMLE DEĞERLENDİRİLMESİ

Amaç: Yoğun bakımda sedasyon, anksiyetenin ve ajitasyonun tedavisinde kullanılmaktadır. Bu ça- lışmada, yoğun bakımda sedasyon amaçlı, infüzyon şeklinde yaygın olarak kullanılan propofol, ke- tamin, tiyopental, deksmedotomidin ve midazolam’ın pratikte kullanılan dozlarının antimikrobiyal aktivitesinin in vitro olarak araştırılması hedeflenmiştir. Gereç ve Yöntem: İntravenöz anestezik ajanların in vitro antimikrobiyal aktiviteleri mikro dilüsyon tekniği ile araştırıldı. Testte kullanılan mikroorganizmalar aşağıdaki gibidir: Escherichia coli (ATCC 25922), Yersinia psödotüberküloz (ATCC 911), Pseudomonas aeruginosa (ATCC 10145), Listeria monocytogenes (ATCC 43251), Enterococcus faecalis (ATCC 29212), Staphylococcus aureus (ATCC 25923), Bacillus cereus 702 Roma, Mycobacterium smegmatis (ATCC 607), Candida albicans (ATCC 60193) ve Saccharomyces cerevisiae RSKK 251. Antibakteriyel deneyler, pH 7.3'te Mueller-Hinton sıvısında gerçekleştirildi ve pH 7.0'da tamponlu Maya Nitrojen Tabanı'nda antifungal analizler ya- pıldı. Bulgular: Sadece ketamin içeren preparat antimikrobiyal aktivite gösterirken diğer ajanlar anti- mikrobiyal etki göstermedi. Sonuç: Yapılan çalışma sonucunda ketamin in vitro ortamda yoğun bakım ünitesinde sık görüle- bilen mikroorganizmalar üzerinde antimikrobiyal etkinlik göstermiştir. Bununla birlikte, klinik kul- lanımda ketaminin antimikrobiyal etkinliğini, antibiyotik tedavisine potansiyel katkısını ve yoğun bakım ünitesi enfeksiyonlarının ortadan kaldırılmasına veya sepsisli hastalara ne kadar fayda sağ- layacağını değerlendirmek için in vivo çalışmalara ihtiyaç vardır.

Evaluation of the Antibacterial Activities of the Agents Used for Sedation in Intensive Care Unit In Vitro Method

Objective: Sedation in the intensive care unit is used for the treatment of anxiety and agitation.This study aims to investigate the in vitro antimicrobial activity of propofol, ketamine, thiopental,dexmedetomidine and midazolam doses used in practice for sedation purposes in the intensivecare unit.Material and Methods: In vitro antimicrobial activities of intravenous sedative agents wereinvestigated by using the microdilution technique. Microorganisms used in the test were asfollows: Escherichia coli (ATCC 25922), Yersinia pseudotuberculosis (ATCC 911), Pseudomonasaeruginosa (ATCC 27853), Enterococcus faecalis (ATCC 29212), Staphylococcus aureus (ATCC25923), Bacillus cereus 709 ROMA, Mycobacterium smegmatis (ATCC 607), Candida albicans (ATCC60193), Candida tropicalis (ATCC 13803) and Saccharomyces cerevisiae RSKK 251. Antibacterialexperiments were performed in Mueller-Hinton Broth with a pH of 7.3, and antifungal analyseswere carried out in buffered Yeast Nitrogen Base with a pH of 7.0.Results: Only the preparation with ketamine showed antimicrobial activity, whereas noantimicrobial activity was detected in the preparations with the other agents.Conclusion: Ketamine has antimicrobial activity in vitro on microorganisms frequently seenin the intensive care unit practice. However, there is a need for in vivo studies to evaluate theantimicrobial efficacy of ketamine in clinical use, its potential contribution to antibiotic therapy,and how well it can eliminate intensive care unit infections or benefit the patients with sepsis.

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